Is there any maximum standardized uptake value variation among positron emission tomography scanners for mediastinal staging in non-small cell lung cancer?

Abstract

The maximum standardized uptake value (SUVmax) varies among positron emission tomography-integrated computed tomography (PET/CT) centers in the staging of non-small cell lung cancer. We evaluated the ratio of the optimum SUVmax cut-off for the lymph nodes to the max median SUVmax of the primary tumor (ratioSUVmax) to determine SUVmax variations between PET/CT scanners. The previously described PET Predictive ratio (PPR) was also evaluated. PET/CT and mediastinoscopy andyor thoracotomy were performed on 337 consecutive patients between September 2005 and March 2009. Thirty-six patients were excluded from the study. The pathological results were correlated with the PETyCT findings. Histopathological examination was performed on 1136 N2 lymph nodes using 10 different PET/CT centers. The majority of patients (group A: 240) used the same PET/CT scanner at four different centers. Others patients were categorized as group B. The ratio SUVmax for groups A and B was 0.18 and 0.22, respectively. The same ratio for centers 1, 2, 3 and 4 was 0.2, 0.21, 0.21, and 0.23, max respectively. The optimal cut-off value of the PPR to predict mediastinal lymph node pathology for malignancy was 0.49 (likelihood ratio q2.02; sensitivity 70%, specificity 65%). We conclude that the ratioSUVmax was similar for different scanners. Thus, SUVmax is a valuable cut-off for comparing-centers. © 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.