The sensitivity of radiomic features to several confounding factors, such as reconstruction settings, makes clinical use challenging. To investigate the impact of harmonized image reconstructions on feature consistency, a multicenter phantom study was performed using 3-dimensionally printed phantom inserts reflecting realistic tumor shapes and heterogeneity uptakes. Methods: Tumors extracted from real PET/CT scans of patients with non–small cell lung cancer served as model for three 3-dimensionally printed inserts. Different heterogeneity pattern were realized by printing separate compartments that could be filled with different activity solutions. The inserts were placed in the National Electrical Manufacturers Association image-quality phantom and scanned various times. First, a list-mode scan was acquired and 5 statistically equal replicates were reconstructed. Second, the phantom was scanned 4 times on the same scanner. Third, the phantom was scanned on 6 PET/CT systems. All images were reconstructed using EANM Research Ltd. (EARL)–compliant and locally clinically preferred reconstructions. EARL-compliant reconstructions were performed without (EARL1) or with (EARL2) point-spread function. Images were analyzed with and without resampling to 2-mm cubic voxels. Images were discretized with a fixed bin width (FBW) of 0.25 and a fixed bin number (FBN) of 64. The intraclass correlation coefficient (ICC) of each scan setup was calculated and compared across reconstruction settings. An ICC above 0.75 was regarded as high. Results: The percentage of features yielding a high ICC was largest for the statistically equal replicates (70%–91% for FBN; 90%–96% for FBW discretization). For scans acquired on the same system, the percentage decreased, but most features still resulted in a high ICC (FBN, 52%–63%; FBW, 75%–85%). The percentage of features yielding a high ICC decreased more in the multicenter setting. In this case, the percentage of features yielding a high ICC was larger for images reconstructed with EARL-compliant reconstructions: for example, 40% for EARL1 and 60% for EARL2 versus 21% for the clinically preferred setting for FBW discretization. When discretized with FBW and resampled to isotropic voxels, this benefit was more pronounced. Conclusion: EARL-compliant reconstructions harmonize a wide range of radiomic features. FBW discretization and a sampling to isotropic voxels enhances the benefits of EARL-compliant reconstructions.

放射学特征对多种混杂因素（如重建环境）的敏感性使临床应用面临挑战。为了研究统一图像重建对特征一致性的影响，使用反映了实际肿瘤形状和异质性摄取的三维打印幻像插入物进行了多中心幻像研究。方法：从非小细胞肺癌患者的真实PET / CT扫描中提取的肿瘤作为三个3D打印插图的模型。通过打印可以填充不同活性溶液的单独隔室，可以实现不同的异质性模式。将插入物放置在美国国家电气制造商协会的图像质量幻像中，并进行了多次扫描。首先，获取列表模式扫描，并重建5个统计学上相等的重复样本。其次，幻像在同一扫描仪上扫描了4次。第三，在6个PET / CT系统上扫描了体模。所有图像均使用符合EANM Research Ltd.（EARL）的和当地临床偏爱的重建方法重建。在没有（EARL1）或没有（EARL2）点扩展功能的情况下执行了符合EARL的重建。在有和没有重采样到2毫米立方体素的情况下分析图像。图像以0.25的固定bin宽度（FBW）和64的固定bin数量（FBN）离散化。计算每个扫描设置的类内相关系数（ICC），并在重建设置之间进行比较。高于0.75的ICC被认为是很高的。结果：在统计学上相等的重复样本中，产生高ICC的特征百分比最大（FBN离散度为70％–91％； FBW离散度为90％–96％）。对于在同一系统上进行的扫描，百分比降低了，但是大多数功能仍导致较高的ICC（FBN，52％–63％； FBW，75％–85％）。在多中心设置中，产生较高ICC的特征百分比进一步降低。在这种情况下，对于使用EARL兼容重建方法重建的图像，产生高ICC的特征百分比更大：例如，EARL1为40％，EARL2为60％，而FBW离散化的临床首选设置为21％。当用FBW离散化并重新采样为各向同性体素时，这种好处更加明显。结论：符合EARL标准的重建技术可以协调广泛的放射学特征。FBW离散化和各向同性体素采样增强了EARL兼容重建的好处。