Intrinsic Flood-Field Uniformity Evaluation

Erick Mora-Ramireza*
a
Nuclear Medicine Department, San Juan de Dios Hospital, San José, Costa Rica.

Abstract. The quality assurance program in a Nuclear Medicine Department pretends to minimize errors and
artifacts that cover all aspects of clinical practice. The intrinsic flood-field uniformity is one of the quality
control procedures to evaluate the response of a gamma camera to a spatially uniform flux of an incident gamma
radiation over the field of view. The purpose of this study is to test our gamma cameras, by recording the
obtained results of the integral and differential uniformity in order to generate a data base which is going to be
our reference benchmark to evaluate the performance of the systems in the future. At the beginning we
performed an evaluation of our acquisition protocol which implies the variation of the acquired counts, the
energy window width and its placement. After that, we analyzed the recording data, creating plots which show
the performance of the systems. As a result using an energy window placed at 140 keV at 20%, with matrix size
of 512 x 512, acquiring 15 million counts and the source activity close to 700 µC; we obtained good images and
both uniformities are within the manufacture’s requirements, however, increasing the number of acquired counts,
images are much better and an improvement in the evaluated parameters can be seen. The performance
evaluation, of the three gamma cameras, was taken into account for approximately 240 days, showing an integral
uniformity range of 1.04 – 3.5 % and the range for differential uniformity varies from 0.88 up to 2.7 %. We
conclude that the gamma cameras were working well, we do not need to vary our acquisition protocol because it
is good to evaluate these figures; also other factors affecting the quality of the images are radioactive waste
material not very well shielded and temperature room variations, especially at the beginning of our workday .

KEYWORDS: Intrinsic uniformity; quality control; gamma camera; integral uniformity, differential
uniformity.

1. Introduction

The nuclear medicine is a diagnostic technique based on the introduction of radio-isotopes into the
human body; these radioactive materials are bind to pharmaceutical products which are specific of the
studied target organ, which means, that when the introduction of these radio-pharmaceutical products
occurs, the physiological behaviour of the organs can be studied [1]. The equipment to carry on these
studies is known as, in the planar studies cases, the Gamma Camera (GC) [2] and in the tomography
study cases is known as Single Photon Emission Computed Tomography (SPECT) [3].

The most used radioactive material is 99mTc, which has a half life (t1/2) of 6.02 hours, a gamma energy
emission (E) of 140 keV [4]. Other radio-isotopes are 131I (t1/2 = 8 days, E = 284 keV, 364 keV, 637 keV,
723 keV) [5] and 67Ga (t1/2 = 8 days, E = 93 keV, 185 keV, 300 keV) [4, 6].

The Nuclear Medicine Department at the San Juan de Dios Hospital (NMD-SJDH) receives patients
from the whole country, including paediatric, adults and elderly patients. Therefore, a quality assurance
program has been established in order to assure the trust on the acquired images, either to the physicians
or the technology staff.

In this quality assurance program to many quality control tests are performed. One of these tests is the
evaluation of the Intrinsic Uniformity [3], which is carried on every morning; therefore, the evaluation
of this parameter can tell if the GC can be used or, if the GC is presenting an electronic or mechanical
trouble (moreover, degradation of images can take place).

The intrinsic uniformity is been tested without using collimators; this test is performed only by the
technology staff from the NMD-SJDH with training (experience) in this area. When the evaluation takes
place the system itself is more sensitive, because the crystal can detect surrounding radioactive

*
Presenting author, E-mail: emoravia@yahoo.com / erick.mora.ramirez@gmail.com

1
materials; therefore, if the spills occurs nearby, the test can be affected degrading the evaluation results
and also the crystal can be contaminated if any spill of radioactive material occurs.

The test evaluates two parameters, the integral and the differential uniformity. The integral uniformity is
based on the maximum and minimum pixel count in the image and can be expressed using the following
equation [4]:
Pixel max − Pixel min
I .U . % = *100 (1)
Pixel max + Pixel min

Where Pixel max is taking into account the maximum pixel count and Pixel min takes into account the
minimum pixel count within the image.

