Guidelines in Oncology
Links are provided here to some Society of Nuclear Medicine (SNM) Practice Management - Procedure Guidelines. The procedure guidelines help to identify those elements of the procedure that are most important in obtaining a high-quality examination, while simultaneously controlling costs.
The written report (or its electronic counterpart) is the primary mode of communication between the physician interpreting an imaging study and the referring physician. The content of this report not only influences patient management and clinical outcomes but also serves as legal documentation of services provided and can be used to justify medical necessity, billing accuracy, and regulatory compliance. Generating a high-quality PET/CT report is perhaps more challenging than generating a report for other imaging studies because of the complexity of this hybrid imaging modality. This article discusses the essential elements of a concise and complete oncologic (18)F-FDG PET/CT report and illustrates these elements through examples taken from routine clinical practice.
Clinical guideline, written in several parts, including therapeutic and diagnostic management of neuroendocrine tumours.
Radionuclide imaging of phaeochromocytomas and paragangliomas involves various functional imaging techniques and approaches for accurate diagnosis, staging and tumour characterization. The purpose of the present guideline is to assist nuclear medicine practitioners in performing, interpreting and reporting the results of the currently available SPECT and PET imaging approaches. These guidelines are intended to present information specifically adapted to European practice.
This work addresses the clinical adoption of FDG-PET/CT for image-guided radiation therapy planning. As such, important technical and methodological aspects of PET/CT-based RTP are reviewed and practical recommendations are given for routine patient management and clinical studies. First, recent developments in PET/CT hardware that are relevant to RTP are reviewed in the context of quality control and system calibration procedures that are mandatory for a reproducible adoption of PET/CT in RTP. Second, recommendations are provided on image acquisition and reconstruction to support the standardization of imaging protocols. Third, state-of-the-art tools for image fusion and co-registration are discussed briefly in the context of PET/CT imaging pre- and post-RTP. Finally, practical aspects of clinical workflow and patient management, such as patient setup and requirements for staff training are emphasized. This document serves as guidance on practical and clinically validated instructions that are deemed useful to the staff involved in PET/CT-guided RTP.
This document summarizes the state-of-the-art knowledge on the use of PET for radiotherapy planning, from tracers and data acquisition to clinical use in various tumors.
The purpose of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of somatostatin receptor scintigraphy with In-111 pentetreotide. The European Association of Nuclear Medicine guideline on 111In-pentetreotide scintigraphy was taken into consideration throughout this guideline. Imaging with other somatostatin analogs is not a subject of this guideline.
The intention of this guideline is to assist breast imaging practitioners in patient selection for, performance, interpretation, and reporting of 99mTc-sestamibi breast-specific gamma imaging (BSGI). The final result has been endorsed by the EANM.
The purpose of these guidelines is to assist practitioners in following a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care.
18F-Fluoride is a highly sensitive bone-seeking PET tracer used for detection of skeletal abnormalities. The uptake mechanism of 18F-Fluoride resembles that of 99mTc-MDP with better pharmacokinetic characteristics including faster blood clearance and two-fold higher uptake in bone. The use of novel hybrid PET/CT systems, has significantly improved the specificity of 18F- Fluoride imaging as the CT component of the study allows morphologic characterization of the functional lesion and more accurate differentiation between benign lesions and metastases. The document has been endorsed by the EANM Board.
The aim of these guidelines is to assist nuclear medicine physicians in recommending, performing, reporting and interpreting the results of somatostatin (SST) receptor PET/CT imaging using 68Ga-DOTA-conjugated peptides, analogues of octreotide, that bind to SST receptors. This imaging modality should not be regarded as the only approach to visualizing tumours expressing SST receptors or as excluding other imaging modalities useful for obtaining comparable results. The corresponding guidelines of 111In-pentetreotide scintigraphy imaging have been considered and partially integrated with this text.
This document provides general information about somatostatin receptor scintigraphy with 111In-pentetreotide. Somatostatin receptors have been identified on many cells of neuroendocrine origin; additionally, several non-neural and non-endocrine cells sometimes display somatostatin receptors with various degrees of density. Consequently, tumours deriving from cell types expressing somatostatin receptors may be imaged by somatostatin receptor scintigraphy.
