Establishment of a UK-wide network to facilitate the acquisition of quality assured FDG-PET data for clinical trials in lymphoma.
BACKGROUND
Multicentre trials are required to determine how [fluorine-18]-2-fluoro-2-deoxy-D-glucose-positron emission tomography imaging can guide cancer treatment. Consistency in quality control (QC), scan acquisition and reporting is mandatory for high-quality results, which are comparable across sites.


METHODS
A national positron emission tomography (PET) clinical trials network (CTN) has been set up with a 'core laboratory' to coordinate QC and interpret scans. The CTN is involved in trials in Hodgkin's lymphoma [Randomised Phase III trial to determine the role of FDG-PET Imaging in Clinical Stages IA/IIA Hodgkin's Disease (RAPID) and Randomised Phase III trial to assess response adapted therapy using FDG-PET imaging in patients with newly diagnosed, advanced Hodgkin lymphoma (RATHL)] and diffuse large B-cell lymphoma [Blinded evaluation of prognostic value of FDG-PET after 2 cycles of chemotherapy in diffuse large B-cell Non-Hodgkins Lymphoma, a sub-study of the R-CHOP-21 vs R-CHOP-14 trial (R-CHOP PET substudy)]. Approval to join requires scanner validation and agreement to follow a standard QC protocol. Scans are transferred to the core laboratory and reported centrally according to predetermined criteria.


RESULTS
The qualification procedure was carried out on 15 scanners. All scanners were able to demonstrate the necessary quantitative accuracy, and following modification of image reconstruction where necessary, scanners demonstrated comparable recovery coefficients (RCs) indicating similar performance. The average RC (±1 standard deviation) was 0.56 ± 0.095 for the 13-mm sphere. Reports from 444 of 473 (94%) patients in RAPID and 67 of 73 (92%) patients in RATHL were available for randomisation of therapy.


CONCLUSIONS
The CTN has enabled consistent quality assured PET results to be obtained from multiple centres in time for clinical decision making. The results of trials will be significantly strengthened by this system.
Barrington
S F
SF
Division of Imaging Sciences, PET Imaging Centre at St Thomas', Kings College London, London. Electronic address: sally.barrington@kcl.ac.uk.
MacKewn
J E
JE
Division of Imaging Sciences, PET Imaging Centre at St Thomas', Kings College London, London.
Schleyer
P
P
Division of Imaging Sciences, PET Imaging Centre at St Thomas', Kings College London, London.
Marsden
P K
PK
Division of Imaging Sciences, PET Imaging Centre at St Thomas', Kings College London, London.
Mikhaeel
N G
NG
Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, London.
Qian
W
W
MRC Clinical Trials Unit, London.
Mouncey
P
P
Cancer Research UK and UCL Clinical Trials Centre, London.
Patrick
P
P
Cancer Research UK and UCL Clinical Trials Centre, London.
Popova
B
B
Cancer Research UK and UCL Clinical Trials Centre, London.
Johnson
P
P
Cancer Research UK Clinical Centre, Southampton.
Radford
J
J
The Christie NHS Foundation Trust, Manchester; University of Manchester, Manchester, UK.
O'Doherty
M J
MJ
Division of Imaging Sciences, PET Imaging Centre at St Thomas', Kings College London, London.
D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000000981:diagnostic imaging*; D006801:Humans; D015337:Multicenter Studies as Topic; D049268:Positron-Emission Tomography / Q000592:standards*; D011786:Quality Control; D019275:Radiopharmaceuticals; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D006113:United Kingdom
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18