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J Nucl Med. 2008; 49 (Supplement 1):106P
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Oncology-Basic Science: Therapy, Metrics & Intervention

Technical Issues, Reproducibility and Quantification

The Netherlands protocol for standardization of FDG whole body PET studies in multi-center trials (NEDPAS)

Ronald Boellaard1, Wim Oyen2, Corneline Hoekstra3, Emile Comans1, Eric Visser2, Antoon Willemsen4, Bertjan Arends5, Fred Verzijlbergen6, Josee Zijlstra1 and Jan Pruim4

1 VU University Medical Centre, Amsterdam, Netherlands; 2 Radboud University Nijmegen Medical Centre, Nijmegen, NL, Netherlands; 3 Jeroen Bosch Hospital, Den Bosch, NL, Netherlands; 4 University Medical Center Groningen, Groningen, NL, Netherlands; 5 Catharina Hospital, Eindhoven, NL, Netherlands; 6 Antonius Hospital, Nieuwengeid, NL, Netherlands

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Objectives: Several studies have shown the usefulness of PET quantification using standardized uptake values (SUV). Many methodological factors affect SUV and variability in methodology across centers prohibits exchange of SUV. Therefore, standardization of PET studies is required in multi-center trials.

Methods: A protocol for standardization of FDG whole body PET studies in the Netherlands (NL) was defined. This protocol is based on standardization of: (1) patient preparation; (2) matching of scan statistics by prescribing dosage as function of patient weight, scan time per bed position, percentage of bed overlap and image acquisition mode; (3) matching of image resolution by prescribing reconstruction settings for each type of scanner; (4) matching of data analysis procedure by defining volume of interest methods and SUV calculations and; (5) a multi-center QC procedure for verification of scanner calibration and of activity concentration recoveries using the NEMA Image Quality phantom.

Results: The protocol reduces variability of SUV across centers participating in multi-center trials. QC phantom experiments demonstrated that use of the protocol reduced calibration errors from up to 15% to within 6%. Difference of 200% in activity concentration recovery coefficients reduced to within 5% (1 SD) for various PET and PET/CT scanners after standardization.

Conclusions: A protocol for standardization for FDG whole body multi-center PET studies was successfully introduced and officially approved in the Netherlands.





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Right arrow Articles by Boellaard, R.
Right arrow Articles by Pruim, J.