The aim of this document is to provide general information about MIBG scintigraphy in cancer patients. This guideline describes the MIBG scintigraphy protocol currently used in the clinical routine, but does not include all existing procedures for neuroendocrine tumours. MIBG scintigraphy is used to image tumours of neuroendocrine origin, particularly those of the sympathoadrenal system (phaeochromocytomas, paragangliomas and neuroblastomas), although other neuroendocrine tumours (carcinoids, medullary thyroid carcinoma, etc.) are also visualised. The final result has been endorsed by the SNMMI.
One hundred twenty-two evidence-based recommendations were created to assist in the clinical care of MTC patients and to share what we believe is current, rational, and optimal medical practice.
The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG).The Procedure Guidelines for Tumour Imaging with FDG PET/CT of the Society of Nuclear Medicine (SNM), the German Guidelines for FDG-PET/CT in Oncology, the quality control/assurance procedures used in the UK for lymphoma/head and neck cancer studies and the Netherlands protocol for standardisation of quantitative whole-body FDG PET/CT studies have been integrated in the present guideline.
Imaging guidelines are provided for osteosarcoma and Ewing sarcoma (including soft tissue variants) which comprise 90% of pediatric malignant bone tumors. The guidelines are separated into anatomic and functional imaging techniques and presented according to the patient’s treatment status. The supporting narrative is also organized by the patient’s treatment status and provides the rationale supporting these recommendations with specific references to the differences between the Ewing sarcoma and osteosarcoma guidelines, when applicable.
The purpose of these guidelines is to offer to the nuclear medicine team a framework that could prove helpful in daily practice. These guidelines contain information related to the indications, acquisition, processing and interpretation of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in paediatric oncology.
The purpose of this guideline is to develop recommendations on the use of (18)F-FDG PET in breast, colorectal, esophageal, head and neck, lung, pancreatic, and thyroid cancer; lymphoma, melanoma, and sarcoma; and unknown primary tumor. Outcomes of interest included the use of (18)F-FDG PET for diagnosing, staging, and detecting the recurrence or progression of cancer.
The purpose of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of 18-fluoro-2-deoxyglucose (FDG) imaging in the evaluation of patients with suspected malignant disease, in adult and pediatric patients, for the staging of malignant disease, or for the monitoring of therapy.
Scintigraphy using 131I or 123I is used to determine the presence and extent of residual functioning thyroid tissue shortly post-thyroidectomy and, after 131I ablation, to detect the presence and location of functioning thyroid cancer, recurrences and/or metastases 18F-FDG PET may be helpful for patients with a rising serum thyroglobulin and negative or minimal iodine uptake. Other radiopharmaceuticals such as 201Tl and 99mTc sestamibi may also provide useful information.
The purpose of the guidelines is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of radiolabelled amino acid analogues for PET or SPECT imaging of brain tumours.
The purpose of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of 99mTc-sestamibi breast scintigraphy (mammoscintigraphy, scintimammography) includes planar and/or single-photon emission computed tomography (SPECT).
The purpose of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of bone scintigraphy - a diagnostic study used to evaluate the distribution of active bone formation in the body.
The purpose of this document is to provide general information about bone scintigraphy in oncology. The corresponding guidelines from the Society of Nuclear Medicine (SNM) have been taken into consideration, reviewed and partially integrated with this text. Bone scintigraphy is an highly sensitive method for demonstrating disease in bone. Phosphate analogues can be labelled with 99mTc and are used for bone imaging because of their good localisation in the skeleton and rapid clearance from soft tissues.
The aim of this document is to provide general information about breast scintigraphy in patients with known or suspected breast cancer. The corresponding guidelines of the Society of Nuclear
Medicine (SNM) have been taken into consideration and partially integrated with the present text. It describes only the 99mTc-SestaMIBI(2-methoxyisobutiylisonitrile) and the 99mTc-Tetrofosmin (1,2-bis bis(2-ethoxy-ethylphosphine)ethane) breast scintigraphy protocols used in the current clinical routine.
The aim of this document is to provide general information about 67Ga scintigraphy in oncology. 67Ga imaging of neoplastic disease has shown the greatest utility in imaging lymphomas but it can also be used for other tumours.
The purpose of this guideline is to offer to the Nuclear Medicine team a useful framework in daily practice. The present document is influenced by the conclusions of the reunion on "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncologic Committee of the French Society of Nuclear Medicine. This guideline summarises the views of the Paediatric Committee of the European Association of Nuclear Medicine.
The purpose of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of somatostatin receptor scintigraphy with In-111 pentetreotide.