Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, 41009 Seville, Spain.
Instituto de Biomedicina de Sevilla, IBiS, 41013 Seville, Spain.
Tomography. 2022 Apr 12;8(2):1097-1112. doi: 10.3390/tomography8020090.
The purpose of this work is to present useful recommendations for the use of [F]FDG-PET/CT imaging in radiotherapy planning and monitoring under different versions of EARL accreditation for harmonization of PET devices. A proof-of-concept experiment designed on an anthropomorphic phantom was carried out to establish the most suitable interpolation methods of the PET images in the different steps of the planning procedure. Based on PET/CT images obtained by using these optimal interpolations for the old EARL accreditation (EARL1) and for the new one (EARL2), the treatment plannings of representative actual clinical cases were calculated, and the clinical implications of the resulting differences were analyzed. As expected, EARL2 provided smaller volumes with higher resolution than EARL1. The increase in the size of the reconstructed volumes with EARL1 accreditation caused high doses in the organs at risk and in the regions adjacent to the target volumes. EARL2 accreditation allowed an improvement in the accuracy of the PET imaging precision, allowing more personalized radiotherapy. This work provides recommendations for those centers that intend to benefit from the new accreditation, EARL2, and can help build confidence of those that must continue working under the EARL1 accreditation.
本工作旨在为不同版本的 EARL 认证（用于协调 PET 设备）下的放疗计划和监测中使用 [F]FDG-PET/CT 成像提供有用的建议。设计了一个基于人体模型的验证实验，以确定在计划过程的不同步骤中最适合的 PET 图像插值方法。基于使用这些最佳内插方法获得的针对旧 EARL 认证（EARL1）和新 EARL 认证（EARL2）的 PET/CT 图像，计算了有代表性的实际临床病例的治疗计划，并分析了由此产生的差异的临床意义。正如预期的那样，EARL2 提供的分辨率比 EARL1 更高，体积更小。EARL1 认证的重建体积增大导致靶区周围和危险器官的高剂量。EARL2 认证提高了 PET 成像精度的准确性，允许进行更个性化的放疗。本工作为那些希望受益于新认证 EARL2 的中心提供了建议，并有助于建立那些必须继续在 EARL1 认证下工作的中心的信心。
