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[[File:3D-PET-SUV.jpg|thumb|3-dimensional [<sup>18</sup>F]FDG-PET image with 3D-ROI generated in one mouse click by a threshold based algorithm. The blue dot in the [[Maximum intensity projection|MIP]] image bottom right marks the maximum SUV within the ROI.]]


The '''standardized uptake value''' ('''SUV''') is often used in [[positron emission tomography]] (PET) imaging for a simple semiquantitative analysis.<ref>{{cite journal | doi=10.1097/01.mnm.0000134329.30912.49 | author=G. Lucignani, G. Paganelli, E. Bombardieri | title=The use of standardized uptake values for assessing FDG uptake with PET in oncology: A clinical perspective| journal=Nuclear Medicine Communications| year=2004| volume=25| pages=651–656 | pmid=15208491}}</ref> Its use is particularly common in the analysis of [[fluorodeoxyglucose|[<sup>18</sup>F]fluorodeoxyglucose]] ([<sup>18</sup>F]FDG) images of cancer patients. It can also be used with other [[Radioactive tracer|PET agents]] especially when no arterial input function is available for more detailed [[Pharmacokinetics|pharmacokinetic]] modeling. If the arterial input function is available from blood sampling or advanced image analysis techniques, other measures like the fractional uptake rate (FUR), may be preferable, or more advanced pharmacokinetic modeling may be undertaken.


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The SUV is calculated either pixel-wise yielding a parametric image, or over a [[region of interest]] (ROI). This may be done for any image acquired at time point ''t'', or for all images of a dynamic series acquired at multiple time points. The SUV is commonly defined as the ratio of (1) the tissue radioactivity concentration ''c'' (e.g. in MBq/kg ''= ''kBq/g)'' ''at time point ''t'', and (2) the ''injected activity'' (e.g. in MBq, extrapolated to the same time ''t'')'' ''divided by the ''body weight'' (e.g. in kg):
 
<math>SUV(t) = \frac {c(t)}{injected\ activity(t) \quad / \quad body\ weight}</math>
 
In other words, the SUV represents the ratio of (1) the image derived radioactivity concentration found in a selected part of the body at a certain time point, and (2) as reference the radioactivity concentration in the hypothetical case of an even distribution of the injected radioactivity across the whole body. Here, the two radioactivity measures need to be from the same time point, e.g. the time of injection or the time of the image (or "image frame"). For example in the latter case, the ''injected activity'' is to be corrected for the [[radioactive decay|physical decay]] between time of injection (''t''=0) and the time of the image frame (''t''). A (small) systematic error might be introduced since the image frame is acquired typically within minutes whereas the injected activity (more precisely, each of the two activity measurements of the syringe, before and after injection) is measured in a relatively short time interval, practically at a time point. Depending on the image frame duration compared to the radioisotope half life, e.g. the image frame midpoint may be considered a good approximation as time point of reference.
 
Moreover, the difference between (a) ''c''(''t'') measured ''per volume'' of soft tissue via PET images and (b) the even distribution reference concentration ''per weight'' of the whole body is ignored here, assuming a [[mass density]] of 1&nbsp;kg/L.
 
Instead of the ''body weight'' used in the equation above, some authors prefer the [[lean body mass|lean body weight]]<ref>{{cite journal | author=K. R. Zasadny and R. L. Wahl | title=Standardized uptake values of normal tissues at PET with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose: variations with body weight and a method for correction | journal=Radiology | year=1993 | volume=189 | pages=847–850}}</ref> or the [[body surface area]].<ref>{{cite journal | author=C. K. Kim, N. C. Gupta, B. Chandramouli, and A. Alavi | title=Standardized uptake values of FDG: body surface area correction is preferable to body weight correction | journal=Journal of Nuclear Medicine | year=1994 | volume=35 | pages=164–167}}</ref>
 
Also for ''c''(''t'') from a region of interest, different measures are found in the literature, e.g. the maximum intensity value within the ROI, the mean intensity value of the ROI,<ref>{{cite web | author=Vesa Oikonen | title=Standardized uptake rate (SUV) | url = http://www.turkupetcentre.net/modelling/methods/suv.html | accessdate = 2009-07-22}}</ref> or the mean intensity value of the ROI after applying an intensity threshold (thus excluding a number of pixels of the ROI).
 