On the other hand the differential uniformity is based on the maximum counts difference for any five
consecutive pixels across all rows and columns of the image; mathematically can be expressed as
follows [4]:
Pixel high − Pixellow
D.U . % = *100 (2)
Pixel high + Pixellow

Where Pixel high refers to the maximum count difference for any five consecutive pixels (row or
column) in the image and Pixel min refers to the minimum count difference for any five consecutive
pixels (row or column) in the image.

Both parameters are evaluated within the Centre Field of View (CFOV) and the Useful Field of View
(UFOV). The CFOV has linear dimensions scaled by 75% with respect to the dimensions of the
UFOV [4].

The purpose of this study is to test our gamma cameras by recording the obtained results of the
integral and differential uniformity in order to generate a data base which is going to be our reference
benchmark to evaluate the performance of the systems in the future.

2. Materials and methodology

The evaluation took place using ADAC gamma cameras, models VERTEX, GENESYS and
THYRUS. The first two are SPECT systems, the first one has two detectors and the other has one; in
these two systems when the acquisition is done, a qualitative evaluation is initially performed, just by
looking at the images, afterwards from same recorded image a quantitative evaluation happens using
manufacture’s software. The THYRUS system is a planar gamma camera mainly used for small
organs, for instance thyroids, and here two images need to be generated, one for the quantitative
evaluation and the other for the qualitative one. The study was carried on using 2007 data.

2.1 Evaluation of the intrinsic uniformity varying acquisition parameters of one gamma camera

This part of the study was performed using the GENESYS gamma camera. The acquisition protocol
normally used place an energy window width of 20 %, centred at 140 keV, using a matrix size of 512
x 512 x 16, acquiring 15 million counts. The last parameter was changed acquiring images of 30 and
10 million counts. Afterwards, the energy window was changed from 20 % to 10% and 15%; finally,
the energy window placement was moved from 140 keV to 115 keV keeping the energy window width
in 20%, which means that the energy window was moved to the left of the photo-peak [7], this last test
was taking into account in order to evaluate the degradation of the images due to the incorporation of
scatter photons into the acquiring energy window. Moving the energy window to the right side of the
photo-peak was not considered because primary photons are very difficult to collect.

2.2 Evaluation of the intrinsic uniformity of three gamma cameras

2
Every morning before the journey begins, acquisition of images take place to evaluate the intrinsic
uniformity. When this test is carried on using the VERTEX and GENESYS gamma cameras, the
chosen protocol is, an energy window width of 20%, centred at 140 keV, matrix size of 512 x 512 x
16, acquiring 15 million counts and using a point source place at five field of view opposite to the
gamma camera face, with an activity ~ 700 µCi.

The THYRUS model has a maintenance menu based on the National Electrical Manufactures
Association (NEMA) [8] test. When the test is chosen from this menu, the system automatically
acquires 8 million counts, using an energy window width of 20%, centred a 140 keV, using a matrix
size of 256 x 256, for a point source place at two meters opposite to the gamma camera face, with an
activity ~ 300 µCi, generating a count rate between ten to twenty thousand counts per second [9];
therefore, a quantitative image is evaluated. On the other hand, using the same protocol but acquiring
2 million counts instead of 8 million, the qualitative evaluation occurs.

3. Results

3.1 Evaluation of the intrinsic uniformity varying acquisition parameters of one gamma camera

Table 1 shows results from the variation of the acquisition parameters. The variation of the acquired
counts was done in order to see the variation results either in the integral and in the differential
uniformity, the GENESYS software generate in the differential uniformity case, results for columns
and rows of the generated digital image, when this variation took place those figures were similar for
columns and rows. It can be notice that, increasing the number of acquired counts, implies that the
acquisition time also increases; this occurs because the count rate does not vary for the same activity
source.

Table 1: Intrinsic uniformity results from the variation of acquisition parameters.

