Multicenter quantitative 18F-fluorodeoxyglucose positron emission tomography performance harmonization: use of hottest voxels towards more robust quantification

BackgroundHarmonization methods reduce variability between different make and models of positron emission tomography (PET) scanners. The study aims to explore harmonization strategies that lead to comparable and robust quantitative metrics in a multicenter setting. MethodsNEMA IEC Phantom data acquisition was performed for low and high spheres-to-background ratios (SBR4:1 and 10:1) on six PET/CT (computed tomography) scanners. Different reconstruction sets, including the number of sub-iterations, number of subsets, and full width at half maximum (FWHM) for each scanner, were evaluated towards optimized and harmonized reconstruction settings. Recovery coefficients (RCs) of four quantitative metrics, including standardized uptake value (SUV)max, SUVISO-50 (SUVmean in 50% isocontour), SUVpeak, and mean uptake of 10 highest concentration voxels were evaluated as RCmax, RCISO-50, RCpeak, and RC10V, representing percent difference relative to the static ground truth case as functions of sphere sizes. A set of image reconstruction parameters was proposed for harmonized reconstruction to minimize variability between scanners. The root mean square error (RMSE), curvature, and reproducibility were examined. The proposed reconstruction protocols for harmonization and standard clinical reconstruction settings were compared to each other across all scanners. ResultsA significant difference (P value