title: Variations in PET/CT methodology for oncologic imaging at U.S. academic medical centers: an imaging response assessment team survey.
abstract: In 2005, 8 Imaging Response Assessment Teams (IRATs) were funded by the National Cancer Institute (NCI) as supplemental grants to existing NCI Cancer Centers. After discussion among the IRATs regarding the need for increased standardization of clinical and research PET/CT methodology, it became apparent that data acquisition and processing approaches differ considerably among centers. To determine the variability in detail, a survey of IRAT sites and IRAT affiliates was performed.
  
  
  METHODS
  A 34-question instrument evaluating patient preparation, scanner type, performance approach, display, and analysis was developed. Fifteen institutions, including the 8 original IRATs and 7 institutions that had developed affiliate IRATs, were surveyed.
  
  
  RESULTS
  The major areas of variation were (18)F-FDG dose (259-740 MBq [7-20 mCi]) uptake time (45-90 min), sedation (never to frequently), handling of diabetic patients, imaging time (2-7 min/bed position), performance of diagnostic CT scans as a part of PET/CT, type of acquisition (2-dimensional vs. 3-dimensional), CT technique, duration of fasting (4 or 6 h), and (varying widely) acquisition, processing, display, and PACS software--with 4 sites stating that poor-quality images appear on PACS.
  
  
  CONCLUSIONS
  There is considerable variability in the way PET/CT scans are performed at academic institutions that are part of the IRAT network. This variability likely makes it difficult to quantitatively compare studies performed at different centers. These data suggest that additional standardization in methodology will be required so that PET/CT studies, especially those performed quantitatively, are more comparable across sites.
authors.affiliation: Department of Radiology, University of Iowa, Iowa City, IA 52242, USA. michael-graham@uiowa.edu
authors.forename: Michael M
authors.initials: MM
authors.lastname: Graham
authors.forename: Ramsey D
authors.initials: RD
authors.lastname: Badawi
authors.forename: Richard L
authors.initials: RL
authors.lastname: Wahl
mesh_terms: D000046:Academic Medical Centers; D001786:Blood Glucose / Q000378:metabolism; D016292:Procedural Sedation; D050528:Diet, Carbohydrate-Restricted; D019788:Fluorodeoxyglucose F18; D019538:Health Care Surveys; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000592:standards; D008499:Medical Records; D009316:National Institutes of Health (U.S.); D009369:Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000295:instrumentation / Q000379:methods* / Q000592:standards*; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000592:standards; D012984:Software; D011795:Surveys and Questionnaires; D014055:Tomography, Emission-Computed / Q000295:instrumentation / Q000379:methods* / Q000592:standards*; D014481:United States
chemical_list: D001786:Blood Glucose; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18