Acquired Energy Acquisition Count Uniformity

Counts window width time rate Integral (%) Differential (%)
(millon) and position (seconds) (kcts) UFOV CFOV UFOV CFOV
10 140 keV, 20% 280 35600 2.56 2.13 1.43 1.3
15 140 keV, 20% 428 37720 2.28 1.86 1.36 1.19
30 140 keV, 20% 816 37000 2.12 1.95 1.23 1.23
15 140 keV, 10% 539 27120 2.42 2.42 1.52 1.52
15 140 keV, 15% 447 35520 2.12 2.12 1.46 1.42
10 115 keV, 20% 962 9960 7.5 6.62 4.38 4.38

If the acquired counts are increased means more gamma camera time in order to do the test, this is a
disadvantage, because the quality control test must be done using minimum time as possible obtaining
an image of good quality to be tested.

Another important point is that when the number of counts increase both uniformities come out better,
specially with the UFOV; however, the CFOV results do not get any better, this effect may be related
with the statistics at the photo-multipliers tubes level.

When the variation of the energy window width occurs, reducing it at 10% [3], (one needs to keep in
mind that our calibration was at 140 keV, with an energy window of 20%) more primary photons are
taking into account rather than scatter photons; therefore, in terms of number of counts, the acquisition
time increases because less photons can not be taken into account; moreover, the uniformity results do
not tend to get better. This may occur because the system calibration is under different conditions.
Similar results are obtained when the system is set at 140 keV with an energy window at 15%. When
the system is set at 115 keV with an energy window at 20%, uniformity values get worst because the

3
presence of scatter photons is even more; so, under Zanzonico [10] point of view the uniformity
correction table should be updated, because our results are above 5%.

Therefore, we conclude that our protocol is the appropriate to carry on the uniformity test, because
when considering the obtained results the uniformity figures are within the reported values.

3.2 Evaluation of the intrinsic uniformity of three gamma cameras

From tables 2 to 5 intrinsic uniformity results can be seen for integral and differential uniformity
considering these three gamma cameras. The integral uniformity results for CFOV and UFOV are
between the reported values 2-4% [4, 10]. Moreover, looking the results, the range varies between
1.04 and 3.5%; therefore, our systems were generating satisfactory findings.

Table 2: Intrinsic uniformity results of the GENESYS Gamma Camera.

Differential Uniformity
Integral Uniformity
Parameter Row Columns
CFOV UFOV CFOV UFOV CFOV UFOV
Average 2.04 2.26 1.4 1.49 1.43 1.5
Standard
0.25 0.27 0.17 0.2 0.19 0.18
Deviation
Range 1.12 / 3.17 1.67 / 3.39 1.03 / 2 1.06 / 2.27 1 / 2.05 1.13 / 2.05

Table 3: Intrinsic uniformity results of the VERTEX (Detector 1) Gamma Camera.

Differential Uniformity
Integral Uniformity
Parameter Row Columns
CFOV UFOV CFOV UFOV CFOV UFOV
Average 2.01 2.13 1.36 1.41 1.37 1.41
Standard
0.26 0.28 0.16 0.15 0.16 0.15
Deviation
Range 1.49 / 3.14 1.55 / 3.07 1.03 / 1.87 1.12 / 1.89 1.06 / 1.86 1.12 / 1.86

Table 4: Intrinsic uniformity results of the VERTEX (Detector 2) Gamma Camera.

Differential Uniformity
Integral Uniformity
Parameter Row Columns
CFOV UFOV CFOV UFOV CFOV UFOV
Average 2.13 2.28 1.55 1.64 1.47 1.62
Standard
0.28 0.29 0.22 0.22 0.23 0.26
Deviation
Range 1.51 / 3.43 1.57 / 3.5 0.98 / 2.25 1.13 / 2.34 1.05 / 2.47 1.12 / 2.7

Table 5: Intrinsic uniformity results of the THYRUS Gamma Camera.

Integral Uniformity Differential Uniformity

Parameter
CFOV UFOV CFOV UFOV
Average 1.84 1.91 1.32 1.35
Standard
0.42 0.47 0.25 0.26
Deviation
Range 1.12 / 3.47 1.04 / 3.39 0.88 / 2.27 0.84 / 2.34

4
In figures 1 to 4, the integral uniformity results for each detector of our systems, considering the
CFOV and UFOV, can be seen. The plots were generating taking into account the outcomes of every
day evaluation.

