Quality Assurance for PET and PET/CT Systems
Improvement in quality assurance (QA) in nuclear medicine and, in particular, in quality control (QC) of related equipment has for a long time been a major field of interest of the IAEA. Starting from the late 1970s, several publications were produced, including Quality Control of Nuclear Medicine Instruments (IAEA-TECDOC-317) in 1984, and the still widely used revision of this publication, IAEA-TECDOC-602, issued in 1991. Additional QC of single photon emission computed tomography (SPECT) systems has been addressed in the IAEA Quality Control Atlas for Scintillation Camera Systems, which provides a comprehensive set of sample SPECT artefacts.
Positron emission tomography (PET) scanners and related performance assessment and QC were not included in the previous publications, as PET has been mainly a research tool, with limited distribution until the 1990s. The tremendous role played at present by PET and PET/CT in oncology, as well as in cardiology and neurology, associated with the increasing use of PET for multiple purposes has prompted the need for updated guidelines specific to PET and PET/CT in terms of acceptance testing, as well as in terms of QC and QA.
This publication provides guidelines for the implementation of QA and QC programmes concerning the combined medical diagnostic modality of PET and CT technologies. The use of these independent, but complementary, imaging techniques is frequent and growing within the fields of diagnostic imaging, oncology, cardiology and neurology, where they allow physicians to locate and diagnose malignant diseases accurately. Specific topics of discussion include the frameworks for reference values, tolerances and action levels, minimal required configurations with corresponding performance characteristics, and the management of ancillary equipment.
Contents
- 1. INTRODUCTION
- 2. BASIC PET/CT TECHNOLOGY
- 3. CLINICAL APPLICATIONS OF PET/CT
- 4. QUALITY ASSURANCE IN PET/CT
- 5. ACCEPTANCE TEST PROCEDURES
- 5.1. PET acceptance testing
- 5.2. Computed tomography acceptance testing
- 5.2.1. Scattered radiation measurements and shielding verification
- 5.2.2. Computed tomography laser alignment
- 5.2.3. Tabletop alignment and positional accuracy, and scout scan accuracy
- 5.2.4. Visual inspection and programme review
- 5.2.5. Display profile and width
- 5.2.6. High contrast modulation
- 5.2.7. The kVp value and the half-value layer
- 5.2.8. Radiation doses, image noise and image uniformity
- 5.2.9. Computed tomography number and electron density accuracy
- 5.3. PET/CT acceptance testing
- 6. ROUTINE QUALITY CONTROL PROCEDURES
- 6.1. Quality control of PET
- 6.1.1. Daily PET detector stability test
- 6.1.2. Daily coincidence timing resolution tests in TOF PETs
- 6.1.3. Test of PET/CT scans in clinical mode
- 6.1.4. Uniformity of the reconstructed image
- 6.1.5. PET normalization 109
- 6.1.6. 2-D–3-D Radioactivity concentration calibration
- 6.1.7. Offset calibration for PET/CT
- 6.1.8. Routine image quality test for PET/CT
- 6.2. Quality control of CT equipment
- 6.3. Quality control for PET/CT
- 6.4. Considerations for mobile PET/CT facilities
- 6.1. Quality control of PET
- APPENDIX I: QUALITY CONTROL OF THE PET COMPONENT OF PET/CT
- APPENDIX II: QUALITY CONTROL OF THE CT COMPONENT OF PET/CT
- REFERENCES
- GLOSSARY
- CONTRIBUTORS TO DRAFTING AND REVIEW
