Top

European Journal of Nuclear Medicine and Molecular Imaging

Published in:

Open Access 01-01-2010 | Guidelines

FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

Authors: Ronald Boellaard, Mike J. O’Doherty, Wolfgang A. Weber, Felix M. Mottaghy, Markus N. Lonsdale, Sigrid G. Stroobants, Wim J. G. Oyen, Joerg Kotzerke, Otto S. Hoekstra, Jan Pruim, Paul K. Marsden, Klaus Tatsch, Corneline J. Hoekstra, Eric P. Visser, Bertjan Arends, Fred J. Verzijlbergen, Josee M. Zijlstra, Emile F. I. Comans, Adriaan A. Lammertsma, Anne M. Paans, Antoon T. Willemsen, Thomas Beyer, Andreas Bockisch, Cornelia Schaefer-Prokop, Dominique Delbeke, Richard P. Baum, Arturo Chiti, Bernd J. Krause

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 1/2010

Abstract

The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) and is provided to help the physician and physicist to assist to carrying out, interpret, and document quantitative FDG PET/CT examinations, but will concentrate on the optimisation of diagnostic quality and quantitative information.

Available only for authorised users

Sections of this document were adapted and reprinted with permission of the Society of Nuclear Medicine, Procedure Guidelines for Tumour Imaging with 18F-FDG PET/CT: Delbeke D (chair), Coleman RE, Guiberteau MJ, Brown ML, Royal HD, Siegel BA, Townsend DW, Berland LL, Parker JA, Hubner K, Stabin MJ, Zubal G, Kachelreiss M, Cronin V, Hoolbrook S. J Nucl Med 2006; 47: 885–895

Sections of this document were translated and reprinted with permission of the DGN (Deutsche Gesellschaft für Nuklearmedizin): Krause BJ, Beyer T, Bockisch A, Delbeke D, Kotzerke J, Minkov V, Reiser M, Willich N und der Arbeitsausschuss Positronen-Emissions-Tomographie der Deutschen Gessellschaft für Nuklearmedizin. FDG-PET/CT in oncology. German Guideline. Nuklearmedizin 2007; 46: 291–301

It should be noted that the entity “effective dose” does not necessarily reflect the radiation risk associated with this nuclear medicine examination. The effective dose values given in this guideline are used to compare the exposure due to different medical procedures. If the risk associated with this procedure is to be assessed, it is mandatory to adjust the radiation-associated risk factors at least according to the gender and age distribution of the institution’s patient population.

Delbeke D, Coleman RE, Guiberteau MJ, Brown ML, Royal HD, Siegel BA, et al. Procedure guideline for tumour imaging with 18F-FDG PET/CT 1.0. J Nucl Med. 2006;47:885–95.PubMed

Krause BJ, Beyer T, Bockisch A, Delbeke D, Kotzerke J, Minkov V, et al. FDG-PET/CT in oncology. German guideline. Nuklearmedizin. 2007;46:291–301.PubMed

Boellaard R, Oyen WJ, Hoekstra CJ, Hoekstra OS, Visser EP, Willemsen AT, et al. The Netherlands protocol for standardisation and quantification of FDG whole body PET studies in multi-centre trials. Eur J Nucl Med Mol Imaging. 2008;35:2320–33.CrossRefPubMed

Bourguet P, Blanc-Vincent MP, Boneu A, Bosquet L, Chauffert B, Corone C, et al. Summary of the standards, options and recommendations for the use of positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET scanning) in oncology (2002). Br J Cancer. 2003;89(Suppl 1):S84–91.CrossRefPubMed

Coleman RE, Delbeke D, Guiberteau MJ, Conti PS, Royal HD, Weinreb JC, et al. Concurrent PET/CT with an integrated imaging system: Intersociety dialogue from the joint working group of the American College of Radiology, the Society of Nuclear Medicine, and the Society of Computed Body Tomography and Magnetic Resonance. J Nucl Med. 2005;46:1225–39.PubMed

Fletcher JW, Djulbegovic B, Soares HP, Siegel BA, Lowe VJ, Lyman GH, et al. Recommendations on the use of F-18-FDG PET in oncology. J Nucl Med. 2008;49:480–508.CrossRefPubMed

Juweid ME, Stroobants S, Hoekstra OS, Mottaghy FM, Dietlein M, Guermazi A, et al. Use of positron emission tomography for response assessment of lymphoma: Consensus of the Imaging Subcommittee of International Harmonization Project in lymphoma. J Clin Oncol. 2007;25:571–8.CrossRefPubMed

Lammertsma AA, Hoekstra CJ, Giaccone G, Hoekstra OS. How should we analyse FDG PET studies for monitoring tumour response? Eur J Nucl Med Mol Imaging. 2006;33(Suppl 1):16–21.CrossRefPubMed

Miller JC, Fischman AJ, Aquino SL, Blake MA, Thrall JH, Lee SI. FDG-PET CT for tumour imaging. J Am Coll Radiol. 2007;4:256–9.CrossRefPubMed

10.

