Multicenter survey of PET/CT protocol parameters that affect standardized uptake values.

Area of Science:

• Medical Imaging
• Oncology
• Clinical Trials

Background:

• Positron emission tomography (PET) imaging is valuable for assessing cancer treatment efficacy.
• Quantitative metrics derived from PET scans can be influenced by numerous factors.
• Site- and manufacturer-specific protocols introduce variability in PET imaging.

Purpose of the Study:

• To identify and quantify sources of bias and variability in PET imaging across different clinical sites.
• To assess the impact of protocol and system variations on PET image metrics used in cancer trials.

Main Methods:

• An observational study utilizing two sequential surveys distributed to hospitals in the United States.
• The surveys collected data on key PET imaging parameters, acquisition, reconstruction methods, and patient preparation.
• Responses were gathered from 63 sites in the first survey and 36 sites in the second.

Main Results:

• Significant variations in key imaging parameters were reported across participating sites.
• Diverse methods for image acquisition and reconstruction indicate mismatched signal biases between sites.
• Inconsistent patient preparation protocols were identified as a potential source of additional variability.

Conclusions:

• Variability in PET imaging protocols and system settings introduces significant bias in quantitative metrics.
• Standardization of imaging procedures is essential for multicenter clinical trials to ensure reliable and comparable results.
• Addressing these biases before patient enrollment is critical for the integrity of cancer treatment evaluation using PET.