100 Chapter 5 SUPPLEMENTARY DATA Participating centers Patients were enrolled in the Radboud university medical center (UMC) (n=13), UMC Groningen (n=10), Amsterdam UMC (n=6) and Leiden UMC (n=4). Patient imaging Contrast-enhanced CT-scan The CT acquisition and reconstructions were performed according to local protocols for Canon Aquilion One GENESIS Edition (Radboudumc & Leiden UMC), Siemens Force/Flash (UMC Groningen) scanner, Discovery CT750 (Amsterdam UMC). Acquisition protocols were as follows;100 or 120 kV protocol (automatic exposure control (AEC) with standard deviation (SD) of 15), with auto mA 120-500, noise index of 25, at a rotation speed of 0.275-0.5 sec. Scan range included chest and abdomen. Reconstruction was performed by the Canon Aquilion scanner using adaptive iterative dose reduction 3dimensional enhance (AIDR 3Denh) in combination with FC08 filter to create axial in 1mm/0.8mm and axial, coronal and sagittal in 5mm/4mm slices and FC86 filter to create axial in 1mm/0.8mm and axial in 5mm/4mm and 10/3 MIP axial. Images from the Flash/Force scanner were reconstructed using SAFIRE iterative reconstructions program 2 to create 1mm slices with an increment of 0.7mm for chest reconstructions and 2mm slices with an increment of 1,5mm in slices of the abdomen and pelvis. CT images of the Discovery CT750 were reconstructed using the adaptive statistical iterative reconstruction (ASIR) algorithm at 60-70% to create 0.625 mm axial and coronal slices of the chest and 3mm slices of the abdomen and pelvis. Image analysis was performed on the venous phase scans after intravenous injection of iodinated contrast at 100-150 ml/kg body weight with bolus tracking at a delay of 30-80 sec (chest - abdomen) and maximal slice thickness of 5.0 mm. Patient imaging – PET/CT The 89Zr imaging procedure was harmonized between participating, EARL-accredited centers (PET/CT-systems)21. Patients underwent [89Zr]Zr-DFO-durvalumab PET/CT 5 days after intravenous (IV) injection of ±37 MBq [89Zr]Zr-DFO-durvalumab. For both PET/CT scans, patients were scanned from the head to upper thigh in up to 6 consecutive bed positions, during 5 minutes for each bed position with a 64-slice PET/CT camera (Siemens Biograph mCT, in Radboudumc, Philips Gemini TF or Philips Ingenuity TF in UMC Groningen and Philips Vereos in Amsterdam UMC and Leiden UMC). All data were corrected for dead time, scatter, randoms, decay and tissue attenuation, with a final reconstruction resolution of 7 mm.
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