ABSTRACT

The first part of the chapter provides an introduction on the implementation of quality-assurance programmes in nuclear medicine (NM) services. It is argued that participation in interlaboratory comparisons has two main benefits. First, on top of existing local quality-assurance programmes, participation can add a level of reassurance on quality. Second, interlaboratory comparisons are prerequisite for clinical multicentre trials. The success of an interlaboratory comparison depends on many parameters, this chapter will discuss financing, selection, and procurement of the quality-control devices and selection of participants. The discussion on the execution and evaluation of a multicentre study is followed by the presentation of potential problems and recommendations on how to avoid them. The chapter discusses the most widely known interlaboratory quality-assurance programmes, including the EANM/EARL 18-F FDG PET/CT accreditation programme and the DAT-Scan SPECT standardization programme. In the second part, examples of multicentre studies, based on Monte-Carlo simulated scintillation camera imaging and a computer phantom, with the aims of investigating how different clinical sites perform evaluation using the routine. These studies started in Sweden 2012 and have included renography, bone scintigraphy, lung scintigraphy, and myocardial studies. The camera- and acquisition parameters for each site were considered, and images were distributed by Dicom files to be read in and processed as they were coming from the site’s own camera. The outcome from the evaluation was then compared to the truth (i.e., the known disease, abnormality, change in function) as defined by the activity distribution in the computer phantom.