Standardization of PET imaging and site qualification program by JSNM: collaboration with EANM/EARL

Excerpt

Everybody knows that the physical features of PET images, such as resolution and noise, depend on the PET camera model and image reconstruction parameters as well as various features of the imaging protocol, such as scanning time, injection activity, and subject body weight. To ensure image quality, diagnostic capability and compatibility with other PET centers, the scanning protocol should be standardized using phantom tests to adapt to the PET camera. The Japanese Society of Nuclear Medicine (JSNM) has been tackling this issue with the Japanese Society of Nuclear Medicine Technology (JSNMT) since 2007, and guidelines to determine the scanning protocol were published for whole-body FDG-PET [1, 2]. Meanwhile, a multicenter PET research project on Alzheimer’s disease named “J-ADNI” was launched, in which standardization of the imaging protocol was essential to combine data acquired in multiple PET centers with various PET cameras [3]. Furthermore, the PET core of the project checked the phantom data and other documents of participating PET centers to qualify them. In those days, such PET protocol standardization and site qualification were usually implemented in clinical trials but rarely in investigator-initiated multicenter PET research. An investigator-initiated research project to verify the therapeutic effect of bevacizumab on brain edema due to radiation necrosis used ¹¹C-methionine PET for subject selection but paid no attention to the method or quality of PET images acquired at individual sites, and some PET centers never knew that the PET data would be used for such a purpose. This incident triggered the establishment of JSNM’s site qualification program based on the protocol standardization and phantom standards [4], and now the program covers brain amyloid and FDG for dementia, whole-body FDG, ¹⁸F-NaF, and ¹¹C-methionine for brain tumor. Retrospectively, it was documented that when phantom data were acquired at each PET center that had participated in the above bevacizumab project with the methods used in the project, many of them did not live up to the JSNM standards of ¹¹C-methionine [5]. …