Scintillation Camera

Testing

G. Donald Frey, Ph.D.

Department of Radiology
Medical University of South Carolina
Charleston, SC
 Testing
• Number of tests that give a collection of
data about the performance of the
equipment
 Does it meet specifications?
 Is it safe to use?
 Will it provide optimal image quality?
 Does it meet any regulatory requirements?
Testing
 Physicist’s Role
• Integrate the results of the tests into a
coherent set of recommendations to
 Improve performance of equipment
 Improve image quality
 Protect patient from adverse affects of
radiation
 Protect staff from adverse affects of
radiation
 Testing
• Cameras are complex so it is not possible to
have a single set of tests
• The physicist should decide if additional
testing is recommended
• Likewise cameras have different
specifications so it is not possible to have a
single set of performance parameters
• Some of the tests are not objective so the
physicist must use experience to make a
subjective decision
 Testing
• The results of the testing must be
effectively communicated to others
 Physicians
 Technologists
 Service Engineers
 Written Report
• Tests done
• Results
• Recommendations for action
 NEMA Testing
• National Association of Electrical
Manufactures (USA)
• Have protocols for many of the tests but
some
 require special phantoms
 are difficult to duplicate in the field
 require special software
• NEMA values are a good way to compare
camera specifications
 Equipment Tested
• Sintillation Camera
• Picture Archiving Systems
• Dose Calibrator
• Well Counter
• Uptake Probe
• GM Counter
• Ionization Chamber
• Ancillary Equipment
 Testing Frequency
• Tests that are usually done only when
the camera is installed or moved
• Tests that are part of the annual physicist
evaluation
• Physicists that are done more frequently
as part of routine quality assurance
testing
• Tests that might be done prior to
introducing a new patient examination
 Prior to Installation

• Any PET
radionuclides?
• Any
radiotherapy?
 Gamma Camera
Installation Tests

• Head Leakage
• Collimator Hole Alignment
• Couch Alignment (SPECT)
• Linearity
 Head Leakage
• To find defects in head shielding
• Move radioactive source around on
external surfaces of camera head
during acquisition
• Leaks at support points
• Visual test
 Collimator Hole Angulation
• Point source (150 MBq) as far away
from collimator as possible
 Frequently limited by room design
• Not easy to radiograph collimator
• Look for areas where holes are not
properly angulated
• Visual test
 Couch Alignment
• SPECT is very dependent on how far
the head is away from the patient.
Errors in table alignment degrade image
quality and could cause patient
collisions
• Should be aligned to within 1 cm
 Linearity
• Visual with bar phantom
 Part of QC but not good enough for
acceptance testing
• Special NEMA phantoms
 Request from manufactures as part of
purchase
• NEMA verification phantom
 Linearity Verification
• Software determines
center of each hole
and checks linearity

Typical < 0.5 mm

 Annual Testing
• Pixel Calibration
• Intrinsic Uniformity
• System Uniformity
• Intrinsic Resolution/ System Spatial
Resolution
• Sensitivity
• Energy Resolution
 Annual Testing
• Count Rate Parameters/ Deadtime
• Multiple Window Spatial Resolution
• Image Quality
• General Safety Checks
• SPECT Performance
 Pixel Calibration
• Allows the conversion of pixel
measurements into linear
measurements
• Use sources a known distance appart
• Determine centroid
• Convert to distance
Xc =  N iXi/  N i

Yc =  N iYi/  N i
6

2
2

0 2 4 6 8
1
 Intrinsic Uniformity
• Image of point
source without
collimator
• 5 Diameters ~1%
• ~2.5 m h

D
2.5 m

Typical CFOV < 3.0%

UFOV < 3.5%
 Pitfalls & Problems
• Distance
• Scattering Materials
• Loss of Intrinsic Uniformity
 Crystal damage - hydroscopic
 Loss of coupling between PMT’s and crystal
 PMT gain issues
 Recalibration of linearity
 Recalibration of energy calibration
 System Uniformity
• Intrinsic + Collimator
performance
• Depends on
uniformity of flood
source
• Liquid Sources
• Co-57 Source
 Co-57 Source
• Std Deviation <1%
• Activity 400-600
MBq
• Counts depend on
head size
 6 M for routine QC
 Problems
• Intrinsic uniformity problems
• Collimator correction issues
• System uniformity should be graphed
over time as a quality control measure
 Rotational Uniformity
• Check uniformity at
 0, 90, 180, & 270 degrees
• Checks for
 Radiation sources
 Changing magnetic fields
 Any loose photomultiplier tubes
Intrinsic Resolution
 Measures of Performance
• Resolution
 Measure with resolution phantom
• LSF
 Image of thin line
• PSF
 Image of point
 Line Source or Point Source
• Line source
 can be made
from thin tube
• Point source
 Point Spread Function
FWHM = ln(2)  p
FWHM = 2.15 x 1.41 x 0.693 = 2.8 mm

5 5
4544 .9 553
.2 90 2.7
36 73
.8 74
.6
07
68

4 4
181

11335.0

165
2038

11058.3
2
5.8

8
2

3.8
1

1849.1
6 0.
9.4

8.

0
2

59 90

2.
2.

