Variations of clinical PET/CT operations for oncology imaging: An international web-based survey

Objectives This survey aims at gathering information about oncology PET/CT operations worldwide to help guide discussions regarding the use and standardization of clinical PET/CT imaging and to initiate further training efforts in the community.

Methods An internet-based survey of PET/CT users was initiated in 11/2009: http://www.surveymonkey.com/s.aspx?sm=RSVLaHlZS_2fHR6EEh7oWo0g_3d_3d. The survey was composed of 50 questions related to (A) PET/CT center and installation and (B) variations in FDG oncology imaging protocols. This survey is open until 03/ 2010 and first preliminary results are reported here.

Results So far 100 imaging centers responded: US (70%), Europe (22%) and APAC (12%). Most sites (65%) are public and operate 1-2 PET/CT systems (80%). 56% sites have 10+ years experience in PET. PET/CT are installed mainly in Nuclear Medicine (57%) and Radiology (20%). Sites use PET/CT for torso/whole-body oncology (95%), RTP (45%), cardiac (61%) and neurology (81%) applications. Average fasting prior to FDG-PET/CT was 7 (4-12) h. All sites measured blood glucose levels while using different cut-offs (50%: 200 mg/dL). Weight-based activity injection is performed at 38% sites. Mean FDG activity injected is 360 (200-555) MBq for 3D-PET and 520 (370-590) MBq for 2D-PET. Mean uptake time is 64 (20-90) min. Split protocols involving patient repositioning are employed at 52% sites. Only 39% use patient positioning aids. 19% sites employ IV contrast in ≥75% patients. 44% sites employ oral contrast in ≥75% patients. Most sites (89%) measure SUV_max values. 18% of the sites report PET and CT from PET/CT separately. Non-FDG PET tracers are used in <3% of all patients.

Conclusions An international survey among clinical PET/CT users reveals significant variations in standard FDG-PET/CT protocol parameters. This illustrates the need for continuous training efforts and standardization to further integrate PET and CT experience for optimized PET/CT imaging in oncology