Publikationsrepositorium - Helmholtz-Zentrum Dresden-Rossendorf

Background
Assessment of dual time point (DTP) positron emission tomography was carried out with the aim of a quantitative determination of Km, the metabolic uptake rate of [18F]fluorodeoxyglucose as a measure of glucose consumption.

Methods
Starting from the Patlak equation, it is shown that Km?mt/ca0 + Vr/?a, where mt is the secant slope of the tissue response function between the dual time point measurements centered at t=t0. ca0=ca(t0) denotes arterial tracer concentration, Vr is an estimate of the Patlak intercept, and ?a is the time constant of the ca(t) decrease. We compared the theoretical predictions with the observed relation between Ks=mt/ca0 and km in a group of nine patients with liver metastases of colorectal cancer for which dynamic scans were available, and Km was derived from conventional Patlak analysis. derived from conventional Patlak analysis. Twenty- two lesion regions of interest (ROIs) were evaluated. ca(t) was determined from a three-dimensional ROI in the aorta. Furthermore, the correlation between Km and late standard uptake value (SUV) as well as retention index was investigated. Additionally, feasibility of the approach was demonstrated in a whole-body investigation.

Results
Patlak analysis yielded a mean Vr of Vr = 0.53?0.08 ml/ml. The patient averaged ?a was 99?23 min. Linear regression between Patlak-derived Km and DTP-derived Ks according to Ks = b ? Km + a yielded b = 0.98 ? 0.05 and a = -0.0054 ? 0.0013 ml/min/ml (r = 0.98) in full accordance with the theoretical predictions b = 1 and a ? -Vr=?a Ks exhibits better correlation with Km than late SUV and retention index, respectively. K(c)s = Ks + Vr=?a is proposed as a quantitative estimator of Km which is independent of patient weight, scan time, and scanner calibration.

Conclusion
Quantification of Km from dual time point measurements compatible with clinical routine is feasible. The proposed approach eliminates the issues of static SUV and conventional DTP imaging regarding influence of chosen scanning times and inter-study variability of the input function. Ks and K(c)s exhibit improved stability and better correlation with the true Km. These properties might prove especially relevant in the context of radiation treatment planning and therapy response control.