CP-1612 Clarify incorrect multiplier for male James SUV lean body mass formula Status Sep 2016 Voting Packet Date of Last Update 2016/05/25 Person Assigned David Clunie Submitter Name QIBA FDG-PET group Submission Date 2015/10/01 Correction Number CP-1612 Log Summary: Clarify incorrect multiplier for male James SUV lean body mass formula Name of Standard PS3.16 (2016a+CP1535) Rationale for Correction: For the James formula (male), the value 128 was misquoted in an article as 120. So, the SUVlbm(James) males should = 1.1 x Weight - 128 x Weight squared / Height squared However, a survey of different vendors reveals that some use 120 and some use 128. It is proposed that the existing definitions in DICOM be relaxed to allow for both possibilities, given that vendors may have implemented it either way, and that a new code be added for the "correct" (128) value. Correction Wording: <section> <title/> <informaltable rules="all" frame="box"> <tr> <td><para><emphasis role="italic">Amend PS 3.3: </emphasis></para></td> </tr> </informaltable> </section> <section label="C.8.9.1" status="4" xml:id="sect_C.8.9.1"> <title>PET Series Module .. .
PET Series Module Attributes
Attribute Name Tag Type Attribute Description
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SUV Type (0054,1006) 3 Type of Standardized Uptake Value (SUV). Enumerated Values: BSA body surface area BW body weight LBM lean body mass by James method (see Note) LBMJAMES128 lean body mass by James method using a multiplier of 128 for males LBMJANMA lean body mass by Janmahasatian method IBW ideal body weight If absent, and the Units (0054,1001) are GML, then the type of SUV shall be assumed to be BW. The type of SUV cannot reliably be deduced from the units alone, i.e., SUVbw, SUVibw and SUVlbm (James or Janmahasatian) all have units of GML.
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The formulas for the determination of SUVbw, SUVbsa, SUVlbm(James) and SUVibw are defined in Sugawara et al. Reevaluation of the Standardized Uptake Value for FDG: Variations with Body Weight and Methods for Correction. Radiology, 1999 at . Unfortunately, Sugawara used a parameter of 120 rather than 128 for males, propagating an error in Morgan DJ, Bray KM. Lean Body Mass as a Predictor of Drug Dosage: Implications for Drug Therapy. Clinical Pharmacokinetics. 1994;26(4):292–307, which misquoted the original LBM definition that used 128 in James WPT, Waterlow JC. Research on Obesity: A Report of the DHSS/MRC Group. London: Her Majesty’s Stationery Office; 1976. Implementations differ in whether they have used 120 or 128 when the DICOM Defined Term is LBM. See Kelly M. SUV: Advancing Comparability and Accuracy. Siemens; 2009. Available from: http://www.mpcphysics.com/documents/SUV_Whitepaper_Final_11.17.09_59807428_2.pdf. The Janmahasatian LBM formula is defined in Janmahasatian et al. Quantification of Lean Bodyweight. Clin Pharmacokinet. 2005 Oct 1;44(10):1051–65. at and its role in SUVlbm(Janma) calculation is discussed in Tahari et al. Optimum Lean Body Formulation for Correction of Standardized Uptake Value in PET Imaging. Journal of Nuclear Medicine. 2014 Sep 1;55(9):1481–4. at . See also ... .