The SUV can be significantly affected among other things by image noise, low image resolution and/or user biased ROI selection.<ref>{{cite journal | author=R. Boellaard, N. C. Krak, O. S. Hoekstra, A. A. Lammertsma | title=Effects of noise, image resolution, and ROI definition on the accuracy of standard uptake values: a simulation study | journal=Journal of Nuclear Medicine | year=2004 | volume=45 | pages=1519–1527 | pmid=15347719 | issue=9}}</ref> For the semi-quantitative analysis of <sup>18</sup>F]FDG uptake in tissue or tumor, several corrections have been recommended (see <ref>{{cite journal | author=S.-C. Huang | title=Anatomy of SUV | journal=Nuclear Medicine and Biology | year=2000 | volume=27 | pages=643–646}}</ref> and references therein).
 
The ratio of the SUV from two different regions within the same PET image (i.e. from a target and a reference region) is commonly abbreviated as SUVR. For the SUVR, the injected activity and body weight that are part of the SUV, cancel.
 
The SUV concept has been only begun to be tested in connection with other radiotracers like [<sup>18</sup>F]fluorothymidine ([<sup>18</sup>F]FLT) and conclusions on its usefulness and robustness in these cases might be premature.<ref>{{cite journal | author=R. J. Hicks | title=The SUV and FLT PET: A tasty alphabet soup or a dog’s breakfast? | journal=Leukemia and Lymphoma | year=2007 | volume=48 | pages=649–652 | pmid=17454619 | doi=10.1080/10428190701262059 | issue=4}}</ref>
 
In summary, SUVs are a convenient measure for the evaluation of [<sup>18</sup>F]FDG PET images within a subject to study therapy monitoring/therapy response, and also for comparison between subjects. However, care has to be taken with respect to its pitfalls and with respect to the interpretation of the results.
 
== See also ==
* [[Functional imaging]]
* [[Medical imaging]]
* [[Positron emission tomography]]
* [[Fluorodeoxyglucose]]
* [[Multi-compartment model]]
* [[Patlak plot]]
* [[Pharmacokinetics]]
* [[Physiologically-based pharmacokinetic modelling]]
 
==References==
{{Reflist}}
 
[[Category:Medical imaging]]

Revision as of 12:43, 10 November 2013

3-dimensional [18F]FDG-PET image with 3D-ROI generated in one mouse click by a threshold based algorithm. The blue dot in the MIP image bottom right marks the maximum SUV within the ROI.

The standardized uptake value (SUV) is often used in positron emission tomography (PET) imaging for a simple semiquantitative analysis.[1] Its use is particularly common in the analysis of [18F]fluorodeoxyglucose ([18F]FDG) images of cancer patients. It can also be used with other PET agents especially when no arterial input function is available for more detailed pharmacokinetic modeling. If the arterial input function is available from blood sampling or advanced image analysis techniques, other measures like the fractional uptake rate (FUR), may be preferable, or more advanced pharmacokinetic modeling may be undertaken.

The SUV is calculated either pixel-wise yielding a parametric image, or over a region of interest (ROI). This may be done for any image acquired at time point t, or for all images of a dynamic series acquired at multiple time points. The SUV is commonly defined as the ratio of (1) the tissue radioactivity concentration c (e.g. in MBq/kg = kBq/g) at time point t, and (2) the injected activity (e.g. in MBq, extrapolated to the same time t) divided by the body weight (e.g. in kg):

In other words, the SUV represents the ratio of (1) the image derived radioactivity concentration found in a selected part of the body at a certain time point, and (2) as reference the radioactivity concentration in the hypothetical case of an even distribution of the injected radioactivity across the whole body. Here, the two radioactivity measures need to be from the same time point, e.g. the time of injection or the time of the image (or "image frame"). For example in the latter case, the injected activity is to be corrected for the physical decay between time of injection (t=0) and the time of the image frame (t). A (small) systematic error might be introduced since the image frame is acquired typically within minutes whereas the injected activity (more precisely, each of the two activity measurements of the syringe, before and after injection) is measured in a relatively short time interval, practically at a time point. Depending on the image frame duration compared to the radioisotope half life, e.g. the image frame midpoint may be considered a good approximation as time point of reference.