2280.6

12

74
13
86

14
15

3 3
.4 .4
71 16
90 92

2 2

1 1
1 2 3 4 5 6 1 2 3 4 5 6
1 1

Point Spread Data Gaussian Fit Data

 Specification
• FWHM = 4 mm
• FWTM = 8 mm
 Problems
• Insufficient counts to make accurate
measure
• Problems are less common
 System Spatial Resolution
• Intrinsic Measures
• Bar Phantoms
 Bar Phantom
• Is a good quality
control test but has
some limitations
• Quadrant
• Hard to use in
intrinsic mode
• Better for system
test
 Factors
• Depends on collimator
• Depends on depth
• In the absence of collimator damage
system spatial resolution should not
change if the intrinsic spatial resolution
does not change
• Collimators are frequently specified at 10
cm
 Sensitivity
• Measured as counts/sec per MBq
• Can be measured intrinsic or system
 Intrinsic Sensitivity
• Crystal thickness
• Window width
• Energy of Radionuclide
• Scatter
• Count rate (dead time)
• Difficult to measure source strength
accurately
• Measurement can lack sensitivity
 System Sensitivity
• Use Extended Source
 Co-57 flood
 Tc-99m in container
• Depends on collimator
• 125 counts/sec per MBq
• Varies inversely as the Correct for
square of the system area not
imaged
resolution
Energy Resolution
 Energy Resolution

• FWHM of
photopeak
• Spectrum may
not be easily
available
• FWHM depends
strongly on FWHM = 15/122 =12%
scatter
10% is typical specificaton
 Energy Errors
• Spatial Location vs gamma
energy
 Ga-67 for example
• 0.5 mm typical

E1 E2
 Multiple Window
• Ga-67
 91 keV
 185 keV
 300 keV
• Image
 Compare Centroids
 1.
7
5 5 1.
8

1.
9
2.0
4 4

2
2

3 3

2.1

1.
7
2 2

1.
6
1 1
1 2 3 4 5 6 1 2 3 4 5 6
1 1

Take difference between centroids

determine R. Change to distance with pixel
calibration. Typical 2 mm
 Dead Time
• Dead time is sensitive to scatter so
testing should be done is system mode
with the window set as for clinical
studies
 20% is not appropriate
• Sources should be counted in scatter
phantom
 Determining Deadtime
• Split Source R1
• R1, R2 &R12
R2

R1 R2

p =[2R12/(R1+R2)2]/ln[(R1+R2)/R12
Background

Source 1

Source 12

Source 2

Source 2

Source 12

Source 1
 Deadtime
• Typical Results
 4.1 usec clinical
window
 1.9 usec wide window
• Deadtime can be
decreased with
sacrifice of image
quality
 Image Quality
• Image quality for clinical examination
depends upon
 Capabilities of camera
 Parameters used for imaging
 Patient body habitus and physiology
• There are a wide variety of “image
quality” phantoms
 Intrinsic Intrinsic
Linearity Energy Cor
Energy
Resolution

Intrinsic Intrinsic
Deadtime
Uniformity Resolution

System System System

Collimator
Uniformity Resolution Sensitivity

Imaging
Technique Image
Quality
 Image Quality Phantom
• Big Picture
• If poor image
quality we still
have to find the
cause
 loss of resolution
 poor techinque
 etc
 General Safety Checks
• Electrical Issues
• Locks
• Collision Sensors
• General Condition of
Room
• General Radiation
Safety Checks
SPECT Performance
Phantom
• Care must be taken to
reproduce the set up precisely
 Activity
 Placement of phantom
 Distance of collimator from
phantom
 Technique
 Reconstruction
 Routine Quality Assurance
• System Flood – Daily
• Resolution & Linearity – Weekly
• High Count Floods (As Required)
• Center of Rotation – Monthly(?)
• Monitor Performance (Monthly)
• Printer Performance (Monthly)
• SPECT Performance - Quarterly
 Daily System Flood
• Visual Assessment
• Quantitative Assessment
 Reduced Performance
14%
12%
10%
8%
6%
4%
2%
0%
Jan-93 Oct-95 Jul-98 Apr-01 Jan-04
UFOV CFOV
 Resolution & Linearity
• Visual Assessment
• If using 4 quadrant
bar rotate weekly
 Center of Rotation
• As necessary -
usually monthly
 Center of Rotation
• SPECT assumes heads always look at
some constant rotation point
 COR
• If heads are mis-aligned or have some
mechanical motion
• Image will have blurring and circular
artifacts
• COR must be tested for and corrected
for
• SPECT of 3 point sources
 Monitor Performance
• Brightness (Photometer)
• Contrast
• Resolution
 SMPTE Test Pattern

Also consider AAPM TG-18 patterns

 Printer Testing
• Print SMPTE
 Compare visually to monitor
 Plot OD of 0, 100, 30 & 60 patches
 Check resolution
 Dose Calibrator
• Geometry Test
 Installation or Environmental Change
• Accuracy
 Annual
• Linearity
 Quarterly
• Constancy
 Daily
 Scintillation Counters
• Energy Calibration
• Energy Resolution
• Efficiency
• Minimum Detectable Activity
• Chi Square Test
• Daily Test Count
• Background
 GM & Ionization Counter
• Annual Calibration
• Generally Done Using Cs-137 Source
• Inverse Square Law
• Calibrate to Read in Dose to Air
 Ancillary Testing
• Pipettes
• Thermometers
 Tests for New Procedure
• Selection of Collimator
• Image Processing
 SPECT Filter
 Counting Time
 Transmission to PACS or Film

Because NM images can be

oriented many ways it is important
to be sure they are not LEFT/RIGHT
reversed when they are sent for
viewing
 Role of Physicist
• Nuclear medicine is complex
• Physicist sees the big picture
• Results of tests must be integrated
• Further testing may be required