DOI: 10.1007/s00259-017-3853-7Pages: 412-422

EANM/EARL FDG-PET/CT accreditation - summary results from the first 200 accredited imaging systems

1. North Estonia Medical Centre Foundation, Department of Medical Technology

2. University of Szeged, Department of Nuclear Medicine

3. On behalf of EANM Research Limited (EARL)

4. The Royal Marsden Hospital, The Institute of Cancer Research, Division of Radiotherapy and Imaging, Department of Nuclear Medicine

5. Rostock University Medical Center, Department of Nuclear Medicine

6. Humanitas Clinical and Research Center, Department of Nuclear Medicine

7. European Organisation for Research and Treatment of Cancer (EORTC) Headquarters

8. University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging

9. VU University Medical Center, Department of Radiology and Nuclear Medicine

Correspondence to:
Andres Kaalep
Tel: +372 53325812




From 2010 until July 2016, the EANM Research Ltd. (EARL) FDG-PET/CT accreditation program has collected over 2500 phantom datasets from approximately 200 systems and 150 imaging sites worldwide. The objective of this study is to report the findings and impact of the accreditation program on the participating PET/CT systems.


To obtain and maintain EARL accredited status, sites were required to complete and submit two phantom scans - calibration quality control (CalQC), using a uniform cylindrical phantom and image quality control (IQQC), using a NEMA NU2–2007 body phantom. Average volumetric SUV bias and SUV recovery coefficients (RC) were calculated and the data evaluated on the basis of quality control (QC) type, approval status, PET/CT system manufacturer and submission order.


SUV bias in 5% (n = 96) of all CalQC submissions (n = 1816) exceeded 10%. After corrective actions following EARL feedback, sites achieved 100% compliance within EARL specifications. 30% (n = 1381) of SUVmean and 23% (n = 1095) of SUVmax sphere recoveries from IQQC submissions failed to meet EARL accreditation criteria while after accreditation, failure rate decreased to 12% (n = 360) and 9% (n = 254), respectively. Most systems demonstrated longitudinal SUV bias reproducibility within ±5%, while RC values remained stable and generally within ±10% for the four largest and ±20% for the two smallest spheres.


Regardless of manufacturer or model, all investigated systems are able to comply with the EARL specifications. Within the EARL accreditation program, gross PET/CT calibration errors are successfully identified and longitudinal variability in PET/CT performances reduced. The program demonstrates that a harmonising accreditation procedure is feasible and achievable.

This article is freely available, click here to access the full text/PDF

  • Accepted: Oct 5, 2017
  • Online: Dec 1, 2017

Article Tools