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Use of Mobile PET-CT in Research

Introduction

This statement has been prepared by the NRCI PET Research Network in consultation with the Steering Committee and the PET Scanning Methodology Panel.

Over recent years mobile PET-CT scanners have become an integral part of the clinical PET network in the UK and there is scope for further utilising this resource for PET research. This statement clarifies the NCRI PET Research Network position on the use of mobile scanners in multicentre trials involving PET. The statement is based on the experience of previous multicentre trials completed by the NCRI PET Clinical Trials Network (formerly the St Thomas' Clinical Trials Network), the advice of the NCRI PET Scanning Methodology Panel and with reference to the latest standards and recommendations developed by the American College of Radiology Imaging Network (ACRIN), the European Organisation for Research and Treatment of Cancer (EORTC), the National Cancer Institute, the Netherlands Society or Nuclear Medicine (NVNG) and the European Association of Nuclear Medicine (EANM). The statement will be reviewed on a regular basis and as additional data becomes available.

Statement on the use of mobile PET-CT scanners in multicentre trials

"Before a scanning site can take part in a multicentre trial it must undergo accreditation by the NCRI PET Clinical Trials Network. If a mobile scanner is to be used in multicentre trials it must conform to the same standards as expected for a fixed scanner site*. Each site will be subject to ongoing audit to ensure compliance with these standards and trial protocols. This applies equally to fixed and mobile scanners.

Particular issues that may impact on the feasibility of using mobile scanners in multicentre trials are:

  1. It is a condition of trials involving multiple scans on a patient that the same scanner is used for all scans.
  2. Sites are required to ensure the same mobile scanner is available on a particular day to comply with complex patient scheduling with respect to therapy.
  3. Sites will need access to phantoms and the ability to perform necessary additional research QC.
  4. Sites will require access to appropriately qualified staff to perform the necessary additional QC, data anonymisation & transfer, study coordination and communication between the NCRI PET Clinical Trials Network, research nurses and trial co-ordinator.
  5. Sites must have a documented QA program in place for both the PET and CT components of the scanner and must be able to demonstrate the same degree of QC tests, records and scanner stability as that of a fixed site. As a part of this all sites are required to provide a minimum of 8 weeks consecutive weekly SUV measurements using a uniform 68Ge resin or 18F cylinder.
  6. Sites must have the ability to anonymise and transfer the DICOM data in a timely way consistent with the requirements of the clinical trial."

*Note that the standards for participation in multicentre trials involving PET will be continually reviewed by the NCRI PET Research Network and may be subject to change to reflect the latest guidelines and recommendations of the relevant professional bodies and societies.

Bibliography

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ACRIN PET and PET/CT scanner qualification. Available at: www.acrin.org accessed 19/10/09.

Boellaard R. 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; 35:2320-2333.

Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med 2009; 50:11S-20S.

Young H, Baur R, Cremerius U, et al. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. Eur J Cancer 1999; 35:1773-1782.

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Boellaard R. et al. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging 2009.