The standard uptake value (SUV)
SUV = C(T) / [injection dose (MBq)/ patient's weight (kg)]
It is used to measure response of cancers to treatment and is considered a semi-quantitative value as it is vulnerable to other sources of variabilities. The most reliable method of measuring activity levels would be to use fractional uptake rate (FUR) which is measured from blood samples. As the FUR and SUV are proportional, related to plasma clearance rate and a dimentionless initial distribution volume, hence careful usage of SUV is widely used over blood sampling.
SUV may be influenced by image noise, low image resolution and variable user-biased region of interest (ROI) selection. The cut off between benign and malignant lesion / nodule is in the SUV range of 2.0 - 2.5. PET sensitivity and specificity decreases with lesions smaller than 7mm. Thus, continued follow-up is recommended.
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- 2. Hamberg LM, Hunter GJ, Alpert NM, Choi NC, Babich JW, Fischman AJ. The dose uptake ratio as an index of glucose metabolism: useful parameter or oversimplification. J Nucl Med. 1994; 35: 1308-1312.
- 3. Huang S-C. Anatomy of SUV. Nucl Med Biol 2000; 27: 643-646.
- 4. Boellaard R, Krak NC, Hoekstra OS et-al. Effects of noise, image resolution, and ROI definition on the accuracy of standard uptake values: a simulation study. J. Nucl. Med. 2004;45 (9): 1519-27. J. Nucl. Med. (link) - Pubmed citation
- 5. Thie JA. Clarification of a fractional uptake concept. J Nucl Med 1995; 36:711-712.
- 6. Thie JA. Understanding the standardized uptake value, its methods, and implications for usage. J Nucl Med 2004; 45: 1431-1434.
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