Optimisation and harmonisation: two sides of the same coin?

Excerpt

¹⁸F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) examinations are executed for several oncological applications [1]. In most cases PET/CT studies are performed with a diagnostic intent, often interpreted using visual inspection of the images. The primary task of the observer is e.g. to identify unknown primary tumours, lymph node involvement and the assessment of distant metastasis. It has been shown that FDG PET/CT is an important tool for either up or down staging of lung cancer patients with a direct impact on patient management [2]. The uptake of FDG can be used as a prognostic factor both in the clinical setting and in trials [3]. In addition to diagnosis and staging, FDG PET/CT is used to measure treatment response. Here residual FDG uptake or changes in uptake during or after treatment are used as predictive factors [4‐6]. To this end, criteria to measure FDG uptake changes and/or metabolic response have been proposed [7, 8]. Finally, PET/CT studies performed at follow-up are used to assess presence or absence of recurrence of disease. Apart from the various applications of FDG PET/CT listed above, there are many other utilities of FDG PET/CT. For example, it can be used for radiation oncology purposes [9‐12], e.g. by identifying areas with high metabolic activity that may require a boost of radiation to improve treatment outcome. …