[Intl_DxMedPhys] ACR PET QC Manual Discrepancy

[Dylan DeAngelis]

Good morning,

I saw an email chain from earlier this month describing a discrepancy between NM QC manual and ACR website for image submission. In reviewing the new PET manual, my colleagues and I found a similar mismatch, and I'm wondering how others interpret this...

On the ACR webpage that details phantom testing, https://urldefense.com/v3/__https://accreditationsupport.acr.org/support/solutions/articles/11000062800-phantom-testing-pet-revised-10-23-2025-__;!!KGKeukY!2B_SaoLiOmxgkrD2pZiXsX8iWJdmjJorE3R8OPYw-gqgZ8632rWlWt6zchEzI-9QoTyEOHVYxzeTCD0ZJAvwFzeuBp3uUNANbdIgtmr4ayGW$ , you are instructed to take your background SUV mean value from the "best 1 cm central slice (around the mid-point of the vials) of the hot cylinders...".

But in the SUV Accuracy test as outlined in the QC manual (starting on page 45), you are told to average three background values from three consecutive slices in the uniform section of the phantom. And this picture accompanies those instructions:

[cid:image001.png at 01DC6450.C3528A40]

I get the argument that the QC manual is for routine testing (acceptance, annual, etc.), while the webpage is showing what's needed for ACR submissions, but isn't it odd that we would evaluate the same parameter (background mean SUV) differently depending on whether it's an ACR survey versus annual?

There's also this text on page 47 of the manual: "For the purpose of accreditation submission, the ACR defines the acceptable background SUVmean range in the Program Requirements but for the purpose of the physicist's annual performance evaluation, background SUVmean should be between 0.95 and 1.05 (i.e. +/- 5%)." Is this an acknowledgment of the discrepancy?

What do others think?

Dylan DeAngelis, MS, DABR
NYS Licensed Medical Physicist
(Diagnostic Radiological Physics and Medical Nuclear Physics)

Upstate Medical Physics - Diagnostic Radiology, Medical Nuclear & Medical Health Physics, P.C.
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