Moreover, the difference between (a) c(t) measured per volume of soft tissue via PET images and (b) the even distribution reference concentration per weight of the whole body is ignored here, assuming a mass density of 1 kg/L.

Instead of the body weight used in the equation above, some authors prefer the lean body weight[2] or the body surface area.[3]

Also for c(t) from a region of interest, different measures are found in the literature, e.g. the maximum intensity value within the ROI, the mean intensity value of the ROI,[4] or the mean intensity value of the ROI after applying an intensity threshold (thus excluding a number of pixels of the ROI).

The SUV can be significantly affected among other things by image noise, low image resolution and/or user biased ROI selection.[5] For the semi-quantitative analysis of 18F]FDG uptake in tissue or tumor, several corrections have been recommended (see [6] and references therein).

The ratio of the SUV from two different regions within the same PET image (i.e. from a target and a reference region) is commonly abbreviated as SUVR. For the SUVR, the injected activity and body weight that are part of the SUV, cancel.

The SUV concept has been only begun to be tested in connection with other radiotracers like [18F]fluorothymidine ([18F]FLT) and conclusions on its usefulness and robustness in these cases might be premature.[7]

In summary, SUVs are a convenient measure for the evaluation of [18F]FDG PET images within a subject to study therapy monitoring/therapy response, and also for comparison between subjects. However, care has to be taken with respect to its pitfalls and with respect to the interpretation of the results.

See also

References

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    The data offered is for normal info purposes only and isn't supposed to be personalised investment or monetary advice. Motley Fool Singapore contributor Stanley Lim would not personal shares in any corporations talked about. Singapore private home costs increased by 1.eight% within the fourth quarter of 2012, up from 0.6% within the earlier quarter. Resale prices of government-built HDB residences which are usually bought by Singaporeans, elevated by 2.5%, quarter on quarter, the quickest acquire in five quarters. And industrial property, prices are actually double the levels of three years ago. No withholding tax in the event you sell your property. All your local information regarding vital HDB policies, condominium launches, land growth, commercial property and more

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    Discover out more about real estate funding in the area, together with info on international funding incentives and property possession. Many Singaporeans have been investing in property across the causeway in recent years, attracted by comparatively low prices. However, those who need to exit their investments quickly are likely to face significant challenges when trying to sell their property – and could finally be stuck with a property they can't sell. Career improvement programmes, in-house valuation, auctions and administrative help, venture advertising and marketing, skilled talks and traisning are continuously planned for the sales associates to help them obtain better outcomes for his or her shoppers while at Knight Frank Singapore. No change Present Rules

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    A vendor's stamp duty has been launched on industrial property for the primary time, at rates ranging from 5 per cent to 15 per cent. The Authorities might be trying to reassure the market that they aren't in opposition to foreigners and PRs investing in Singapore's property market. They imposed these measures because of extenuating components available in the market." The sale of new dual-key EC models will even be restricted to multi-generational households only. The models have two separate entrances, permitting grandparents, for example, to dwell separately. The vendor's stamp obligation takes effect right this moment and applies to industrial property and plots which might be offered inside three years of the date of buy. JLL named Best Performing Property Brand for second year running

    The data offered is for normal info purposes only and isn't supposed to be personalised investment or monetary advice. Motley Fool Singapore contributor Stanley Lim would not personal shares in any corporations talked about. Singapore private home costs increased by 1.eight% within the fourth quarter of 2012, up from 0.6% within the earlier quarter. Resale prices of government-built HDB residences which are usually bought by Singaporeans, elevated by 2.5%, quarter on quarter, the quickest acquire in five quarters. And industrial property, prices are actually double the levels of three years ago. No withholding tax in the event you sell your property. All your local information regarding vital HDB policies, condominium launches, land growth, commercial property and more

