Quality Control of Nuclear Medicine

Equipment:

The Anger Scintillation Gamma

Camera
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Benedict Cassen

An undated photo of a rectilinear scanner used

to detect of iodine uptake by the thyroid gland.

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 Pulse- Scaler
Amplifier height Display
analyzer Processor
Ratemeter

High-voltage
supply

Scanner drive
Scanner head mechanism Display
devices

A block diagram of the basic components of the rectilinear scanner.

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 D

lead Collimator
crystal
septa
side

Focal
distance

Focal
Patient’s
plane Focal point
d side

Focusing collimator of a rectilinear

scanner nath
The figure shows an example of a
radionuclide image produced by a
rectilinear scanner

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 THE ANGER
SCINTILLATION CAMERA

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Hal O. Anger
The Anger Scintillation Camera

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COLLIMATOR SYSTEM

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 COLLIMATOR TYPES
Image in crystal Image in crystal

Object
2. PARALLEL HOLE
Object
1. PINHOLE

Image in crystal
Image in crystal

Object
Object

3. CONVERGING 4. DIVERGING

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COLLIMATORS

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 The effect of collimator-to-object distance on collimator
performance parameters

Collimator Spatial Efficiency Field size Magnification

Resolution

Parallel Decreases Approx. Constant Constant (m= 1.0)

hole constant

Converging Decreases Increases Decreases Increases (m>1 at

collimator surface

Diverging Decreases Decreases Increases Decreases (m<1

at collimator
surface)
Pinhole Decreases Decreases Increases Decreases (m
largest near
pinhole)
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 SCINTILLATION CRYSTAL

Scintillation light
exits to PM tubes
NaI(Tl) Glass
crystal entrance
window

Aluminum Gamma rays

casing enter from this Reflector
side material
Schematic cross-section of a NaI(Tl) crystal assembly for a
gamma camera.
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 SCINTILLATION CRYSTAL

•For circular ones, usually 6- to 12.5-mm thick

x 25 to 50 cm diameter.
•Rectangular crystals, with sizes up to 60 x 60
cm are also available
•The choice of thickness is a trade-off between
its detection efficiency and intrinsic spatial
resolution
•Most general purpose gamma cameras have
thickness of approx. 9.5 mm
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 Photo-
Multiplier
Tube or
PMT

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 zzzzzzzz

Most modern
cameras employ
between 30 and Typical PM tube sizes
100 PM tubes. are 5 cm in diameter.

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 Pulses Y position
from pulse Cathode
Position
individual ray tube
circuit X position
PMTs
pulse
Logic pulse
(if Z in
Summing Single window of
circuit channel SCA)
Z
analyzer
energy
pulse

Electronics circuits of a fully analog scintillation camera

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 Position Corrected
and position and
ADCs energy energy
signals signals
Pulses
from Digital
individual position Y Digital Y
circuit energy Digital
PMTs
X and X computer
spatial
linearity
Digital correction Z
summing circuits
circuit Z

Analog Digital

Electronic circuits of a modern digital scintillation camera

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SCINTILLATION EVENT
DETECTION
Valid event nath
Detector Scatter event nath
Object Scatter event nath
Septal Penetration nath
SCINTILLATION EVENT
LOCALIZATION

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Light sharing between photomultiplier tubes

*The fraction of light scintillation that

strikes the photocathode of the PMT
varies inversely with the distance of
the PMT from the point of interaction.
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 Y+

X- X+

Y- X
Y
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 Y+

X- X+

Y- X
Y
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 Y+

X- X+

Y- X
Y
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ENERGY SELECTION

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 ENERGY SELECTION

•Is important for imaging because it provides

a means to discriminate against gamma rays
that have scattered into the body and
therefore lost their positional information
•The energy of the interaction is the
amplitude of the sum of the outputs of all the
PMTs
•Done by choosing the appropriate pulse
height analyzer window.
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 TYPES OF GAMMA
CAMERA AND THEIR
CLINICAL USES

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Cardiac Gamma
Camera

Breast Gamma
Camera

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Mainly used for Gated
Blood Pool scanning
and studies on
patients in intensive
care.

Mainly used for lung

scans, renals, high
energy imaging and
general imaging
studies.

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Mainly used for high
energy imaging, renal,
colonic & small
bowel transit and
thyroid studes.

Dual-headed Gamma
Camera-used for SPECT
studies of brains, breast
lymphoscintigraphy, whole
body bone scans and
general SPECT studies.

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Gamma Camera
SPECT
SYSTEMS

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 PERFORMANCE
CHARACTERISTICS

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 Intrinsic Spatial Resolution
 is the limit of spatial resolution of the gamma camera
achievable by the detector and the electronics.
 Is limited by the following factors:
1. Multiple scattering of the photons within the
detector
2. Statistical fluctuation in the distribution of light
photons among PMTs
 Improves with increased efficiency of collection of
scintillation photons.
 The use of thinner crystal, greater number of PM tubes
and improved electronics also contribute to the
improvement of intrinsic resolution.
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 System Resolution

 Refers to the ability of the imaging

system to provide sharpness or detail in
the images
 Takes into account the presence of the
collimator
 Depend on the type of collimator being
used

