Fig. 2.
Limitation of maximum SUV (SUVmax) as compared with mean SUV (SUVmean) and its SD (SDSUV) for evaluating bone involvement in multiple myeloma SUVmean. (a), (b), and (c) correspond to patients visually classified as presenting mild, moderate, and marked bone involvement, respectively. Their correspondent SUVmax, SUVmean, and SDSUV are shown. The point with the highest SUV in each patient is, respectively, the sternum, right shoulder, and clavicle for (a), (b), and (c). Note that, in opposition to SUVmean and SDSUV, SUVmax was not able to express the progressive intensity of bone involvement from (a) to (c), as defined by visual analysis. Also note that the proposed method evaluates only the osseous portion of the lesions and does not account for extraosseous extension of the disease, as seen in the left shoulder of the patient in (b). SUV, standardized uptake values; SUVmax, maximum SUV; SUVmean, mean SUV; SDsuv, standard deviation of SUV.