    There are various methods to go about discovering the precise property. Some local newspapers (together with the Straits Instances ) have categorised property sections and many local property brokers have websites. Now there are some specifics to consider when buying a 'new launch' rental. Intended use of the unit Every sale begins with 10 p.c low cost for finish of season sale; changes to 20 % discount storewide; follows by additional reduction of fiftyand ends with last discount of 70 % or extra. Typically there is even a warehouse sale or transferring out sale with huge mark-down of costs for stock clearance. Deborah Regulation from Expat Realtor shares her property market update, plus prime rental residences and houses at the moment available to lease Esparina EC @ Sengkang
  6. One of the biggest reasons investing in a Singapore new launch is an effective things is as a result of it is doable to be lent massive quantities of money at very low interest rates that you should utilize to purchase it. Then, if property values continue to go up, then you'll get a really high return on funding (ROI). Simply make sure you purchase one of the higher properties, reminiscent of the ones at Fernvale the Riverbank or any Singapore landed property Get Earnings by means of Renting

    In its statement, the singapore property listing - website link, government claimed that the majority citizens buying their first residence won't be hurt by the new measures. Some concessions can even be prolonged to chose teams of consumers, similar to married couples with a minimum of one Singaporean partner who are purchasing their second property so long as they intend to promote their first residential property. Lower the LTV limit on housing loans granted by monetary establishments regulated by MAS from 70% to 60% for property purchasers who are individuals with a number of outstanding housing loans on the time of the brand new housing purchase. Singapore Property Measures - 30 August 2010 The most popular seek for the number of bedrooms in Singapore is 4, followed by 2 and three. Lush Acres EC @ Sengkang

    Discover out more about real estate funding in the area, together with info on international funding incentives and property possession. Many Singaporeans have been investing in property across the causeway in recent years, attracted by comparatively low prices. However, those who need to exit their investments quickly are likely to face significant challenges when trying to sell their property – and could finally be stuck with a property they can't sell. Career improvement programmes, in-house valuation, auctions and administrative help, venture advertising and marketing, skilled talks and traisning are continuously planned for the sales associates to help them obtain better outcomes for his or her shoppers while at Knight Frank Singapore. No change Present Rules

    Extending the tax exemption would help. The exemption, which may be as a lot as $2 million per family, covers individuals who negotiate a principal reduction on their existing mortgage, sell their house short (i.e., for lower than the excellent loans), or take part in a foreclosure course of. An extension of theexemption would seem like a common-sense means to assist stabilize the housing market, but the political turmoil around the fiscal-cliff negotiations means widespread sense could not win out. Home Minority Chief Nancy Pelosi (D-Calif.) believes that the mortgage relief provision will be on the table during the grand-cut price talks, in response to communications director Nadeam Elshami. Buying or promoting of blue mild bulbs is unlawful.

    A vendor's stamp duty has been launched on industrial property for the primary time, at rates ranging from 5 per cent to 15 per cent. The Authorities might be trying to reassure the market that they aren't in opposition to foreigners and PRs investing in Singapore's property market. They imposed these measures because of extenuating components available in the market." The sale of new dual-key EC models will even be restricted to multi-generational households only. The models have two separate entrances, permitting grandparents, for example, to dwell separately. The vendor's stamp obligation takes effect right this moment and applies to industrial property and plots which might be offered inside three years of the date of buy. JLL named Best Performing Property Brand for second year running

    The data offered is for normal info purposes only and isn't supposed to be personalised investment or monetary advice. Motley Fool Singapore contributor Stanley Lim would not personal shares in any corporations talked about. Singapore private home costs increased by 1.eight% within the fourth quarter of 2012, up from 0.6% within the earlier quarter. Resale prices of government-built HDB residences which are usually bought by Singaporeans, elevated by 2.5%, quarter on quarter, the quickest acquire in five quarters. And industrial property, prices are actually double the levels of three years ago. No withholding tax in the event you sell your property. All your local information regarding vital HDB policies, condominium launches, land growth, commercial property and more

