TY - JOUR
T1 - Forward to the Past
T2 - The Case for Quantitative PET Imaging
AU - Lammertsma, Adriaan A
N1 - © 2017 by the Society of Nuclear Medicine and Molecular Imaging.
PY - 2017/7
Y1 - 2017/7
N2 - PET was developed in the 1970s as an in vivo method to measure regional pathophysiologic processes. In the 1990s the focus moved to the detection of local increases in uptake, first in the brain (activation studies) and later in oncology (finding metastases), with18F-FDG emerging as a highly sensitive staging technique. This focus on sensitivity has overshadowed the other main characteristic of PET, its quantitative nature. In recent years there has been a shift. PET is now seen as a promising tool for drug development and precision medicine-that is, a method to monitor or even predict response to therapy. Quantification is essential for precision medicine, but many studies today use simplified semiquantitative methods without properly validating them. This review provides several examples illustrating that simplified methods may lead to less accurate or even misleading results. Simplification is important for routine clinical practice, but finding the optimal balance between accuracy and simplicity requires careful studies. It is argued that the use of simplified approaches without proper validation not only may waste time and resources but also may raise ethical questions, especially in drug development studies.
AB - PET was developed in the 1970s as an in vivo method to measure regional pathophysiologic processes. In the 1990s the focus moved to the detection of local increases in uptake, first in the brain (activation studies) and later in oncology (finding metastases), with18F-FDG emerging as a highly sensitive staging technique. This focus on sensitivity has overshadowed the other main characteristic of PET, its quantitative nature. In recent years there has been a shift. PET is now seen as a promising tool for drug development and precision medicine-that is, a method to monitor or even predict response to therapy. Quantification is essential for precision medicine, but many studies today use simplified semiquantitative methods without properly validating them. This review provides several examples illustrating that simplified methods may lead to less accurate or even misleading results. Simplification is important for routine clinical practice, but finding the optimal balance between accuracy and simplicity requires careful studies. It is argued that the use of simplified approaches without proper validation not only may waste time and resources but also may raise ethical questions, especially in drug development studies.
KW - Biomarkers
KW - Brain Diseases
KW - Humans
KW - Image Interpretation, Computer-Assisted
KW - Molecular Imaging
KW - Positron-Emission Tomography
KW - Journal Article
KW - Review
U2 - 10.2967/jnumed.116.188029
DO - 10.2967/jnumed.116.188029
M3 - Review article
C2 - 28522743
VL - 58
SP - 1019
EP - 1024
JO - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JF - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
SN - 1535-5667
IS - 7
ER -