Figures 1, 2, and 3, show no great scatter data around the y axis. This means that every day the
systems were generating satisfactory results. However, some points are above the 2.5%, this happens
when the air conditioning systems were broken, so the temperature in the room raised; therefore, the
internal temperature of each head detector (the electronic component) increased as well; thus, we
considered in the GENESYS and VERTEX models that room temperature is a key factor because it
can degrade the quality of the images, so the obtained values can increase until 3.5%. We have to
mention that these two models have more than ten years working in our department.

Figure 1: Integral uniformity variation within the CFOV and UFOV for GENESYS gamma camera.

3.5 CFOV Int. Unif.

UFOV Int. Unif.
Average-CFOV Int. Unif.
Average-UFOV Int. Unif.
3
Uniformity Values

2.5

1.5

1
0 50 100 150 200
Time (days)

In the case of the THYRUS model, and looking figure 4, when the plot start, a similar behaviour can
be seen in comparison to the previous three figures, until day 192. After this day, an increment in the
outcomes values occurs and later the values decrease, this may happen considering the next aspects: a)
staff in charge of carrying on this test did not check for another radiation source within the room
where the camera is placed; this means an increment in the scatter photons reaching the crystal face, so
the degradation of the results occurs, b) the point source was not with the appropriate activity to carry
on the test, because the equipment could lost information related to the dead time, associate to the
detection of photons by the photo-multipliers tubes (if the source has more than 400 µCi). Here no
association with air conditioning failure can be related, because in this room another systems is
working and is very stable.

In the differential uniformity case, looking the tables, the values are vary from 0.88 up to 2.7%, and
we have to remember that this parameter evaluates local variations in the image; so it comes more
important than the integral uniformity, because this local variations can raise great trouble in
tomographic studies, where the generating artefacts are considerable. For instance, the bull´s eye [10,
11, 12]. We have to notice that figures never increase more than 3% for the three gamma cameras; so
the results were satisfactory for all of them. The VERTEX model is the most used in SPECT studies
and no artefacts related to uniformity failure have been seen.

Figures 5 to 7 consider results for CFOV of the GENESYS and VERTEX models, taking into account
the columns and rows of the generated images; these figures show no great scatter around the y axis,
moreover data never reach the 2.5%. This means that every day the systems were generating

5
satisfactory results. Figure 8 shows similar results as we previously mentioned for figure 4, both of
them are referring to the same equipment.

Figure 2: Integral uniformity variation within the CFOV and UFOV for VERTEX (Detector 1)
gamma camera

CFOV Int. Unif.

3.5 UFOV Int. Unif.
Average-CFOV Int. Unif.
Average-UFOV Int. Unif.
3
Uniformity Values

2.5

1.5

1
0 50 100 150 200
Time (days)

Figure 3: Integral uniformity variation within the CFOV and UFOV for VERTEX (Detector 2)
gamma camera

3.5 CFOV Int. Unif.

UFOV Int. Unif.
Average-CFOV Int. Unif.
Average-UFOV Int. Unif.
3
Uniformity Values

2.5

1.5

1
0 50 100 150 200
Time (days)

6
Figure 4: Integral uniformity variation within the CFOV and UFOV for THYRUS gamma camera

CFOV Int. Unif.

3.3 UFOV Int. Unif.
Average-CFOV Int. Unif.
3 Average-UFOV Int. Unif.

2.7
Uniformity Values

2.4

2.1

1.8

1.5

1.2

0.9
32 52 72 92 112 132 152 172 192 212 232
Time (days)

Figure 5: Differential uniformity variation within the CFOV for GENESYS gamma camera

CFOV Diff. Unif. Col.

CFOV Diff. Unif. Row
2.2 Average-CFOV Diff. Unif. Col.
Average-CFOV Diff. Unif. Row

1.9
Uniformity Values

1.6

1.3

1
0 50 100 150 200
Time (days)

7
Figure 6: Differential uniformity variation within the CFOV for VERTEX (Detector 1) gamma
camera

2.2
CFOV Diff. Unif. Col.
CFOV Diff. Unif. Row
Average-CFOV Diff. Unif. Col.
Average-CFOV Diff. Unif. Row

1.9
Uniformity Values

1.6

1.3

1
0 50 100 150 200
Time (days)

Figure 7: Differential uniformity variation within the CFOV for VERTEX (Detector 2) gamma
camera.

