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. 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 is dedicated towards improving and supporting the quality of nuclear medicine procedures.  Click here to review presentation on this EARL update, given by Prof. Dr. R. Boellaard.

Calibration QC acceptability criteria for ¹⁸F, ⁶⁸Ga and ⁸⁹Zr are set to +/-10% for each isotope independently.

SUV recovery coefficients for  ¹⁸F standards 1 and 2 effective as of quarter 3 of 2020:

NEMA IEC phantom spheres		18F standards 1 RCs		18F standards 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 

Recovery coefficient values are calculated based on:

• RCSUVmean – 50% background corrected isocontour VOI
• RCSUVmax – the maximum voxel value included in VOI
• RCSUVpeak – spherical VOI with a diameter of 12 mm, positioned so to yield the highest uptake

VOIs used for the analysis are based on the PET data, not on the CT. 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.