CP-1682 Defined PET Units Defined terms by reference to UCUM used in Context Group <informaltable rules="all" frame="box"> <tr> <td rowspan="1" colspan="1" valign="top"><para>Status</para></td> <td rowspan="1" colspan="1" valign="top"><para>Letter Ballot</para></td> </tr> <tr> <td rowspan="1" colspan="1" valign="top"><para>Date of Last Update</para></td> <td rowspan="1" colspan="1" valign="top"><para>2017/06/21</para></td> </tr> <tr> <td rowspan="1" colspan="1" valign="top"><para>Person Assigned</para></td> <td rowspan="1" colspan="1" valign="top"><para>David Clunie</para><para><link xl:href="mailto:dclunie@dclunie.com"/></para></td> </tr> <tr> <td rowspan="1" colspan="1" valign="top"><para>Submitter Name</para></td> <td rowspan="1" colspan="1" valign="top"><para>QIICR</para></td> </tr> <tr> <td rowspan="1" colspan="1" valign="top"><para>Submission Date</para></td> <td rowspan="1" colspan="1" valign="top"><para>2017/01/19</para></td> </tr> </informaltable> <informaltable rules="all" frame="box"> <tr> <td rowspan="1" colspan="1" valign="top"><para>Correction Number CP-1682</para></td> </tr> <tr> <td rowspan="1" colspan="1" valign="top"><para>Log Summary: Defined PET Units Defined terms by reference to UCUM used in Context Group</para></td> </tr> <tr> <td rowspan="1" colspan="1" valign="top"> <para>Name of Standard</para> <para>PS3.3, PS3.16</para> </td> </tr> <tr> <td rowspan="1" colspan="1" valign="top"><para>Rationale for Correction:</para> <para>A context group equivalent to the PET Units (0054,1001) Defined Terms was added in the past, but the two were not specifically mapped.</para> <para>Not all of the Units defined terms are included in CID 84. Those that are intended for SUV have more specific meanings with the SUV type pre-coordinated in CID 85. Standard deviation is challenging, because it could be the square root of any quantity.</para> </td> </tr> <tr> <td rowspan="1" colspan="1" valign="top">Correction Wording:</td> </tr> </informaltable> </chapter> <chapter> <title/> <informaltable rules="all" frame="box"> <tr> <td> <para><emphasis role="italic">Amend DICOM PS3.3 as follows (changes to existing text are bold and <emphasis role="bold"><emphasis role="underline">underlined</emphasis></emphasis> for additions and <emphasis role="bold"><emphasis role="strikethrough">struckthrough</emphasis></emphasis> for removals):</emphasis></para> </td> </tr> </informaltable> <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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Units (0054,1001) 1 Pixel value units. See for explanation Defined Terms. <emphasis role="bold"><emphasis role="strikethrough">Defined Terms:</emphasis></emphasis> CNTS NONE CM2 CM2ML PCNT CPS BQML MGMINML UMOLMINML MLMING MLG 1CM UMOLML PROPCNTS PROPCPS MLMINML MLML GML STDDEV
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 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.
... ... ... ...
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: . 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 .
PET Series Attribute Descriptions
Units The units of the pixel values obtained after conversion from the stored pixel values (SV) (Pixel Data (7FE0,0010)) to pixel value units (U), as defined by Rescale Intercept (0028,1052) and Rescale Slope (0028,1053). Defined Terms: CNTS counts ({counts}, UCUM, "Counts") NONE unitless (1, UCUM, "no units") CM2 centimeter**2 (cm2, UCUM, "Centimeter**2") PCNT percent (%, UCUM, "Percent") CPS counts/second ({counts}/s, UCUM, "Counts per second") BQML Becquerels/milliliter (Bq/ml, UCUM, "Becquerels/milliliter") MGMINML milligram/minute/milliliter (mg/min/ml, UCUM, "Milligrams/minute/milliliter") UMOLMINML micromole/minute/milliliter (umol/min/ml, UCUM, "Micromole/minute/milliliter") MLMING milliliter/minute/gram (ml/min/g, UCUM, "Milliliter/minute/gram") MLG milliliter/gram (ml/g, UCUM, "Milliliter/gram") 1CM 1/centimeter (/cm, UCUM, "/Centimeter") UMOLML micromole/milliliter (umol/ml, UCUM, "Micromole/milliliter") PROPCNTS proportional to counts ({propcounts}, UCUM, "Proportional to counts") PROPCPS proportional to counts/sec ({propcounts}/s, UCUM, "Proportional to counts per second") MLMINML milliliter/minute/milliliter (ml/min/ml, UCUM, "Milliliter/minute/milliliter") MLML milliliter/milliliter (ml/ml, UCUM, "Milliliter/milliliter") GML grams/milliliter (g/ml, UCUM, "Gram/milliliter") STDDEV standard deviations The majority of these defined terms are equivalent to PS3.16 CID 84 PET Units. Those that are used for SUV are not qualified by the type of SUV, which is encoded separately as SUV Type (0054,1006).
Amend DICOM PS3.16 as follows (changes to existing text are bold and underlined for additions and struckthrough for removals):
PET Units Type: Extensible Version: 20141110
PET Units
Coding Scheme Designator Code Value Code Meaning
Include
UCUM {counts} Counts
UCUM {counts}/s Counts per second
UCUM {propcounts} Proportional to counts
UCUM {propcounts}/s Proportional to counts per second
UCUM cm2 Centimeter**2
UCUM % Percent
UCUM Bq/ml Becquerels/milliliter
UCUM mg/min/ml Milligrams/minute/milliliter
UCUM umol/min/ml Micromole/minute/milliliter
UCUM ml/min/g Milliliter/minute/gram
UCUM ml/g Milliliter/gram
UCUM /cm /Centimeter
UCUM umol/ml Micromole/milliliter
SUV Units Type: Extensible Version: 20161106
SUV Units
Coding Scheme Designator Code Value Code Meaning
UCUM g/ml{SUVbw} Standardized Uptake Value body weight
UCUM g/ml{SUVlbm} Standardized Uptake Value lean body mass (James)
UCUM g/ml{SUVlbm(James128)} Standardized Uptake Value lean body mass (James 128 multiplier)
UCUM g/ml{SUVlbm(Janma)} Standardized Uptake Value lean body mass (Janma)
UCUM cm2/ml{SUVbsa} Standardized Uptake Value body surface area
UCUM g/ml{SUVibw} Standardized Uptake Value ideal body weight
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: . 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 * (weight/height) ^2 SUVlbm (James): females: 1.07 * weight - 148 * (weight/height) ^2 SUVlbm(Janma): males: 9.27E3 * weight / (6.68E3 + 216 * weight / (height^2)) SUVlbm(Janma): 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)