Infiltration Effect on SUV
| Status: | Terminated |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/5/2019 |
| Start Date: | August 27, 2018 |
| End Date: | February 13, 2019 |
A Study to Assess the Impact of Moderate/Significant Infiltrations on the Standardized Uptake Values of Target Lesions
A widely used semi-quantitative parameter to assess tumor status is the standardized uptake
value (SUV). SUV estimation accuracy can be impacted by many variables. Today there still
exists a significant amount of variability in PET/CT results in test and re-test studies.
This variability can be introduced by instrumentation and subject-specific factors.
Variability reduces image quality and increases the required changes in tumor quantification
to reflect real tumor response or progression.
PET/CT scanning process requires that the entire net injected dose of radiolabeled tracer is
administered intravenously as a bolus. The quality and quantification of a PET/CT image is
highly dependent on the uptake of radiolabeled tracer. Boellaard et al. have indicated
infiltrations could potentially underestimate SUV measurements by as much as 50%.
Infiltrations and obstructions are not uncommon.
Recent studies using a novel QA/QC tool (LaraTM System) for the radiotracer injection process
revealed that current means to detect infiltration do not completely identify all
infiltrations/obstructions. Since infiltrations may not be visible in the standard field of
view (FOV) and since the impact of a peripheral circulatory obstruction may not be visible
even if an injection site is in the FOV, it is possible for reading and treating physicians
to be unaware that a patient's image and quantification has been impacted. Additionally, when
current means do detect an infiltration, they under-represent the severity because they are
not capturing that infiltrations often resolve during the uptake period. As a result,
infiltrations or obstructions may cause SUV inaccuracy and could adversely impact staging and
tumor assessments.
The purpose of this study will be to characterize the impact of moderate or greater
infiltrations on standardized uptake values. Patients experiencing a moderate or greater
infiltration on a routine clinical PET scan will be invited to return for a repeat scan with
injection performed by specially trained personnel to reduce the risk of repeat infiltration.
The two scans will be compared to assess for changes in tumor uptake intensity.
value (SUV). SUV estimation accuracy can be impacted by many variables. Today there still
exists a significant amount of variability in PET/CT results in test and re-test studies.
This variability can be introduced by instrumentation and subject-specific factors.
Variability reduces image quality and increases the required changes in tumor quantification
to reflect real tumor response or progression.
PET/CT scanning process requires that the entire net injected dose of radiolabeled tracer is
administered intravenously as a bolus. The quality and quantification of a PET/CT image is
highly dependent on the uptake of radiolabeled tracer. Boellaard et al. have indicated
infiltrations could potentially underestimate SUV measurements by as much as 50%.
Infiltrations and obstructions are not uncommon.
Recent studies using a novel QA/QC tool (LaraTM System) for the radiotracer injection process
revealed that current means to detect infiltration do not completely identify all
infiltrations/obstructions. Since infiltrations may not be visible in the standard field of
view (FOV) and since the impact of a peripheral circulatory obstruction may not be visible
even if an injection site is in the FOV, it is possible for reading and treating physicians
to be unaware that a patient's image and quantification has been impacted. Additionally, when
current means do detect an infiltration, they under-represent the severity because they are
not capturing that infiltrations often resolve during the uptake period. As a result,
infiltrations or obstructions may cause SUV inaccuracy and could adversely impact staging and
tumor assessments.
The purpose of this study will be to characterize the impact of moderate or greater
infiltrations on standardized uptake values. Patients experiencing a moderate or greater
infiltration on a routine clinical PET scan will be invited to return for a repeat scan with
injection performed by specially trained personnel to reduce the risk of repeat infiltration.
The two scans will be compared to assess for changes in tumor uptake intensity.
Inclusion Criteria:
- Subjects with solid tumors undergoing PET/CT scan who have at least one measurable
target lesion and sustain a moderate or greater infiltration.
Exclusion Criteria:
- Subjects unwilling or unable to tolerate a repeat PET/CT scan.
- Subjects with meaningful medical intervention between PET/CT scans that would likely
impact SUV.
- Subjects with follow up injection infiltrations that would likely impact the SUV.
- Pregnant patients.
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