To systematically evaluate the consistency of various standardized uptake value (SUV) lean body mass (LBM) normalization methods in a clinical positron emission tomography/magnetic resonance imaging (PET/MR) setting. SUV of brain, liver, prostate, parotid, blood, and muscle were measured in 90 18F-FDG and 28 18F-PSMA PET/MR scans and corrected for LBM using the James, Janma (short for Janmahasatian), and Dixon approaches. The prospective study was performed from December 2018 to August 2020 at Shanghai East Hospital. Forty dual energy X-ray absorptiometry (DXA) measurements of non-fat mass were used as the reference standard. Agreement between different LBM methods was assessed by linear regression and Bland-Altman statistics. SUV’s dependency on BMI was evaluated by means of linear regression and Pearson correlation. Compared to DXA, the Dixon approach presented the least bias in LBM/weight% than James and Janma models (bias 0.4±7.3%, − 8.0±9.4%, and − 3.3±8.3% respectively). SUV normalized by body weight (SUVbw) was positively correlated with body mass index (BMI) for both FDG (e.g., liver: r = 0.45, p < 0.001) and PSMA scans (r = 0.20, p = 0.31), while SUV normalized by lean body mass (SUVlean) revealed a decreased dependency on BMI (r = 0.22, 0.08, 0.14, p = 0.04, 0.46, 0.18 for Dixon, James, and Janma models, respectively). The liver SUVbw of obese/overweight patients was significantly larger (p < 0.001) than that of normal patients, whereas the bias was mostly eliminated in SUVlean. One-way ANOVA showed significant difference (p < 0.001) between SUVlean in major organs measured using Dixon method vs James and Janma models. Significant systematic variation was found using different approaches to calculate SUVlean. A consistent correction method should be applied for serial PET/MR scans. The Dixon method provides the most accurate measure of LBM, yielding the least bias of all approaches when compared to DXA.

中文翻译：

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基于Dixon，James和Janma的瘦体重校正法评估FDG和PSMA PET / MR中SUVlean一致性

若要在临床正电子发射断层扫描/磁共振成像（PET / MR）设置中系统评估各种标准化摄取值（SUV）瘦体重（LBM）标准化方法的一致性。在90 18F-FDG和28 18F-PSMA PET / MR扫描中测量了大脑，肝脏，前列腺，腮腺，血液和肌肉的SUV，并使用James，Janma（Janmahasatian的缩写）和Dixon方法校正了LBM。前瞻性研究于2018年12月至2020年8月在上海东方医院进行。非脂肪质量的四十次双能X射线吸收法（DXA）测量用作参考标准。通过线性回归和Bland-Altman统计来评估不同LBM方法之间的一致性。SUV对BMI的依赖性通过线性回归和Pearson相关性进行评估。与DXA相比，与James和Janma模型相比，Dixon方法的LBM /权重百分比偏差最小（分别为0.4±7.3％，-8.0±9.4％和-3.3±8.3％）。对于FDG（例如，肝脏：r = 0.45，p <0.001）和PSMA扫描（r = 0.20，p = 0.31），通过体重标准化的SUV（SUVbw）与体重指数（BMI）呈正相关。瘦体重（SUVlean）的研究表明，对BMI的依赖性降低（Dixon，James和Janma模型分别为r = 0.22、0.08、0.14，p = 0.04、0.46、0.18）。肥胖/超重患者的肝脏SUVbw显着大于正常患者（p <0.001），而在SUVlean中大部分消除了偏倚。单向方差分析显示，使用Dixon方法测量的主要器官SUVlean与James和Janma模型之间存在显着差异（p <0.001）。发现使用不同的方法计算SUVlean会产生重大的系统差异。连续PET / MR扫描应采用一致的校正方法。与DXA相比，Dixon方法提供了最准确的LBM度量，所有方法的偏差最小。