    There are various methods to go about discovering the precise property. Some local newspapers (together with the Straits Instances ) have categorised property sections and many local property brokers have websites. Now there are some specifics to consider when buying a 'new launch' rental. Intended use of the unit Every sale begins with 10 p.c low cost for finish of season sale; changes to 20 % discount storewide; follows by additional reduction of fiftyand ends with last discount of 70 % or extra. Typically there is even a warehouse sale or transferring out sale with huge mark-down of costs for stock clearance. Deborah Regulation from Expat Realtor shares her property market update, plus prime rental residences and houses at the moment available to lease Esparina EC @ Sengkang
  7. One of the biggest reasons investing in a Singapore new launch is an effective things is as a result of it is doable to be lent massive quantities of money at very low interest rates that you should utilize to purchase it. Then, if property values continue to go up, then you'll get a really high return on funding (ROI). Simply make sure you purchase one of the higher properties, reminiscent of the ones at Fernvale the Riverbank or any Singapore landed property Get Earnings by means of Renting

    In its statement, the singapore property listing - website link, government claimed that the majority citizens buying their first residence won't be hurt by the new measures. Some concessions can even be prolonged to chose teams of consumers, similar to married couples with a minimum of one Singaporean partner who are purchasing their second property so long as they intend to promote their first residential property. Lower the LTV limit on housing loans granted by monetary establishments regulated by MAS from 70% to 60% for property purchasers who are individuals with a number of outstanding housing loans on the time of the brand new housing purchase. Singapore Property Measures - 30 August 2010 The most popular seek for the number of bedrooms in Singapore is 4, followed by 2 and three. Lush Acres EC @ Sengkang

    Discover out more about real estate funding in the area, together with info on international funding incentives and property possession. Many Singaporeans have been investing in property across the causeway in recent years, attracted by comparatively low prices. However, those who need to exit their investments quickly are likely to face significant challenges when trying to sell their property – and could finally be stuck with a property they can't sell. Career improvement programmes, in-house valuation, auctions and administrative help, venture advertising and marketing, skilled talks and traisning are continuously planned for the sales associates to help them obtain better outcomes for his or her shoppers while at Knight Frank Singapore. No change Present Rules

    Extending the tax exemption would help. The exemption, which may be as a lot as $2 million per family, covers individuals who negotiate a principal reduction on their existing mortgage, sell their house short (i.e., for lower than the excellent loans), or take part in a foreclosure course of. An extension of theexemption would seem like a common-sense means to assist stabilize the housing market, but the political turmoil around the fiscal-cliff negotiations means widespread sense could not win out. Home Minority Chief Nancy Pelosi (D-Calif.) believes that the mortgage relief provision will be on the table during the grand-cut price talks, in response to communications director Nadeam Elshami. Buying or promoting of blue mild bulbs is unlawful.

    A vendor's stamp duty has been launched on industrial property for the primary time, at rates ranging from 5 per cent to 15 per cent. The Authorities might be trying to reassure the market that they aren't in opposition to foreigners and PRs investing in Singapore's property market. They imposed these measures because of extenuating components available in the market." The sale of new dual-key EC models will even be restricted to multi-generational households only. The models have two separate entrances, permitting grandparents, for example, to dwell separately. The vendor's stamp obligation takes effect right this moment and applies to industrial property and plots which might be offered inside three years of the date of buy. JLL named Best Performing Property Brand for second year running

    The data offered is for normal info purposes only and isn't supposed to be personalised investment or monetary advice. Motley Fool Singapore contributor Stanley Lim would not personal shares in any corporations talked about. Singapore private home costs increased by 1.eight% within the fourth quarter of 2012, up from 0.6% within the earlier quarter. Resale prices of government-built HDB residences which are usually bought by Singaporeans, elevated by 2.5%, quarter on quarter, the quickest acquire in five quarters. And industrial property, prices are actually double the levels of three years ago. No withholding tax in the event you sell your property. All your local information regarding vital HDB policies, condominium launches, land growth, commercial property and more

    There are various methods to go about discovering the precise property. Some local newspapers (together with the Straits Instances ) have categorised property sections and many local property brokers have websites. Now there are some specifics to consider when buying a 'new launch' rental. Intended use of the unit Every sale begins with 10 p.c low cost for finish of season sale; changes to 20 % discount storewide; follows by additional reduction of fiftyand ends with last discount of 70 % or extra. Typically there is even a warehouse sale or transferring out sale with huge mark-down of costs for stock clearance. Deborah Regulation from Expat Realtor shares her property market update, plus prime rental residences and houses at the moment available to lease Esparina EC @ Sengkang