<informaltable rules="all" frame="box"> <tr> <td><para><emphasis role="italic">Amend DICOM PS 3.16:</emphasis></para></td> </tr> </informaltable> </section> <section label="CID 85" status="3" xml:id="sect_CID_85"> <title>SUV Units Type: Extensible Version: 20160314yyyymmdd
SUV Units
Coding Scheme Designator Code Value Code Meaning
UCUM {SUVlbm}g/ml{SUVlbm} Standardized Uptake Value lean body mass (James)
UCUM g/ml{SUVlbm(James128)} Standardized Uptake Value lean body mass (James 128 multiplier)
The formulas for the determination of SUVbw, SUVbsa, SUVlbm(James) and SUVibw are defined in Sugawara et al. Reevaluation of the Standardized Uptake Value for FDG: Variations with Body Weight and Methods for Correction. Radiology, 1999 at . Unfortunately, Sugawara used a parameter of 120 rather than 128 for males, propagating an error in Morgan DJ, Bray KM. Lean Body Mass as a Predictor of Drug Dosage: Implications for Drug Therapy. Clinical Pharmacokinetics. 1994;26(4):292–307, which misquoted the original LBM definition that used 128 in James WPT, Waterlow JC. Research on Obesity: A Report of the DHSS/MRC Group. London: Her Majesty’s Stationery Office; 1976. Implementations differ in whether they have used 120 or 128 for ({SUVlbm}g/ml{SUVlbm}, UCUM, "Standardized Uptake Value lean body mass (James)"). See Kelly M. SUV: Advancing Comparability and Accuracy. Siemens; 2009. Available from: http://www.mpcphysics.com/documents/SUV_Whitepaper_Final_11.17.09_59807428_2.pdf. The Janmahasatian LBM formula is defined in Janmahasatian et al. Quantification of Lean Bodyweight. Clin Pharmacokinet. 2005 Oct 1;44(10):1051–65. at and its role in SUVlbm(Janma) calculation is discussed in Tahari et al. Optimum Lean Body Formulation for Correction of Standardized Uptake Value in PET Imaging. Journal of Nuclear Medicine. 2014 Sep 1;55(9):1481–4. at . The patient size correction factors are summarized here, where weight is in kg and height is in cm: SUVbw: males & females: weight SUVlbm(James): males: 1.10 * weight - (120 or 128) * (weight/height) ^2 females: 1.07 * weight - 148 * (weight/height) ^2 SUVlbm(Janma): males: 9.27E3 * weight / (6.68E3 + 216 * weight / (height^2)) females: 9.27E3 * weight / (8.78E3 + 244 * weight / (height^2)) SUVbsa: males & females: weight^ 0.425 * height^0.725 * 0.007184 SUVibw: males: 48.0 + 1.06 * (height - 152) females: 45.5 + 0.91 * (height - 152)
Abstract Multi-dimensional Image Model Component Semantics Type: Extensible Version: 20160314yyyymmdd
Abstract Multi-dimensional Image Model Component Semantics
Coding Scheme Designator Code Value Code Meaning SNOMED-CT Concept ID UMLS Concept Unique ID
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DCM 126402 SUVlbm
DCM ddd001 SUVlbm(James128)
<informaltable rules="all" frame="box"> <tr> <td><para><emphasis role="italic">Amend DICOM PS3.16 concept definitions:</emphasis></para></td> </tr> </informaltable> </section> <section> <title/> <table frame="box" label="D-1" rules="all" xml:id="table_D-1"> <caption>DICOM Controlled Terminology Definitions</caption> <thead> <tr valign="top"> <th align="center" colspan="1" rowspan="1"> <para xml:id="para_f05607a1-90fe-4408-ad56-d194c3203ae5"> <emphasis role="bold">Code Value</emphasis> </para> </th> <th align="center" colspan="1" rowspan="1"> <para xml:id="para_022556ee-7c69-4138-a152-b3fa16bb86b2"> <emphasis role="bold">Code Meaning</emphasis> </para> </th> <th align="center" colspan="1" rowspan="1"> <para xml:id="para_e0270183-1962-48d5-877f-b63624671b37"> <emphasis role="bold">Definition</emphasis> </para> </th> <th align="center" colspan="1" rowspan="1"> <para xml:id="para_5aa10e80-ebb2-45b9-a2a9-fe4b3eb4497c"> <emphasis role="bold">Notes</emphasis> </para> </th> </tr> </thead> <tbody> <tr valign="top"> <td align="center" colspan="1" rowspan="1"> <para xml:id="DCM_126402">126402</para> </td> <td align="left" colspan="1" rowspan="1"> <para xml:id="para_3c2e3e95-49e9-48a1-a260-e335bb835e86">SUVlbm</para> </td> <td align="left" colspan="1" rowspan="1"> <para xml:id="para_d02b3c10-d16f-443f-9a53-fbe81c4be75d">Standardized Uptake Value calculated using lean body mass by James method. The patient size correction factor for males is 1.10 * weight - <emphasis role="bold"><emphasis role="underline">(</emphasis></emphasis>120<emphasis role="bold"><emphasis role="underline"> or 128)</emphasis></emphasis> * (weight/height) ^2, and for females is 1.07 * weight - 148 * (weight/height) ^2.</para> <para xml:id="para_9df819b6-d333-4b0a-91eb-cbe77579617d">Defined in Sugawara et al. <emphasis role="italic">Reevaluation of the Standardized Uptake Value for FDG: Variations with Body Weight and Methods for Correction.