Accreditation specifications

Accreditation specifications

During the EANM Conference 2018 in Düsseldorf EARL announced the update of the EARL performance specifications. The current standard allows sites to benefit from state-of-the-art PET/CT technology and is based on a recent publication by EARL entitled “Feasibility of state-of-the-art PET/CT systems performance harmonisation”, by Kaalep et al. EJNMMI 2018. The impact of the new ¹⁸F standard 2 on the quantification of clinical studies has been described in “Quantitative implications of the updated EARL 2019 PET–CT performance standards”, by Kaalep et al. EJNMMI Physics 2019. EARL has now initiated this ¹⁸F standard 2 accreditation, while keeping effective ¹⁸F standard 1 for a transition period.

 

Imperative points to consider include but are not limited to:

• the images conforming to EARL ¹⁸F standards 1 cannot be pooled with those conforming to EARL ¹⁸F standards 2
• the visual interpretation of the PET images may differ between these two standards as stated in “Updating PET/CT performance standards and PET/CT interpretation criteria should go hand in hand”, by Boellaard et al. EJNMMI Research 2019
• ¹⁸F standard 2 allows sites to benefit from state-of-the-art PET/CT technology while still ensuring harmonized PET/CT system performance and SUV comparability in a multicenter study with a new ¹⁸F standard 2.

 

In addition, EARL added ⁸⁹Zr PET/CT accreditation and initialized it in collaboration with the European Infrastructure for Translational Medicine (EATRIS). It aims at harmonizing PET/CT calibration and quantitative image quality using ⁸⁹Zr labeled pharmaceuticals. The ⁸⁹Zr PET/CT accreditation is based on and derived from the procedures performed for the ¹⁸F-FDG PET/CT accreditation which is a prerequisite for ⁸⁹Zr PET/CT accreditation[1].

The presentation on this EARL update, given by Prof. Dr. R. Boellaard, can be found here . 

The update specifications are effective as of quarter 3 of 2020. 

  

EARL FDG PET/CT optimization procedure: 

EARL procedure for assessing PET/CT system specific patient FDG activity preparations for quantitative FDG PET/CT studies . R.Boellaard, A.T. Willemsen, B.Arends, E.P. Visser.

EARL FDG PET/CT accreditation specifications for SUV recovery coefficients

EARL is dedicated towards improving and supporting the quality of nuclear medicine procedures. The EARL accreditation is based on quality control (QC) experiments that were described and published in the EANM guidelines in 2010. Meanwhile the field has moved forward and new developments, technologies and insights have become available. 

 

As of July2020, the following specifications are valid for EARL ¹⁸F standard 1 and 2:  

 

NEMA IEC phantom spheres		18F standard 1 RCs		18F standard 2 RCs
Diameter (mm)	Volume (mL)	max	mean	max*	mean	peak**
37	26.52	0.95 – 1.16	0.76 – 0.89	1.05 – 1.29	0.85 – 1.00	0.90 – 1.10
28	11.49	0.91 – 1.13	0.72 – 0.85	1.01 – 1.26	0.82 – 0.97	0.90 – 1.10
22	5.57	0.83 – 1.09	0.63 – 0.78	1.01 – 1.32	0.80 – 0.99	0.90 – 1.10
17	2.57	0.73 – 1.01	0.57 – 0.73	1.00 – 1.38	0.76 – 0.97	0.75 – 0.99
13	1.15	0.59 – 0.85	0.44 – 0.60	0.85 – 1.22	0.63 – 0.86	0.45 – 0.70
10	0.52	0.34 – 0.57	0.27 – 0.43	0.52 – 0.88	0.39 – 0.61	0.27 – 0.41

 

*SUVmax for total body PET/CT scanners is under investigation

**SUVpeak limits are under a revision

 

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