Correlation between tissue metabolism and cellularity assessed by standardized uptake value and apparent diffusion coefficient in peritoneal metastasis

J Magn Reson Imaging. 2014 Jul;40(1):99-105. doi: 10.1002/jmri.24361. Epub 2013 Oct 29.


Purpose: To evaluate the correlation between standardized uptake value (SUV) (tissue metabolism) and apparent diffusion coefficient (ADC) (water diffusivity) in peritoneal metastases.

Materials and methods: Patients with peritoneal dissemination detected on (18)F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) were prospectively recruited for MRI examinations with informed consent and the study was approved by the local Institutional Review Board. FDG-PET/CT, diffusion-weighted imaging (DWI), MRI, and DWI/MRI images were independently reviewed by two radiologists based on visual analysis. SUVmax/SUVmean and ADCmin/ADCmean were obtained manually by drawing ROIs over the peritoneal metastases on FDG-PET/CT and DWI, respectively. Diagnostic characteristics of each technique were evaluated. Pearson's coefficient and McNemar and Kappa tests were used for statistical analysis.

Results: Eight patients were recruited for this prospective study and 34 peritoneal metastases were evaluated. ADCmean was significantly and negatively correlated with SUVmax (r = -0.528, P = 0.001) and SUVmean (r = -0.548, P = 0.001). ADCmin had similar correlation with SUVmax (r = -0.508, P = 0.002) and SUVmean (r = -0.513, P = 0.002). DWI/MRI had high diagnostic performance (accuracy = 98%) comparable to FDG-PET/CT, in peritoneal metastasis detection. Kappa values were excellent for all techniques.

Conclusion: There was a significant inverse correlation between SUV and ADC.

Keywords: ADC; FDG-PET/CT; SUV; diffusion-weighted imaging; peritoneal metastases.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Male
  • Middle Aged
  • Peritoneal Neoplasms / metabolism*
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / secondary*
  • Peritoneum / metabolism*
  • Peritoneum / pathology*
  • Psyllium / pharmacokinetics*
  • Reference Values
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Statistics as Topic


  • Psyllium