</emphasis>Radiology, 1999 at <link xl:href="http://radiology.rsna.org/content/213/2/521"/><emphasis role="bold"><emphasis role="underline">, except that either 120 or 128 may be used as the multiplier parameter for males).</emphasis></emphasis></para> <para><emphasis role="bold"><emphasis role="underline">Unfortunately, Sugawara used a parameter of 120 rather than 128, propagating an error in Morgan DJ, Bray KM. Lean Body Mass as a Predictor of Drug Dosage: Implications for Drug Therapy. Clinical Pharmacokinetics. 1994;26(4):292–307, which misquoted the original LBM definition that used 128 in James WPT, Waterlow JC. Research on Obesity: A Report of the DHSS/MRC Group. London: Her Majesty’s Stationery Office; 1976. Implementations differ in whether they have used 120 or 128 when using this code. See Kelly M. SUV: Advancing Comparability and Accuracy. Siemens; 2009. Available from: http://www.mpcphysics.com/documents/SUV_Whitepaper_Final_11.17.09_59807428_2.pdf.</emphasis></emphasis></para> </td> <td align="left" colspan="1" rowspan="1"> <para xml:id="para_cea7ee94-c1bb-4c81-9588-3b9ff43dbbce"/> </td> </tr> <tr> <td align="center" colspan="1"><para xml:id="DCM_ddd001"><emphasis role="bold"><emphasis role="underline">ddd001</emphasis></emphasis></para></td> <td align="left" colspan="1"><para><emphasis role="bold"><emphasis role="underline">SUVlbm(James128)</emphasis></emphasis></para></td> <td align="left" colspan="1"><para><emphasis role="bold"><emphasis role="underline">Standardized Uptake Value calculated using lean body mass by James method, using the originally published 128 multiplier for males. The patient size correction factor for males is 1.10 * weight - 128) * (weight/height) ^2, and for females is 1.07 * weight - 148 * (weight/height) ^2.</emphasis></emphasis></para></td> <td align="left" colspan="1"><para></para></td> </tr> <tr valign="top"> <td align="center" colspan="1" rowspan="1"> <para xml:id="DCM_126411">126411</para> </td> <td align="left" colspan="1" rowspan="1"> <para xml:id="para_115b009c-9a00-4d1b-af00-2724e1778217">SUV lean body mass calculation method</para> </td> <td align="left" colspan="1" rowspan="1"> <para xml:id="para_f4eaf243-c419-4a5c-a16f-d12f274b9fcc">James method of calculating Standardized Uptake Value using lean body mass. The patient size correction factor for males is 1.10 * weight - <emphasis role="bold"><emphasis role="underline">(</emphasis></emphasis>120<emphasis role="bold"><emphasis role="underline"> or 128)</emphasis></emphasis> * (weight/height) ^2, and for females is 1.07 * weight - 148 * (weight/height) ^2.</para> <para xml:id="para_68853096-7935-4e69-af20-506c5b778d33">Defined in Sugawara et al. <emphasis role="italic">Reevaluation of the Standardized Uptake Value for FDG: Variations with Body Weight and Methods for Correction.</emphasis>Radiology, 1999 at <link xl:href="http://radiology.rsna.org/content/213/2/521"/><emphasis role="bold"><emphasis role="underline">, except that either 120 or 128 may be used as the multiplier parameter for males).</emphasis></emphasis></para> <para><emphasis role="bold"><emphasis role="underline">Unfortunately, Sugawara used a parameter of 120 rather than 128, propagating an error in Morgan DJ, Bray KM. Lean Body Mass as a Predictor of Drug Dosage: Implications for Drug Therapy. Clinical Pharmacokinetics. 1994;26(4):292–307, which misquoted the original LBM definition that used 128 in James WPT, Waterlow JC. Research on Obesity: A Report of the DHSS/MRC Group. London: Her Majesty’s Stationery Office; 1976. Implementations differ in whether they have used 120 or 128 when using this code. See Kelly M. SUV: Advancing Comparability and Accuracy. Siemens; 2009. Available from: http://www.mpcphysics.com/documents/SUV_Whitepaper_Final_11.17.09_59807428_2.pdf.</emphasis></emphasis></para> </td> <td align="left" colspan="1" rowspan="1"> <para xml:id="para_7a6df8ef-87c8-4c1b-aa6e-5edb88eb8636"/> </td> </tr> <tr> <td align="center" colspan="1"><para xml:id="DCM_ddd002"><emphasis role="bold"><emphasis role="underline">ddd002</emphasis></emphasis></para></td> <td align="left" colspan="1"><para><emphasis role="bold"><emphasis role="underline">SUV lean body mass calculation method using 128 multiplier</emphasis></emphasis></para></td> <td align="left" colspan="1"><para><emphasis role="bold"><emphasis role="underline">James method of calculating Standardized Uptake Value using lean body mass with the originally published 128 multiplier for males. The patient size correction factor for males is 1.10 * weight - 128) * (weight/height) ^2, and for females is 1.07 * weight - 148 * (weight/height) ^2.</emphasis></emphasis></para></td> <td align="left" colspan="1"><para></para></td> </tr> </tbody> </table> </section> </chapter> </book>