Quality assessment of positron emission tomography scans: recommendations for future multicentre trials

Evelyn E.C. de Jong, Wouter van Elmpt, Otto S. Hoekstra, Harry J.M. Groen, Egbert F. Smit, Ronald Boellaard, Philippe Lambin, Anne Marie C. Dingemans*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)
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Standardization protocols and guidelines for positron emission tomography (PET) in multicenter trials are available, despite a large variability in image acquisition and reconstruction parameters exist. In this study, we investigated the compliance of PET scans to the guidelines of the European Association of Nuclear Medicine (EANM). From these results, we provide recommendations for future multicenter studies using PET.

Material and methods: 

Patients included in a multicenter randomized phase II study had repeated PET scans for early response assessment. Relevant acquisition and reconstruction parameters were extracted from the digital imaging and communications in medicine (DICOM) header of the images. The PET image parameters were compared to theguidelines of the EANM for tumor imaging version 1.0 recommended parameters. 


From the 223 included patients, 167 baseline scans and 118 response scans were available from 15 hospitals. Scans of 19% of the patients had an uptake time that fulfilled the Uniform Protocols for Imaging in Clinical Trials response assessment criteria. The average quality score over all hospitals was 69%. Scans with a non-compliant uptake time had a larger standard deviation of the mean standardized uptake value (SUVmean) of the liver than scans with compliant uptake times. 


Although a standardization protocol was agreed on, there was a large variability in imaging parameters. For future, multicenter studies including PET imaging a prospective central quality review during patient inclusion is needed to improve compliance with image standardization protocols as defined by EANM.

Original languageEnglish
Pages (from-to)1459-1464
Number of pages6
JournalActa Oncologica
Issue number11
Publication statusPublished - 2 Nov 2017
Externally publishedYes

Bibliographical note

Funding Information:
The NVALT12 is a multicenter randomized open-label parallel group phase II trial conducted by the Dutch Lung Physician Society (NVALT) and was supported by the Dutch Cancer Society under Grant UM 2010-4883.

Publisher Copyright:
© 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


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