Schelbert HR, Hoh CK, Royal HD, Brown M, Dahlbom MN, Dehdashti F, et al. Procedure guideline for tumour imaging using fluorine-18-FDG. Society of Nuclear Medicine. J Nucl Med. 1998;39:1302–5.PubMed

11.

Shankar LK, Hoffman JM, Bacharach S, Graham MM, Karp J, Lammertsma AA, et al. Consensus recommendations for the use of F-18-FDG PET as an indicator of therapeutic response in patients in National Cancer Institute trials. J Nucl Med. 2006;47:1059–66.PubMed

12.

Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumours. J Nucl Med. 2009;50(Suppl 1):122S–50.CrossRefPubMed

13.

Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, et al. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer. 1999;35:1773–82.CrossRefPubMed

14.

Zijlstra JM, Comans EF, van Lingen A, Hoekstra OS, Gundy CM, Coebergh JW, et al. FDG PET in lymphoma: the need for standardization of interpretation. An observer variation study. Nucl Med Commun. 2007;28:798–803.CrossRefPubMed

15.

Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med. 2009;50(Suppl 1):11S–20.CrossRefPubMed

16.

Lowe VJ, Delong DM, Hoffman JM, Coleman RE. Optimum scanning protocol for FDG-PET evaluation of pulmonary malignancy. J Nucl Med. 1995;36:883–7.PubMed

17.

Avril NE, Weber WA. Monitoring response to treatment in patients utilizing PET. Radiol Clin North Am. 2005;43:189–204.CrossRefPubMed

18.

Bastiaannet E, Groen H, Jager PL, Cobben DCP, van der Graaf WTA, Vaalburg W, et al. The value of FDG-PET in the detection, grading and response to therapy of soft tissue and bone sarcomas; a systematic review and meta-analysis. Cancer Treat Rev. 2004;30:83–101.CrossRefPubMed

19.

Borst GR, Belderbos JSA, Boellaard R, Comans EFI, de Jaeger K, Lammertsma AA, et al. Standardised FDG uptake: a prognostic factor for inoperable non-small cell lung cancer. Eur J Cancer. 2005;41:1533–41.CrossRefPubMed

20.

Erdi YE. The use of PET for radiotherapy. Curr Med Imaging Rev. 2007;3:3–16.CrossRef

21.

Geus-Oei LF, van der Heijden HF, Corstens FH, Oyen WJ. Predictive and prognostic value of FDG-PET in nonsmall-cell lung cancer: a systematic review. Cancer. 2007;110:1654–64.CrossRefPubMed

22.

Hoekstra CJ, Stroobants SG, Smit EF, Vansteenkiste J, van Tinteren H, Postmus PE, et al. Prognostic relevance of response evaluation using [F-18]-2-fluoro-2-deoxy-D-glucose positron emission tomography in patients with locally advanced non-small-cell lung cancer. J Clin Oncol. 2005;23:8362–70.CrossRefPubMed

23.

Larson SM, Schwartz LH. 18F-FDG PET as a candidate for “qualified biomarker”: functional assessment of treatment response in oncology. J Nucl Med. 2006;47:901–3.PubMed

24.

Vansteenkiste JF, Stroobants SG. The role of positron emission tomography with 18F-fluoro-2-deoxy-D-glucose in respiratory oncology. Eur Respir J. 2001;17:802–20.CrossRefPubMed

25.

Weber WA. Use of PET for monitoring cancer therapy and for predicting outcome. J Nucl Med. 2005;46:983–95.PubMed

26.

Borst G, Belderbos J, Boellaard R, Comans E, de Jaeger K, Lammertsma A, et al. Prognostic significance of the 18FDG-PET standardized uptake value for inoperable non-small cell lung cancer patients after high-dose radiotherapy. Lung Cancer. 2005;49:S50.CrossRef

27.

Dai KS, Tai DY, Ho P, Chen CC, Peng WC, Chen ST, et al. Accuracy of the EasyTouch blood glucose self-monitoring system: a study of 516 cases. Clin Chim Acta. 2004;349:135–41.CrossRefPubMed

28.

