How SUV Is Calculated on FDG PET
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Question
In FDG PET/CT, the standardized uptake value (SUV) is used to semi-quantitatively measure radiotracer uptake. How is SUV calculated?
- ASUV = (Activity in ROI [kBq/mL]) / (Injected activity [kBq] / Body weight [g]) — normalized to body weight
- BSUV = (Injected activity × Scan time) / Body surface area
- CSUV = Peak tumor activity / Mean liver activity
- DSUV = Total body PET counts / Number of image slices
Show the answer and explanation
A. SUV = (Activity in ROI [kBq/mL]) / (Injected activity [kBq] / Body weight [g]) — normalized to body weight
SUV (standardized uptake value) = [Activity concentration in region of interest (kBq/mL)] / [Injected dose (kBq) / Body weight (g)]. It normalizes regional activity to the injected dose and patient weight, allowing comparison across patients and time points. SUVmax (maximum pixel value in the ROI) is most commonly used in clinical practice. An SUV of 1.0 means uptake equals what would be expected if the dose distributed uniformly throughout the body. Tumors typically have SUVmax >2.5 (though this varies by tumor type). SUV is used for treatment response assessment (decrease in SUV after therapy) and for staging/prognosis.
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