% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Ursprung:302839, author = {S. Ursprung and L. Zender and P. Ghibes and F. Hagen and K. Nikolaou$^*$ and C. la Fougère$^*$ and M. Weissinger}, title = {{V}ariability of {M}etabolic {R}ate and {D}istribution {V}olume {Q}uantification in {W}hole-{B}ody {P}arametric {PATLAK} [18{F}]-{FDG} {PET}/{CT}-{A} {P}rospective {T}rial in {P}atients with {L}ung {C}ancer.}, journal = {Diagnostics}, volume = {15}, number = {13}, issn = {2075-4418}, address = {Basel}, publisher = {MDPI}, reportid = {DKFZ-2025-01379}, pages = {1719}, year = {2025}, abstract = {Background: The recent introduction of whole-body positron emission tomography/ computed tomography (PET/CT) scanners and multi-bed, multi-time point acquisition technique enable calculating fluorodeoxyglucose (FDG) kinetics in the whole body. However, validating parametric, Patlak-derived data is difficult on phantoms. Methods: This prospective study investigated the effect of quantification methods mean, max, and peak on the metabolic rate (MR-FDG) and distribution volume (DV-FDG) quantification, as well as the diagnostic accuracy of parametric Patlak FDG-PET scans in diagnosing lung lesions and lymph node metastases, using histopathology and follow-up as reference standards. Dynamic whole-body FDG PET was acquired for 80 minutes in 34 patients with indeterminate lung lesions and kinetic parameters extracted from lung lesions and representative mediastinal and hilar lymph nodes. Results: All quantification methods-mean, max, and peak-demonstrated high diagnostic accuracy (AUC: MR-FDG: 0.987-0.991 and 0.893-0.905; DV-FDG: 0.948-0.975 and 0.812-0.825) for differentiating benign from malignant lymph nodes and lung lesions. Differences in the magnitude of MR-FDG (-4.76-14.09) and DV-FDG $(-10.64-46.10\%)$ were substantial across methods. Variability was more pronounced in lymph nodes (MR-FDG: 1.37-3.48) than in lung lesions (MR-FDG: 3.31-5.04). The variability was lowest between mean and max quantification, with percentage differences of 40.87 ± $5.69\%$ for MR-FDG and 39.26 ± $7.68\%$ for DV-FDG. Conclusions: The choice of method to measure MR-FDG and DV-FDG greatly influences the results, especially in smaller lesions with large and systematic differences. For lung lesions, a conversion factor between mean and max methods of $40\%$ provides acceptable agreement, facilitating retrospective comparisons of measurements, e.g., in meta-analyses.}, keywords = {FDG (Other) / PET/CT (Other) / Patlak (Other) / dynamic PET (Other) / parametric FDG (Other) / whole-body (Other)}, cin = {TU01}, ddc = {610}, cid = {I:(DE-He78)TU01-20160331}, pnm = {899 - ohne Topic (POF4-899)}, pid = {G:(DE-HGF)POF4-899}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:40647718}, pmc = {pmc:PMC12249058}, doi = {10.3390/diagnostics15131719}, url = {https://inrepo02.dkfz.de/record/302839}, }