Optimization of ⁸⁹Zr PET Imaging for Improved Multisite Quantification and Lesion Detection Using an Anthropomorphic Phantom

Our objective was to harmonize multicenter ⁸⁹Zr PET imaging for oncology trials and to evaluate lesion detection. Methods: Seven PET scanners were evaluated using a custom chest oncology phantom with 9 spheric lesions 7-20 mm in diameter. A 4:1 signal-to-background ratio simulated a patient dose of 92.5 MBq. Various image reconstructions were evaluated. Images were assessed for lesion detection, and recovery coefficients and background signal variance were measured. Results: Two scanners failed to provide acceptable images and data. Optimal reconstruction algorithms enabling adequate lesion detection and reliable quantification across the other 5 scanners were determined without compromising the data quality. On average, 95% of the 10-mm lesions were detected, and the 7-mm lesion was visualized by only 1 scanner. Background variance was 8.6%-16%. Conclusion: We established multicenter harmonization procedures for ⁸⁹Zr PET imaging in oncology, optimizing small-lesion (≥10 mm) detectability and accurate quantification.