Comparison of IRAT Survey Results with Recommendations of NCI, European Group, and ACRIN

ParameterNCIEuropean groupACRINIRAT survey
Administered dose370–740 MBq (10–20 mCi)5 mBq/kg for 2D, 2.5 MBq for 3D (370 MBq [10 mCi] for 2D, 185 MBq [5 mCi] for 3D for 70-kg patient)Dose is specific to each trial259–740 MBq (7–20 mCi)
Uptake time50–70 min55–65 min50–70 min45–90 min
Duration of fastingMinimum of 4 h4 h, prefer 6Minimum of 4 h4 or 6 h (evenly split)
Recommendation for low-carbohydrate dietRecommend for 24 h beforeNot mentionedRecommend for 24 h beforeHalf the sites recommend
Blood glucose cutoff<120 mg/dL for nondiabetic patients; 150–200 mg/dL for diabetic patientsReschedule if more than 126 mg/dLReschedule if more than 150–200 mg/dLReschedule if more than 200 mg/dL
Duration of emission scan per bed positionNot mentionedTypically 5 min per bed positionUse manufacturer recommendations2–7 min
CT techniqueNot mentioned30 mAs or lessTechnique is specific to each trialVariable and center-specific
Reconstruction algorithmsNo specific recommendationsSpecific for GE, Siemens, and PhillipsUse manufacturer recommendations2D OSEM, 2 iterations. 20–30 subsets
How to handle diabetic patientsScan in morning after overnight fast and before first use of medicationSpecific recommendations for type I and type II *Scheduled in morning with instructions provided in consultation with primary physicianWide variation, as described in text
  • * Type I: Study will be scheduled preferably at end of morning; patient will have normal breakfast at 7:00 AM and use regular dose of insulin, followed by fasting for at least 4 h. Type II: Study will be scheduled preferably at end of morning; patient needs to have fasted for at least 4 h; intake of water is recommended; oral antidiabetic drugs should be continued.