ICRP. Radiation dose to patients from radiopharmaceuticals. Addendum 3 to ICRP Publication 53. ICRP Publication 106. Approved by the Commission in October 2007. Ann ICRP. 2008;38:1–197.PubMed

29.

Lassmann M, Biassoni L, Monsieurs M, Franzius C. The new EANM paediatric dosage card: additional notes with respect to F-18. Eur J Nucl Med Mol Imaging. 2008;35:1666–8.CrossRefPubMed

30.

Boellaard R, Krak NC, Hoekstra OS, Lammertsma AA. Effects of noise, image resolution, and ROI definition on the accuracy of standard uptake values: a simulation study. J Nucl Med. 2004;45:1519–27.PubMed

31.

Masuda Y, Kondo C, Matsuo Y, Uetani M, Kusakabe K. Comparison of imaging protocols for 18F-FDG PET/CT in overweight patients: optimizing scan duration versus administered dose. J Nucl Med. 2009;50:844–8.CrossRefPubMed

32.

Boellaard R, van Lingen A, van Balen SCM, Lammertsma AA. Optimization of attenuation correction for positron emission tomography studies of thorax and pelvis using count-based transmission scans. Phys Med Biol. 2004;49:N31–8.CrossRefPubMed

33.

Westerterp M, Pruim J, Oyen W, Hoekstra O, Paans A, Visser E, et al. Quantification of FDG PET studies using standardised uptake values in multi-centre trials: effects of image reconstruction, resolution and ROI definition parameters. Eur J Nucl Med Mol Imaging. 2007;34:392–404.CrossRefPubMed

34.

Meignan M, Gallamini A, Haioun C. Report on the first international workshop on interim-PET scan in lymphoma. Leuk Lymphoma. 2009;1–4.

35.

Krak NC, Boellaard R, Hoekstra OS, Twisk JWR, Hoekstra CJ, Lammertsma AA. Effects of ROI definition and reconstruction method on quantitative outcome and applicability in a response monitoring trial. Eur J Nucl Med Mol Imaging. 2005;32:294–301.CrossRefPubMed

36.

Geets X, Lee JA, Bol A, Lonneux M, Gregoire V. A gradient-based method for segmenting FDG-PET images: methodology and validation. Eur J Nucl Med Mol Imaging. 2007;34:1427–38.CrossRefPubMed

37.

van Dalen JA, Hoffmann AL, Dicken V, Vogel WV, Wiering B, Ruers TJ, et al. A novel iterative method for lesion delineation and volumetric quantification with FDG PET. Nucl Med Commun. 2007;28:485–93.CrossRefPubMed

38.

Hatt M, Lamare F, Boussion N, Turzo A, Collet C, Salzenstein F, et al. Fuzzy hidden Markov chains segmentation for volume determination and quantitation in PET. Phys Med Biol. 2007;52:3467–91.CrossRefPubMed

39.

Greuter HN, Boellaard R, van Lingen A, Franssen EJ, Lammertsma AA. Measurement of 18F-FDG concentrations in blood samples: comparison of direct calibration and standard solution methods. J Nucl Med Technol. 2003;31:206–9.PubMed

Title: FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0
Authors: Ronald Boellaard
Mike J. O’Doherty
Wolfgang A. Weber
Felix M. Mottaghy
Markus N. Lonsdale
Sigrid G. Stroobants
Wim J. G. Oyen
Joerg Kotzerke
Otto S. Hoekstra
Jan Pruim
Paul K. Marsden
Klaus Tatsch
Corneline J. Hoekstra
Eric P. Visser
Bertjan Arends
Fred J. Verzijlbergen
Josee M. Zijlstra
Emile F. I. Comans
Adriaan A. Lammertsma
Anne M. Paans
Antoon T. Willemsen
Thomas Beyer
Andreas Bockisch
Cornelia Schaefer-Prokop
Dominique Delbeke
Richard P. Baum
Arturo Chiti
Bernd J. Krause
Publication date: 01-01-2010
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 1/2010
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-009-1297-4

At a glance: The STEP trials

Springer Medicine

FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2010

The impact of reconstruction method on the quantification of DaTSCAN images

Assessment of long-term radiotoxicity after treatment with the low-dose-rate alpha-particle-emitting radioimmunoconjugate 227Th-rituximab

Unifying the predictive value of pretransplant FDG PET in patients with lymphoma: a review and meta-analysis of published trials

New starch-based radiotracer for lung perfusion scintigraphy

Predictive potential of pre-operative functional neuroimaging in patients treated with subthalamic stimulation

Somatostatin receptor scintigraphy might be useful for detecting skeleton abnormalities in patients with multiple myeloma and plasmacytoma