SUV variability in EARL-accredited conventional and digital PET

Daniëlle Koopman*, Pieter L. Jager, Cornelis H. Slump, Siert Knollema, Jorn A. van Dalen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
26 Downloads (Pure)


Background: A high SUV-reproducibility is crucial when different PET scanners are in use. We evaluated the SUV variability in whole-body FDG-PET scans of patients with suspected or proven cancer using an EARL-accredited conventional and digital PET scanner. In a head-to-head comparison we studied images of 50 patients acquired on a conventional scanner (cPET, Ingenuity TF PET/CT, Philips) and compared them with images acquired on a digital scanner (dPET, Vereos PET/CT, Philips). The PET scanning order was randomised and EARL-compatible reconstructions were applied. We measured SUVmean, SUVpeak, SUVmax and lesion diameter in up to 5 FDG-positive lesions per patient. The relative difference ΔSUV between cPET and dPET was calculated for each SUV-parameter. Furthermore, we calculated repeatability coefficients, reflecting the 95% confidence interval of ΔSUV.

Results: We included 128 lesions with an average size of 19 ± 14 mm. Average ΔSUVs were 6-8% with dPET values being higher for all three SUV-parameters (p < 0.001). ΔSUVmax was significantly higher than ΔSUVmean (8% vs. 6%, p = 0.002) and than ΔSUVpeak (8% vs. 7%, p = 0.03). Repeatability coefficients across individual lesions were 27% (ΔSUVmean and ΔSUVpeak) and 33% (ΔSUVmax) (p < 0.001).

Conclusions: With EARL-accredited conventional and digital PET, we found a limited SUV variability with average differences up to 8%. Furthermore, only a limited number of lesions showed a SUV difference of more than 30%. These findings indicate that EARL standardisation works.

Trial registration: This prospective study was registered on the 31th of October 2017 at ClinicalTrials.cov. URL:

Original languageEnglish
Article number106
JournalEJNMMI Research
Issue number1
Publication statusPublished - 1 Jan 2019


  • Cancer
  • Conventional PET
  • Digital PET
  • EARL-accreditation

Fingerprint Dive into the research topics of 'SUV variability in EARL-accredited conventional and digital PET'. Together they form a unique fingerprint.

Cite this