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The idea of harmonization of the image acquisition and analysis approach to establish intersite compatibility for multicentre trials based on initial phantom studies has been explored in the literature (for example [ 14, 15]).
Although SUVmean may be used for harmonization because of being unsusceptible to image noise, it never reached the uptake value of 4 even for the largest sphere (37 mm) due to partial volume effect.
Fig. 5 Impact of the EARL harmonization strategy on Dice and concordance indices between MATVs extracted from OSEM images and PSF images (observer 1).
Impact of the EARL harmonization strategy on Dice and concordance indices between MATVs extracted from OSEM images and PSF images (observer 2).
Whereas harmonization of manually segmented hippocampus is in progress [ 17], automated image analysis software (NeuroQuant; CorTechs Labs Inc., San Diego, CA, USA) was recently approved as a medical device to provide an aid in dementia diagnosis [ 18].
While many sources of error in SUV measurements are overcome by complying with the EANM guidelines for PET tumour imaging [17 19], reconstruction-dependent variations require either the use of an additional filtering step [20] or the generation of two sets of images: one to provide optimal diagnostic quality and another to meet quantitative harmonization standards [21].
A code book (harmonization guidelines) was made explaining how the variables were harmonized (see additional file 1: Harmonization guidelines).
Although studies so far have shown clinical promise, there are still technical considerations to contemplate, particularly the effect of image acquisition, image quality, texture methods and software platforms on parameter values, the need for harmonization of acquisitions, and a standardized analysis approach for clinical application [5, 12, 32, 53, 54, 55, 56].
So we need to make the harmonization of the denoising uncertainty among the classes of the noise-free component of the acquired image.
Although it's early days yet and the new rules aren't old enough to draw any conclusions, "simplified procedures will certainly improve Europe's image and standing as a more welcoming research area and friendly environment for researchers outside Europe," says Shen. "Harmonization would definitely help the mobility of non-E.U.
Since SUV is susceptible to spatial resolution and image noise, reconstruction conditions should be properly adjusted for each camera to provide reliable and robust SUVs in terms of the harmonization of SPECT/CT quantitation.
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