Observed inter-camera variability of clinically relevant performance characteristics for Siemens Symbia gamma cameras

Application of a medium-energy collimator for I-131 imaging after ablation treatment of differentiated thyroid cancer

PURPOSE

High-energy (HE) collimators are usually applied for I-131 imaging after ablation treatment of differentiated thyroid cancer (DTC). However, purchase of HE collimators has been avoided in many nuclear medicine departments because the HE collimators are more expensive than other collimators. In this study, we compared the I-131 imaging using HE- and medium-energy (ME) collimators, which is more versatile than HE collimators.

MATERIALS AND METHODS

To simulate DTC patients with extra-thyroid beds, a phantom of acrylic containers containing I-131 was used. To simulate patients with thyroid beds, four phantoms representing extra-thyroid beds were arranged around the phantom representing normal thyroid tissues. Patients administered 1.11 or 3.70 GBq NaI-131 were also evaluated. Whole-body imaging and SPECT imaging of the phantoms and patients performed using HE-general-purpose (HEGP) and ME-low-penetration (MELP) collimators, and full-width at half maximum (FWHM) and percent coefficient of variation (%CV) were measured.

RESULTS

In the extra-thyroid beds, FWHM and %CV with MELP were negligibly different from those with HEGP in whole-body imaging. Although FWHM with MELP was a little different from that with HEGP in SPECT imaging, %CV with MELP was significantly higher than that with HEGP. In the thyroid beds, only an extra-thyroid bed including higher radioactivity was identified in whole-body imaging with both collimators. Although SPECT images with MELP could not clarify extra-thyroid beds with low radioactivity, HEGP could identify them. In patients, although some whole-body images with MELP could not detect extra-thyroid beds, whole-body imaging with HEGP and SPECT imaging with both collimators could detect them.

CONCLUSIONS

Although HEGP is the best collimator for I-131 imaging, MELP is applicable for not only whole-body imaging but also SPECT imaging.

Characterization of the count rate performance of modern gamma cameras

PURPOSE

Evaluation of count rate performance (CRP) is an integral component of gamma camera quality assurance and system deadtime (τ) may be utilized for image correction in quantitative studies. This work characterizes the CRP of three modern gamma cameras and estimates τ using two established methods (decay and dual source) under a variety of experimental conditions.

METHODS

For the decay method, uncollimated detectors were exposed to a Tc-99m source of relatively high activity and count rates were sampled regularly over 48 h. Input count rate at each time point was based on the lowest observed count rate data point. The input count rate was plotted against the observed count rate and fit via least-squares to the paralyzable detector model (PDM) to estimate τ (rates method). A novel expression for observed counts as a function of measurement time interval was derived, taking into account the PDM and the presence of background but making no assumption regarding input count rate. The observed counts were fit via least-squares to this novel expression to estimate τ (counts method). Correlation and Bland-Altman analyses were performed to assess agreement in estimates of τ between the rates and counts methods. The dependence of τ on energy window definition and incident energy spectrum were characterized. The dual source method was also used to estimate τ and its agreement with estimates from the decay method under identical conditions was also investigated. The dependences of τ on the total activity and the ratio of source activities were characterized.

RESULTS

The observed CRP curves for each gamma camera agreed with the PDM at low count rates but deviated substantially from it at high count rates. The estimates of τ determined from the paralyzable portion of the CPR curve using the rates method and the counts method were found to be highly correlated (r = 0.999) but with a small (~6%) difference. No statistically significant difference was observed between the estimates of τ using the decay or dual source methods under identical experimental conditions (p = 0.13). Estimates of τ increased as a power-law function with decreasing ratio of counts in the photopeak to the total counts. Also, estimates of τ increased linearly as spectral effective energy decreased. No significant difference was observed between the dependences of τ on energy window definition or incident spectrum between the decay and dual source methods. Estimates of τ using the dual source method varied as a quadratic on the ratio of the single source to combined source activities and linearly with total activity.

CONCLUSIONS

The CRP curves for three modern gamma camera models have been characterized, demonstrating unexpected behavior that necessitates the determination of both τ and maximum count rate to fully characterize the CRP curve. τ was estimated under a variety of experimental conditions, based on which guidelines for the performance of CRP testing in a clinical setting have been proposed.

Performance characteristics of a new pixelated portable gamma camera

PURPOSE

To evaluate and characterize the performance of a new commercially available pixelated portable gamma camera Ergo (Digirad, Poway, CA).