CFOV Diff. Unif. Col.

2.2 CFOV Diff. Unif. Row
Average-CFOV Diff. Unif. Col.
Average-CFOV Diff. Unif. Row

1.9
Uniformity Values

1.6

1.3

1
0 50 100 150 200
Time (days)

8
Figure 8: Differential uniformity variation within the CFOV and UFOV for THYRUS gamma Camera

CFOV Diff. Unif.

2.35 UFOV Diff. Unif.
Average-CFOV Diff. Unif.
Average-UFOV Diff. Unif.

2.05
Uniformity Values

1.75

1.45

1.15

0.85
32 82 132 182 232
Time (days)

4. Conclusion

We conclude that the gamma cameras were working well, we do not need to vary our acquisition
protocol because it is good for the evaluation of these figures; also other factors affecting the quality
of the images are radioactive waste material not very well shielded and temperature room variations,
especially at the beginning of our workday. On the other hand, we have to develop a data base which
is going to help us to evaluate the behavior of each detector along the time. This is really important
for us because we can identify aspects which can degrade the images.

Acknowledgements

The author wish to thank his workmates from the Nuclear Medicine Department at the San Juan de
Dios Hospital, for their collaboration performing this quality control test; to the Heads of the
Department and to the “Comité Local de Bio-ética en Investigación (CLOBI)” from the Hospital for
allowing me to develop this paper this paper.

REFERENCES

[1] EARLY, J.E.; SODEE, D.B., Principles and Practice of Nuclear Medicine, Mosby, Missouri,
USA, pp. 251 (1995).
[2] SHARP, P. F.; GEMMELL, H. G.; MURRAY, A. D., Practical Nuclear Medicine, 3rd
Edition, Springer, London, England, pp. 49 (2005).
[3] HINES, H.; KAYAYAN, R.; COLSHER, J.; HASHIMOTO, D.; SCHUBERT, R.,
FERNANDO, J.; SIMCIC, V.; VERNON, P.; SINCLAIR, R. L., Recommendations for
implementing SPECT instrumentation and quality control, European Journal of Nuclear
Medicine, 26, 527-532 (1999).
[4] CHERRY, S.M; SORENSON, J. A.; PHELPS, M. E., Physics in Nuclear Medicine, Saunders,
Philadelphia, USA, pp. 227 (2003).
[5] DEWARAJA, Y.K.; LJUNGBERG, M.; KORAL, K. F., Characterization of Scatter and
Penetrating Using Monte Carlo Simulation in 131I Imaging, Journal of Nuclear Medicine, 41,
123-130 (2000).

9
[6] TOCHAROENCHAI, C.; TSUI, B.M.W.; LEWIS, D.P.; FREY E.C.; ZHAO, X.,
Compensation of the Response Function of Medium Energy Collimator in 67Ga and SPECT
Imaging, Nuclear Medicine Symposium, Conference Record, IEEE, Vol. 3, 1405-1408 (1998).
[7] ICHIHARA, T.; OGAWA, K.; MOTOMURA, N.; KUBO, A.; HASHIMOTO, S., Compton
Scatter Compensation Using the Triple-Energy Window Method for Single- and Dual-Isotope
SPECT, Journal of Nuclear Medicine, 34, 2216-2221 (1993).
[8] NATIONAL ELECTRICAL MANUFACTURERS ASSOCIATION, Performance
Measurements of Scintillator Gamma Cameras, Standards Publication No. UN-1-2001,
Washington DC (2001).
[9] ADAC, Thyrus Operator´s Manual, Version 3.5 (1996).
[10] ZANZONICO, P., Routine Quality Control of Clinical Nuclear Medicine Instrumentation: A
Brief Review, Journal of Nuclear Medicine, 49, 1114-1131 (2008).
[11] GROCH, M. W;, EDWIN, W. D., Single-Photon Emission Computed Tomography in the year
2001: Instrumentation and Quality Control, Journal of Nuclear Medicine Technology, 29, 9-15
(2001).
[12] LEVI DE CABREJAS., M., Tomografía en Medicina Nuclear, ALASBIMN, Argentina, pp.
50 (1999).

10