Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for PET imaging of brain metastases: version 1.0

This joint practice guideline/procedure standard was collaboratively developed by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neuro-Oncology (EANO), and the PET task force of the Response Assessment in Neurooncology Working Group (PET/RANO). Brain metastases are the most common malignant central nervous system (CNS) tumors. PET imaging with radiolabeled amino acids and to lesser extent [¹⁸F]FDG has gained considerable importance in the assessment of brain metastases, especially for the differential diagnosis between recurrent metastases and treatment-related changes which remains a limitation using conventional MRI. The aim of this guideline is to assist nuclear medicine physicians in recommending, performing, interpreting and reporting the results of brain PET imaging in patients with brain metastases. This practice guideline will define procedure standards for the application of PET imaging in patients with brain metastases in routine practice and clinical trials and will help to harmonize data acquisition and interpretation across centers.