Revision History
It is recommended that the quality control (QC) testing be performed in accordance with the ACR Technical Standard for Medical Nuclear Physics Performance Monitoring of PET Imaging Equipment, as applicable. Data will continue to be collected regarding the QC tests performed by the facility. Based on these data, the ACR Committee on Nuclear Medicine Accreditation may establish QC requirements in the future. At this time, the ACR strongly recommends quarterly testing of each PET system with an appropriate ACR-approved phantom such as described below in addition to other tests recommended by the vendor. At a minimum, testing with the appropriate phantom must be performed semi-annually, but quarterly testing is strongly recommended.
Acceptance Tests
Initial performance testing of imaging equipment must be performed upon installation and should be completed before clinical use. This testing should be more comprehensive than periodic performance testing and shall be consistent with current acceptance testing practice.
Annual Physics Survey
All tests noted in the PET Equipment Evaluation Summary Form and QC Review (attached below in both pdf and excel formats) must be performed and the form uploaded in the accreditation testing packet.
A physics survey must be performed on each PET unit at least annually. The ACR realizes that surveys cannot usually be scheduled exactly on the anniversary date of the previous survey; therefore, a period of up to 14 months between surveys is acceptable. A qualified medical physicist (QMP) may perform the testing. Alternatively, testing may be performed by a qualified PET technologist or medical physicist in training approved by the QMP. The test results must be reviewed by the QMP and documented in the annual medical physicist survey report. As a part of the annual survey, the QMP should meet with the supervising physician and the QC technologist to review the results of the survey and the effectiveness of the technologist QC program, and to recommend any corrective action or repairs that are needed. The supervising physician is responsible for assuring compliance with the recommendations of the medical physicist.
The annual physics survey must include the following:
| PET Performance Tests | |
| Test | Description |
| Spatial Resolution | Performed to ensure that the detector resolution is sufficient to provide satisfactory detection of lesions and delineate detail in clinical images. |
| Count Rate Performance (optional) | Performed to evaluate scanner performance at high count rates. |
| Sensitivity | Performed to measure the number of counts per second per unit activity. |
| Image Uniformity (Tested along the full axial extent of the scanner) | Performed to assess the uniformity of the activity concentration within a slice, as well as across slices of a uniform phantom. |
| Image Quality Phantom | Performed to verify the PET systems provide satisfactory uniformity, contrast and spatial resolution. |
| Accuracy of CT number (not required for PET/MR systems) | Performed to assess CT artifacts as well as the accuracy of the CT numbers. |
| Accuracy of standard uptake value (SUV) measurement | Performed to verify accurate quantification. |
| Image Co-registration | Performed to ensure registration of PET and CT or MRI image sets. |
| Processing Monitor | Performed to ensure that systems used to produce hard copy and monitors that are used for processing of clinical studies provide satisfactory image quality. |
| Safety Evaluation | Performed to ensure that the mechanical and electrical systems are working correctly and safely. |
| Dose Calibrators | Performed to verify that readings from this instrument are accurate. All basic measurements of performance must be done at the time of installation and repeated after major repair. This test must be done according to protocols accepted by the appropriate state regulatory agencies or the NRC.
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Continuous Quality Control
The PET technologist is responsible for verifying day-to-day operation of instruments and performing a few additional tests on a quarterly basis. These requirements represent the standard of practice and are in compliance with requirements and recommendations of The Joint Commission (TJC) and state and federal agencies. Documentation of compliance with all quality control tests and corrective action is required as part of the application process.
| PET Technologist's Quality Control Tests | ||
| Test | Description | Frequency |
| Daily PET Detector Check | Per manufacturer recommendations | Each day of use |
| Daily CT Check (if applicable) | Per manufacturer recommendations | Each day of use |
| PET Phantom Testing | Testing of each PET system with the appropriate ACR-approved phantom | Semi-annually (quarterly testing is strongly recommended) |
| Dose Calibrators | Constancy test | Daily |
Preventive Maintenance
Preventive maintenance must be scheduled, performed, and documented by a qualified service engineer on a regular basis. Service performed to correct system deficiencies must also be documented and service records maintained by the facility.
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