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Using PET for therapy monitoring in oncological clinical trials: challenges ahead

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Abstract

Molecular imaging with PET has emerged as a powerful imaging tool in the clinical care of oncological patients. Assessing therapy response is a prime application of PET and so the integration of PET into multicentre trials can offer valuable scientific insights and shape future clinical practice. However, there are a number of logistic and methodological challenges that have to be dealt with. These range from availability and regulatory compliance of the PET radiopharmaceutical to availability of scan time for research purposes. Standardization of imaging and reconstruction protocols, quality control, image processing and analysis are of paramount importance. Strategies for harmonization of the final image and the quantification result are available and can be implemented within the scope of multicentre accreditation programmes. Data analysis can be performed either locally or by centralized review. Response assessment can be done visually or using more quantitative approaches, depending on the research question. Large-scale real-time centralized review can be achieved using web-based solutions. Specific challenges for the future are inclusion of PET/MRI scanners in multicentre trials and the incorporation of radiomic analyses. Inclusion of PET in multicentre trials is a necessity to guarantee the further development of PET for routine clinical care and may yield very valuable scientific insights.

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Acknowledgements

We thank Dr. Claudio Rossetti, Dr. Iván Peñuelas Sánchez, and Dr. Arturo Chiti from the EANM for the information on GMP requirements in seven European countries and their comments on European regulations on radiopharmaceuticals.

Yan Liu thanks Fonds Cancer (FOCA) of Belgium for their support of this work.

Christophe M. Deroose is a Senior Clinical Investigator of the Research Foundation Flanders (FWO).

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Authors and Affiliations

  1. Nuclear Medicine, UZ Leuven, Leuven, Belgium

    C. M. Deroose

  2. Nuclear Medicine & Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium

    C. M. Deroose

  3. European Organisation for Research and Treatment of Cancer (EORTC) Imaging Group, Leuven, Belgium

    C. M. Deroose, S. Stroobants, Y. Liu & P. Bourguet

  4. Department of Nuclear Medicine, Antwerp, University Hospital, Edegem, Belgium

    S. Stroobants

  5. EORTC Headquarters, Brussels, Belgium

    Y. Liu

  6. Diagnostic Imaging Branch, Cancer Imaging Program, National Cancer Institute, Bethesda, MD, USA

    L. K. Shankar

  7. Department of Nuclear Medicine, University of Rennes 1, Rennes, France

    P. Bourguet

Authors
  1. C. M. Deroose
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  2. S. Stroobants
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  3. Y. Liu
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  4. L. K. Shankar
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  5. P. Bourguet
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Correspondence to C. M. Deroose.

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Deroose, C.M., Stroobants, S., Liu, Y. et al. Using PET for therapy monitoring in oncological clinical trials: challenges ahead. Eur J Nucl Med Mol Imaging 44 (Suppl 1), 32–40 (2017). https://doi.org/10.1007/s00259-017-3689-1

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  • DOI: https://doi.org/10.1007/s00259-017-3689-1

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