title: Digital PET compliance to EARL accreditation specifications.
abstract: BACKGROUND
  Our aim was to evaluate if a recently introduced TOF PET system with digital photon counting technology (Philips Healthcare), potentially providing an improved image quality over analogue systems, can fulfil EANM research Ltd (EARL) accreditation specifications for tumour imaging with FDG-PET/CT.
  
  
  RESULTS
  We have performed a phantom study on a digital TOF PET system using a NEMA NU2-2001 image quality phantom with six fillable spheres. Phantom preparation and PET/CT acquisition were performed according to the European Association of Nuclear Medicine (EANM) guidelines. We made list-mode ordered-subsets expectation maximization (OSEM) TOF PET reconstructions, with default settings, three voxel sizes (4 × 4 × 4 mm3, 2 × 2 × 2 mm3and 1 × 1 × 1 mm3) and with/without point spread function (PSF) modelling. On each PET dataset, mean and maximum activity concentration recovery coefficients (RCmeanand RCmax) were calculated for all phantom spheres and compared to EARL accreditation specifications. The RCs of the 4 × 4 × 4 mm3voxel dataset without PSF modelling proved closest to EARL specifications. Next, we added a Gaussian post-smoothing filter with varying kernel widths of 1-7 mm. EARL specifications were fulfilled when using kernel widths of 2 to 4 mm.
  
  
  CONCLUSIONS
  TOF PET using digital photon counting technology fulfils EARL accreditation specifications for FDG-PET/CT tumour imaging when using an OSEM reconstruction with 4 × 4 × 4 mm3voxels, no PSF modelling and including a Gaussian post-smoothing filter of 2 to 4 mm.
authors.affiliation: Department of Nuclear Medicine, Isala Hospital, Zwolle, the Netherlands. d.koopman@isala.nl.|MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands. d.koopman@isala.nl.
authors.forename: Daniëlle
authors.identifier: http://orcid.org/0000-0002-8976-5434
authors.initials: D
authors.lastname: Koopman
authors.affiliation: Department of Nuclear Medicine, Isala Hospital, Zwolle, the Netherlands.|MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands.
authors.forename: Maureen
authors.initials: M
authors.lastname: Groot Koerkamp
authors.affiliation: Department of Nuclear Medicine, Isala Hospital, Zwolle, the Netherlands.
authors.forename: Pieter L
authors.initials: PL
authors.lastname: Jager
authors.affiliation: Department of Nuclear Medicine, Isala Hospital, Zwolle, the Netherlands.
authors.forename: Hester
authors.initials: H
authors.lastname: Arkies
authors.affiliation: Department of Nuclear Medicine, Isala Hospital, Zwolle, the Netherlands.
authors.forename: Siert
authors.initials: S
authors.lastname: Knollema
authors.affiliation: MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands.
authors.forename: Cornelis H
authors.initials: CH
authors.lastname: Slump
authors.affiliation: Health Systems, Philips Benelux, Eindhoven, the Netherlands.
authors.forename: Pedro G
authors.initials: PG
authors.lastname: Sanches
authors.affiliation: Department of Medical Physics, Isala Hospital, Zwolle, the Netherlands.
authors.forename: Jorn A
authors.initials: JA
authors.lastname: van Dalen
keywords: Digital PET; EANM guidelines; EARL accreditation; FDG-PET; Tumour imaging