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      Feasibility of state of the art PET/CT systems performance harmonisation

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          Abstract

          Purpose

          The objective of this study was to explore the feasibility of harmonising performance for PET/CT systems equipped with time-of-flight (ToF) and resolution modelling/point spread function (PSF) technologies. A second aim was producing a working prototype of new harmonising criteria with higher contrast recoveries than current EARL standards using various SUV metrics.

          Methods

          Four PET/CT systems with both ToF and PSF capabilities from three major vendors were used to acquire and reconstruct images of the NEMA NU2–2007 body phantom filled conforming EANM EARL guidelines. A total of 15 reconstruction parameter sets of varying pixel size, post filtering and reconstruction type, with three different acquisition durations were used to compare the quantitative performance of the systems. A target range for recovery curves was established such that it would accommodate the highest matching recoveries from all investigated systems. These updated criteria were validated on 18 additional scanners from 16 sites in order to demonstrate the scanners’ ability to meet the new target range.

          Results

          Each of the four systems was found to be capable of producing harmonising reconstructions with similar recovery curves. The five reconstruction parameter sets producing harmonising results significantly increased SUVmean (25%) and SUVmax (26%) contrast recoveries compared with current EARL specifications. Additional prospective validation performed on 18 scanners from 16 EARL accredited sites demonstrated the feasibility of updated harmonising specifications. SUVpeak was found to significantly reduce the variability in quantitative results while producing lower recoveries in smaller (≤17 mm diameter) sphere sizes.

          Conclusions

          Harmonising PET/CT systems with ToF and PSF technologies from different vendors was found to be feasible. The harmonisation of such systems would require an update to the current multicentre accreditation program EARL in order to accommodate higher recoveries. SUVpeak should be further investigated as a noise resistant alternative quantitative metric to SUVmax.

          Electronic supplementary material

          The online version of this article (10.1007/s00259-018-3977-4) contains supplementary material, which is available to authorized users.

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          Most cited references45

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          Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma.

          To develop guidelines for performing and interpreting positron emission tomography (PET) imaging for treatment assessment in patients with lymphoma both in clinical practice and in clinical trials. An International Harmonization Project (IHP) was convened to discuss standardization of clinical trial parameters in lymphoma. An imaging subcommittee developed consensus recommendations based on published PET literature and the collective expertise of its members in the use of PET in lymphoma. Only recommendations subsequently endorsed by all IHP subcommittees were adopted. PET after completion of therapy should be performed at least 3 weeks, and preferably at 6 to 8 weeks, after chemotherapy or chemoimmunotherapy, and 8 to 12 weeks after radiation or chemoradiotherapy. Visual assessment alone is adequate for interpreting PET findings as positive or negative when assessing response after completion of therapy. Mediastinal blood pool activity is recommended as the reference background activity to define PET positivity for a residual mass > or = 2 cm in greatest transverse diameter, regardless of its location. A smaller residual mass or a normal sized lymph node (ie, < or = 1 x 1 cm in diameter) should be considered positive if its activity is above that of the surrounding background. Specific criteria for defining PET positivity in the liver, spleen, lung, and bone marrow are also proposed. Use of attenuation-corrected PET is strongly encouraged. Use of PET for treatment monitoring during a course of therapy should only be done in a clinical trial or as part of a prospective registry.
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            Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0.

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              Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations

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                Author and article information

                Contributors
                +372 53325812 , kaalep@gmail.com
                +31-(0)50-3613471 , r.boellaard@umcg.nl
                Journal
                Eur J Nucl Med Mol Imaging
                Eur. J. Nucl. Med. Mol. Imaging
                European Journal of Nuclear Medicine and Molecular Imaging
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1619-7070
                1619-7089
                2 March 2018
                2 March 2018
                2018
                : 45
                : 8
                : 1344-1361
                Affiliations
                [1 ]ISNI 0000 0004 0631 377X, GRID grid.454953.a, Department of Medical Technology, , North Estonia Medical Centre Foundation, ; J. Sutiste Str 19, 13419 Tallinn, Estonia
                [2 ]ISNI 0000 0001 1016 9625, GRID grid.9008.1, Department of Nuclear Medicine, , University of Szeged, ; Szeged, Hungary
                [3 ]ISNI 0000000110156808, GRID grid.488256.5, On behalf of EANM Research Limited (EARL), ; Vienna, Austria
                [4 ]ISNI 0000 0004 0398 8384, GRID grid.413532.2, Department of Medical Physics, , Catharina Hospital, ; Eindhoven, The Netherlands
                [5 ]ISNI 0000 0004 0435 165X, GRID grid.16872.3a, Department of Radiology and Nuclear Medicine, , VU University Medical Center, ; Amsterdam, The Netherlands
                [6 ]ISNI 0000 0004 0631 9063, GRID grid.416468.9, Department of Radiology, , Martini Hospital, ; Groningen, Netherlands
                [7 ]ISNI 0000 0001 2171 9311, GRID grid.21107.35, Russell H. Morgan Department of Radiology and Radiological Science, , Johns Hopkins University, ; Baltimore, MD 21287 USA
                [8 ]Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, Groningen, the Netherlands
                Author information
                http://orcid.org/0000-0002-5593-8886
                Article
                3977
                10.1007/s00259-018-3977-4
                5993859
                29500480
                4b852d01-23ac-41cb-9ad1-2827e6250e0a
                © The Author(s) 2018

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 26 July 2017
                : 12 February 2018
                Categories
                Original Article
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2018

                Radiology & Imaging
                performance,harmonisation,pet/ct,quantification,earl accreditation
                Radiology & Imaging
                performance, harmonisation, pet/ct, quantification, earl accreditation

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