EANM/EARL harmonization strategies in PET quantification: from daily practice to multicentre oncological studies
Open accessAbstract
Quantitative positron emission tomography/computed tomography (PET/CT) can be used as diagnostic or prognostic tools (i.e. single measurement) or for therapy monitoring (i.e. longitudinal studies) in multicentre studies. Use of quantitative parameters, such as standardized uptake values (SUVs), metabolic active tumor volumes (MATVs) or total lesion glycolysis (TLG), in a multicenter setting requires that these parameters be comparable among patients and sites, regardless of the PET/CT system used. This review describes the motivations and the methodologies for quantitative PET/CT performance harmonization with emphasis on the EANM Research Ltd. (EARL) Fluorodeoxyglucose (FDG) PET/CT accreditation program, one of the international harmonization programs aiming at using FDG PET as a quantitative imaging biomarker. In addition, future accreditation initiatives will be discussed. The validation of the EARL accreditation program to harmonize SUVs and MATVs is described in a wide range of tumor types, with focus on therapy assessment using either the European Organization for Research and Treatment of Cancer (EORTC) criteria or PET Evaluation Response Criteria in Solid Tumors (PERCIST), as well as liver-based scales such as the Deauville score. Finally, also presented in this paper are the results from a survey across 51 EARL-accredited centers reporting how the program was implemented and its impact on daily routine and in clinical trials, harmonization of new metrics such as MATV and heterogeneity features.
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The test-retest variability of lesion SUVs has undermined attempts to establish widely adoptable SUV thresholds unless rigorous harmonization measures are followed.
“This has undermined any attempts to establish widely adoptable SUV thresholds unless rigorous harmonization measures are followed [101,103,181].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [181]
The section on EORTC response criteria and PERCIST says reconstruction variability can push lesion SUV changes across response thresholds, and the Conclusions say harmonization is needed for comparable measurements across PET systems. But the Background describes improved test-retest repeatability; it does not identify test-retest variability as the reason widely adoptable thresholds have been undermined. The cited problem is principally variation between reconstruction methods and systems. Page numbers are unavailable in our copy. (LLM, conf=0.84)
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Lactate and Lactate Transporters as Key Players in the Maintenance of the Warburg Effect
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[18F]FDG PET/CT: EANM procedure guidelines for tumour imaging: version 3.0
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The value of the Standardized Uptake Value (SUV) and Metabolic Tumor Volume (MTV) in lung cancer.
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Self-citationRole of Fludeoxyglucose in Breast Cancer
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Self-citationDoes PET Reconstruction Method Affect Deauville Score in Lymphoma Patients?
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Self-citationENETS consensus guidelines for synoptic reporting of molecular imaging studies
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on behalf of the SPUtNIk investigators, Weir-McCall, J. R., Harris, S., Miles, K. A., Qureshi, N. R., Rintoul, R. C., Dizdarevic, S., Pike, L. C., Cheow, H., & Gilbert, F. J. (2020) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-020-05089-y · Cited by 22 · see citing works
Daisaki, H., Kitajima, K., Nakajo, M., Watabe, T., Ito, K., Sakamoto, F., Nakahara, T., Ishibashi, M., & Toriihara, A. (2021) · Scientific Reports · doi:10.1038/s41598-021-87942-0 · Cited by 21 · see citing works
Miwa, K., Wagatsuma, K., Iimori, T., Sawada, K., Kamiya, T., Sakurai, M., Miyaji, N., Murata, T., & Sato, E. (2018) · Physica Medica · doi:10.1016/j.ejmp.2018.07.001 · Cited by 20 · see citing works
Kitajima, K., Watabe, T., Nakajo, M., Ishibashi, M., Daisaki, H., Soeda, F., Tanemura, A., Kanekura, T., Yamazaki, N., & Ito, K. (2021) · Japanese Journal of Radiology · doi:10.1007/s11604-021-01174-w · Cited by 17 · see citing works
- Authors
- Aide, N., Lasnon, C., Veit-Haibach, P., Sera, T., Sattler, B., & Boellaard, R.
- Affiliations
- Inserm (FR)
- University Hospital Leipzig (DE)
- University Medical Center Groningen (NL)
- Corresponding author
- Aide, Nicolas
- Venue
- European Journal of Nuclear Medicine and Molecular Imaging
- Published
- 2017-06-16
- Volume
- 44
- Issue
- S1
- Pages
- 17-31
- ISSN
- 1619-7070 (ISSN-L)
- 1619-7089
- PMC
- PMC5541084
- OpenAlex
- W2625583840
- Cited by
- 344
- References
- 64
- Citations by year
- 2026: 37 · 2025: 49 · 2024: 37 · 2023: 33 · 2022: 30 · 2021: 54 · 2020: 32 · 2019: 26 · 2018: 33 · 2017: 12 · 2012: 1
- FWCI
- 4.26
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Journal of Nuclear Medicine and Molecular Imaging (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- SZTE Publicatio Repozitórium (University of Szeged) (acceptedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
- HAL (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
- Keywords
- PET quantification, method harmonization, FDG PET/CT, standardized uptake value, total lesion glycolysis, therapy response assessment, EORTC criteria, PERCIST, Deauville score, imaging biomarkers
- MeSH terms
- Humans, Magnetic Resonance Imaging, Neoplasms, Reference Standards, Societies, Medical, Multicenter Studies as Topic, Positron-Emission Tomography
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