{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:28:55Z","timestamp":1760059735701,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T00:00:00Z","timestamp":1751673600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: The recent introduction of whole-body positron emission tomography\/ computed tomography (PET\/CT) scanners and multi-bed, multi-time point acquisition technique enable calculating fluorodeoxyglucose (FDG) kinetics in the whole body. However, validating parametric, Patlak-derived data is difficult on phantoms. Methods: This prospective study investigated the effect of quantification methods mean, max, and peak on the metabolic rate (MR-FDG) and distribution volume (DV-FDG) quantification, as well as the diagnostic accuracy of parametric Patlak FDG-PET scans in diagnosing lung lesions and lymph node metastases, using histopathology and follow-up as reference standards. Dynamic whole-body FDG PET was acquired for 80 minutes in 34 patients with indeterminate lung lesions and kinetic parameters extracted from lung lesions and representative mediastinal and hilar lymph nodes. Results: All quantification methods\u2014mean, max, and peak\u2014demonstrated high diagnostic accuracy (AUC: MR-FDG: 0.987\u20130.991 and 0.893\u20130.905; DV-FDG: 0.948\u20130.975 and 0.812\u20130.825) for differentiating benign from malignant lymph nodes and lung lesions. Differences in the magnitude of MR-FDG (\u22124.76\u201314.09) and DV-FDG (\u221210.64\u201346.10%) were substantial across methods. Variability was more pronounced in lymph nodes (MR-FDG: 1.37\u20133.48) than in lung lesions (MR-FDG: 3.31\u20135.04). The variability was lowest between mean and max quantification, with percentage differences of 40.87 \u00b1 5.69% for MR-FDG and 39.26 \u00b1 7.68% for DV-FDG. Conclusions: The choice of method to measure MR-FDG and DV-FDG greatly influences the results, especially in smaller lesions with large and systematic differences. For lung lesions, a conversion factor between mean and max methods of 40% provides acceptable agreement, facilitating retrospective comparisons of measurements, e.g., in meta-analyses.<\/jats:p>","DOI":"10.3390\/diagnostics15131719","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T02:53:07Z","timestamp":1751856787000},"page":"1719","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Variability of Metabolic Rate and Distribution Volume Quantification in Whole-Body Parametric PATLAK [18F]-FDG PET\/CT\u2014A Prospective Trial in Patients with Lung Cancer"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2476-178X","authenticated-orcid":false,"given":"Stephan","family":"Ursprung","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Zender","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Pneumology (Internal Medicine VIII), University Hospital Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Ghibes","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1215-9428","authenticated-orcid":false,"given":"Florian","family":"Hagen","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2668-7325","authenticated-orcid":false,"given":"Konstantin","family":"Nikolaou","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany"},{"name":"iFIT-Cluster of Excellence, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7519-0417","authenticated-orcid":false,"given":"Christian","family":"la Foug\u00e8re","sequence":"additional","affiliation":[{"name":"iFIT-Cluster of Excellence, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Tuebingen, 72076 Tuebingen, Germany"},{"name":"Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2044-3047","authenticated-orcid":false,"given":"Matthias","family":"Weissinger","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, 72076 Tuebingen, Germany"},{"name":"Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, 72076 Tuebingen, Germany"},{"name":"Department of Nuclear Medicine, Marienhospital Stuttgart, 70072 Stuttgart, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1007\/s00259-014-2961-x","article-title":"FDG PET\/CT: EANM procedure guidelines for tumour imaging: Version 2.0","volume":"42","author":"Boellaard","year":"2015","journal-title":"Eur. 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Imaging"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/13\/1719\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:05:12Z","timestamp":1760033112000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/13\/1719"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,5]]},"references-count":29,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["diagnostics15131719"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15131719","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2025,7,5]]}}}