PET/CT Accreditation Protocol for Multicenter Studies

The uniform calibration QC phantom and NEMA NU2 IQ body phantom images uploaded into the EARL database are evaluated centrally, making use of a standardised semi-automatic quantitative analysis tool developed internally within EARL. The software uses activity and time information provided by the scan report forms. The average volumetric SUV bias is generated as relative deviation between measured and calculated activity concentration values (Eq. 1). The SUV recovery coefficients (RCs) for the six spherical inserts are based on 50% background corrected isocontour VOI (RC_SUVmean) and maximum voxel value included in the VOI (RC_SUVmax). $$\mathit{\text{SUVbias}}\left(\%\right)=\left(\frac{C_{\mathit{\text{measured}}}}{C_{\mathit{\text{calculated}}}}-1\right)\times 100\%;$$ , where $$C_{\mathit{\text{measured}}}-\mathit{\text{activity concentration measured from images}}$$
$$C_{\mathit{\text{calculated}}}-\mathit{\text{activity concentration calculated from injection data}}$$
EARL is applying SUV bias and RC values acceptance criteria, which were defined by feasibility studies performed on the systems used in clinical practices at the start of the standardisation - a study is underway in order to update these. When approval is not granted, the site undergoing (re-)accreditation is asked to take corrective actions, for example: recalibration of the PET system, adjustment of reconstruction parameters, repeating the phantom scan and so on. When required, EARL is advising the sites. A Manual describing the accreditation program in detail as well as information on the EARL website [42 ] is also available. If submitted QC documents meet the standard requirements, FDG-PET/CT accreditation is granted, and the department is listed on the EARL website (http://earl.eanm.org) as an accredited PET/CT centre of excellence. Furthermore, the site is provided with an accreditation certificate and signet, which can be used on its correspondence and website.