FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0

Ronald Boellaard, Roberto Delgado-Bolton, Wim J G Oyen, Francesco Giammarile, Klaus Tatsch, Wolfgang Eschner, Fred J Verzijlbergen, Sally F Barrington, Lucy C Pike, Wolfgang A Weber, Sigrid Stroobants, Dominique Delbeke, Kevin J Donohoe, Scott Holbrook, Michael M Graham, Giorgio Testanera, Otto S Hoekstra, Josee Zijlstra, Eric Visser, Corneline J Hoekstra, Jan Pruim, Antoon Willemsen, Bertjan Arends, Jörg Kotzerke, Andreas Bockisch, Thomas Beyer, Arturo Chiti, Bernd J Krause, European Association of Nuclear Medicine (EANM), Ronald Boellaard, Roberto Delgado-Bolton, Wim J G Oyen, Francesco Giammarile, Klaus Tatsch, Wolfgang Eschner, Fred J Verzijlbergen, Sally F Barrington, Lucy C Pike, Wolfgang A Weber, Sigrid Stroobants, Dominique Delbeke, Kevin J Donohoe, Scott Holbrook, Michael M Graham, Giorgio Testanera, Otto S Hoekstra, Josee Zijlstra, Eric Visser, Corneline J Hoekstra, Jan Pruim, Antoon Willemsen, Bertjan Arends, Jörg Kotzerke, Andreas Bockisch, Thomas Beyer, Arturo Chiti, Bernd J Krause, European Association of Nuclear Medicine (EANM)

Abstract

The purpose of these guidelines is to assist physicians in recommending, performing, interpreting and reporting the results of FDG PET/CT for oncological imaging of adult patients. PET is a quantitative imaging technique and therefore requires a common quality control (QC)/quality assurance (QA) procedure to maintain the accuracy and precision of quantitation. Repeatability and reproducibility are two essential requirements for any quantitative measurement and/or imaging biomarker. Repeatability relates to the uncertainty in obtaining the same result in the same patient when he or she is examined more than once on the same system. However, imaging biomarkers should also have adequate reproducibility, i.e. the ability to yield the same result in the same patient when that patient is examined on different systems and at different imaging sites. Adequate repeatability and reproducibility are essential for the clinical management of patients and the use of FDG PET/CT within multicentre trials. A common standardised imaging procedure will help promote the appropriate use of FDG PET/CT imaging and increase the value of publications and, therefore, their contribution to evidence-based medicine. Moreover, consistency in numerical values between platforms and institutes that acquire the data will potentially enhance the role of semiquantitative and quantitative image interpretation. Precision and accuracy are additionally important as FDG PET/CT is used to evaluate tumour response as well as for diagnosis, prognosis and staging. Therefore both the previous and these new guidelines specifically aim to achieve standardised uptake value harmonisation in multicentre settings.

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