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@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},
}