METHODS

The authors evaluated a pixelated portable gamma camera system, Ergo, that consists of 11 520 elements of 3 × 3 mm(2) CsI(Tl) crystals that are 6-mm thick and are coupled to silicon photodiodes. The detector element has a size of 3.31 × 3.24 mm(2). The gamma camera performance was evaluated for both low-energy all-purpose (LEAP) and low-energy high-resolution (LEHR) collimators. The flood-field uniformity for (99m)Tc and (201)Tl was assessed using fillable uniform flood phantoms. Energy spectra were acquired for (99m)Tc, (111)In, (201)Tl, and (67)Ga to evaluate energy linearity and energy resolution. Spectral fits were performed to calculate the photopeak energies and resolutions. The pixel size and multiwindow spatial registration (MWSR) was evaluated by measuring mixed (99m)Tc and (201)Tl point sources placed at known distances apart. The system's sensitivity was measured according to the National Electrical Manufacturer's Association (NEMA) NU1-2007 standards for both LEAP and LEHR collimators as a function of distance from the collimator surface (5, 10, 15, 20, 25, 30, and 40 cm). The system resolution without scatter was measured for both LEAP and LEHR using (99m)Tc-filled capillary tubes located at 0, 2, 4, 6, 10, and 12 cm away from the surface of the collimator. As a measure of the spatial resolution, the full width at half maximum (FWHM) at a given distance was calculated from the presampling line spread function (LSF), constructed from the line profiles of the capillary tubes at the same distance. As a comparison, the FWHM at 10 cm away from LEHR and LEAP collimators was also calculated from linear interpolation as described by NEMA NU-1 2007 and from fitting the profiles to a Gaussian-plus-constant model.

RESULTS

All isotope-collimator pairs demonstrated good flood-field uniformity with an integral uniformity of ≤5% and a differential uniformity of ≤3%. The system demonstrated excellent energy linearity with maximum discrepancy of measured keV from true keV of <1%. The energy resolution of the (99m)Tc 140-keV photopeak was 7.4%. The image pixel size was measured as 3.23 × 3.18 mm(2), and the MWSR was within 0.3 mm (or ~10% of the nominal pixel size). The system sensitivity at 10 cm was 112.6 cps/MBq (249.9 cpm/μCi) for LEAP and 63.1 cps/MBq (140.1 cpm/μCi) for LEHR. The system spatial resolution varied linearly with distance from the collimator and the FWHM were measured to be 7.2 and 8.9 mm at 10 cm for LEHR and LEAP, respectively.

CONCLUSIONS

Herein, the authors describe detailed performance evaluation procedures of a new pixelated portable gamma camera system, which can also be applied to evaluate other pixelated gamma camera system. Spatial resolution assessment in near-field imaging condition offers a unique challenge where the measured FWHM is highly dependent on relative position between the capillary tube and the detector element. The evaluations of the Ergo gamma camera suggest suitable clinical imaging performance. This portable gamma camera has a high (LEAP) planar sensitivity, high energy and spatial resolutions that are comparable to other available gamma cameras, and it exhibits superior count rate performance that is linear up to tens of millions count per second. The Ergo imaging performance, however, can still be improved, for example, by optimizing collimator design for near field imaging.

Technological development and advances in single-photon emission computed tomography/computed tomography

Single-photon emission computed tomography/computed tomography (SPECT/CT) has emerged during the past decade as a means of correlating anatomical information from CT with functional information from SPECT. The integration of SPECT and CT in a single imaging device facilitates anatomical localization of the radiopharmaceutical to differentiate physiological uptake from that associated with disease and patient-specific attenuation correction to improve the visual quality and quantitative accuracy of the SPECT image. The first clinically available SPECT/CT systems performed emission-transmission imaging using a dual-headed SPECT camera and a low-power x-ray CT subsystem. Newer SPECT/CT systems are available with high-power CT subsystems suitable for detailed anatomical diagnosis, including CT coronary angiography and coronary calcification that can be correlated with myocardial perfusion measurements. The high-performance CT capabilities also offer the potential to improve compensation of partial volume errors for more accurate quantitation of radionuclide measurement of myocardial blood flow and other physiological processes and for radiation dosimetry for radionuclide therapy. In addition, new SPECT technologies are being developed that significantly improve the detection efficiency and spatial resolution for radionuclide imaging of small organs including the heart, brain, and breast, and therefore may provide new capabilities for SPECT/CT imaging in these important clinical applications.