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FET PET imaging timepoints are pre-chemoradiotherapy (FET1), 1-month post-chemoradiotherapy (FET2), and at suspected progression (FET3). Before participant recruitment, site nuclear medicine physicians (NMPs) underwent credentialing of FET PET delineation and image interpretation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Sites were required to complete contouring and dynamic analysis by\u2009\u2265\u20092 NMPs on benchmarking cases (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096) assessing biological tumour volume (BTV) delineation (3\u2009\u00d7\u2009FET1) and image interpretation (3\u2009\u00d7\u2009FET3). Data was reviewed by experts and violations noted. BTV definition includes tumour-to-background ratio (TBR) threshold of 1.6 with crescent-shaped background contour in the contralateral normal brain. Recurrence\/pseudoprogression interpretation (FET3) required assessment of maximum TBR (TBR\n                      <jats:sub>max<\/jats:sub>\n                      ), dynamic analysis (time activity curve [TAC] type, time to peak), and qualitative assessment. Intraclass correlation coefficient (ICC) assessed volume agreement, coefficient of variation (CoV) compared maximum\/mean TBR (TBR\n                      <jats:sub>max<\/jats:sub>\n                      \/TBR\n                      <jats:sub>mean<\/jats:sub>\n                      ) across cases, and pairwise analysis assessed spatial (Dice similarity coefficient [DSC]) and boundary agreement (Hausdorff distance [HD], mean absolute surface distance [MASD]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data was accrued from 21 NMPs (10 centres,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009\u2265\u20092 each) and 20 underwent review. The initial pass rate was 93\/119 (78.2%) and 27\/30 requested resubmissions were completed. Violations were found in 25\/72 (34.7%; 13\/12 minor\/major) of FET1 and 22\/74 (29.7%; 14\/8 minor\/major) of FET3 reports. The primary reasons for resubmission were as follows: BTV over-contour (15\/30, 50.0%), background placement (8\/30, 26.7%), TAC classification (9\/30, 30.0%), and image interpretation (7\/30, 23.3%). CoV median and range for BTV, TBR\n                      <jats:sub>max<\/jats:sub>\n                      , and TBR\n                      <jats:sub>mean<\/jats:sub>\n                      were 21.53% (12.00\u201330.10%), 5.89% (5.01\u20136.68%), and 5.01% (3.37\u20136.34%), respectively. BTV agreement was moderate to excellent (ICC\u2009=\u20090.82; 95% CI, 0.63\u20130.97) with good spatial (DSC\u2009=\u20090.84\u2009\u00b1\u20090.09) and boundary (HD\u2009=\u200915.78\u2009\u00b1\u20098.30\u00a0mm; MASD\u2009=\u20091.47\u2009\u00b1\u20091.36\u00a0mm) agreement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The FIG study credentialing program has increased expertise across study sites. TBR\n                      <jats:sub>max<\/jats:sub>\n                      and TBR\n                      <jats:sub>mean<\/jats:sub>\n                      were robust, with considerable variability in BTV delineation and image interpretation observed.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-023-06371-5","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T21:01:56Z","timestamp":1691701316000},"page":"3970-3981","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Delineation and agreement of FET PET biological volumes in glioblastoma: results of the nuclear medicine credentialing program from the prospective, multi-centre trial evaluating FET PET In Glioblastoma (FIG) study\u2014TROG 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