petctqualityassuranceinclinicaltrialsandgoodclinicalpractice.pptVIP

Considerations for Quantitative Imaging Calibration of all instrumentation is required at commissioning and regular intervals (PET/CT scanners, dose calibrators, scales, clocks) Consistent patient preparation is critical (e.g. fasting) Technical acquisition should be standardized and critical parameters should be recorded Arms down Arms up Arms down Arms up PET image quality Intravenous contrast media Chemotherapy port artifact CT PET PET/CT Movement artifact CT PET Uncorrected PET Hardware/Software Requirements for Accurate SUV Quantification Dose calibrator accuracy – traceable standard Scanner normalization (detector efficiency) Scanner calibration PET corrections: attenuation, scatter, randoms, decay (images and doses) Partial volume correction for small objects Appropriate reconstruction algorithm Daily/weekly/monthly scanner QC Requirements for Reproducible SUV Quantification PET technique: 18FDG dose, 18FDG uptake period, emission scan length, scanning range, scanning direction (e.g. head to toe) Patient preparation: fasting, resting, medication Reconstruction parameters: slice thickness, filters Region-of-interest definition methods (mostly manual or semi-automated) Consistency is the most important factor! Mandatory measurements Acquisition parameters Patient height, weight Injected activity, residual, and time Circulating glucose Infiltrated doses Patient compliance (e.g. fasting state, movement) Protocol deviations Injection time/scan delays Injected activity Standardized Uptake Value Under certain circumstances, 18FDG SUV correlates with metabolic rate of glucose and/or the number of viable tumor cells Simplified semi-quantitative measure that can be routinely performed in clinical PET studies Adjusts for differences in patient size and injected activity SUV (time) = Radioactive Concentration x Weight Injected Activity SUV Units Assuming the following: water-equivalent tissue a body weight correction in grams decay-correction to