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FWHM

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 Detection Efficiency
 Detection efficiency improves with thicker
crystals (note that intrinsic resolution improves
with thinner crystals)
 At higher energies, decreasing detection
efficiency as well as increasing collimator
septal penetration limits the performance of
gamma cameras with 0.64- to 1.27-cm thick
crystals
 Because of these, the optimal gamma ray
energy range is approximately between 100 to
200 keV.
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 Energy Resolution
 Is also dependent on the statistical fluctuations in
the number of light photons collected from a
scintillation event.
 Two advantages obtained with improved energy
resolution:
1. Efficient detection of unscattered photons
within the chosen energy window
2. Gamma rays scattered through large angles
are rejected more efficiently, thus, image
contrast is improved.
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Performance at High Counting Rates

 At higher counting rates, there is a

likelihood of recording two events at the
same time.
 Worst effect is the Pulse Pile-up resulting
to:
1. Counting losses
2. Image distortion

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 Pile-up source

source

Amplitude
voltage

defect

time
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 Detector Limitations
 Image Non-linearity
- Straight-line objects appear as curve-line
images
Pincushion distortion – inward bowing of line
images
Barrel distortion – outward bowing of line images

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 Detector Limitations

 Image Non-uniformity
- caused by:
1. Non-uniform detection efficiency arising
from small differences collection efficiency
of scintillation light by the PMTs
2. PM tube failure
3. Crystal cracking
4. Collimator defects

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QA & QC

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 List of tools for quality control of Gamma
Cameras
 Co-57, 400-2000 kBq or 10-50 Ci point or “button”
sources
 Co-57, 200-400 MBq or 5-10 mCi flood source
 Fillable flood source that is verified to be uniform
 Planar performance phantom (thyroid or liver, typically)
 Resolution pattern: quadrant bar, hole pattern or other
 Method of routinely making line sources
 Method of routinely making point sources
 Mask for the UFOV of the camera
 SPECT performance phantom. This phantom should
provide for testing SPECT uniformity, SPECT
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 Tools for quality control of Gamma
Cameras that can be borrowed from
manufacturer
 NEMA resolution pattern
 Dead time scatter phantom for extrinsic
dead time measurements
 Copper sheets and source holders for
intrinsic dead time measurements
 Software for performance evaluation is
often available from the manufacturer,
sometimes permanently or more often on
loan and usable only under supervision of
the service person.
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 Measurements of Gamma Camera
Performance
 Intrinsic Spatial Resolution
- Determined without the collimator using a linearity test
pattern placed on the surface of the crystal housing
- Uses a 99mTc or 57Co point source placed at 5XUFOV
from camera face
- Data acquired with system count <30,000 cps to avoid
pile-up related to mispositioning
- Typical values are 2.5 to 3.5 mm

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 System Resolution
- Source consists of 1-mm diameter line sources
placed at 5 cm apart at a distance of 10 cm from the
front face of the collimator

- Images are acquired at a rate of <30,000 cps to avoid

pile-up and profiles taken through the image of the
line sources are fitted to gaussian functions to
determine FWHM

- Results vary depending on the type of collimator used

but are typically in the range of 8 to 14 for 99mTc

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 Spatial Linearity
- This measurement uses a slit pattern and
conditions for the intrinsic resolution
measurement
- Measurements are taken with two orientations of
the pattern , rotated by 90 degrees, to provide
linearity measurements in both X and Y
directions
- The absolute spatial linearity is defined as the
maximum deviation of the location from their true
location

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 Uniformity
- Intrinsic flood-field images are acquired with
collimator removed, using a point source placed far
enough from the surface of the gamma camera to
give uniform irradiation of the surface such that
distance 5xUFOV
- Extrinsic flood-field images are acquired with the
collimator in place using a disk or thin field phantom
that covers the area of the detector.
- 99mTc or 57Co are the two most commonly used

radionuclides
- Modern gamma cameras incorporate techniques that
attempt to correct the causes of non-uniformity

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 Energy Resolution
- Measured using flood illumination of the gamma
camera face, without the collimator, using 99mTc
suspended 5xUFOV above the camera face
- The resulting pulse-height spectrum is analyzed to
determine the FWHM of the photopeak
- Is in the range of 8% to 11% for 99mTc

 Counting Rate Performance

- Two 99mTc sources are placed about 1.5 m away from
the camera face. Counting rates are then measured
with both sources present, and each with individual
source present.
- Care must be taken that all measurements are taken
with exactly the same source geometry
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 System Sensitivity
- Needs to be measured separately for each collimator
- Sensitivity of low-energy collimators is measured
using a 99mTc (E= 140 keV), that of medium-energy
collimator using 111In (E=172,247 keV) and 131I (E =
364 keV) is used for high energy collimators.
- A solution of the radionuclide is placed in a 10-cm
diameter dish to a depth of 2 to 3 mm. The source is
placed 10 cm from the front face of the collimator and
an image is acquired.
- General purpose collimator typically has a sensitivity
in the order of 1 to 1.5 x10-4 cps/Bq

- Sensitivity(cps/Bq) = counts in ROI – Background counts in ROI

time x source activity

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 Typical intrinsic performance characteristics of a
Modern Scintillation Camera, measured by NEMA
Protocol

Intrinsic spatial resolution (FWHM of FSF for 140 keV) 2.7 to 4.2 mm
Energy resolution (FWHM of photopeak for 140 keV
photons) 9.2% to 11%
Integral uniformity (max. pixel – min. pixel)/(max. pixel +
min. pixel)
2% to 5%
Absolute spatial linearity Less than 1.5
mm
Observed count rate at 20% count loss (measured without 110,000-
scatter) 260,000 counts
per second
170,000-500,00
Observed maximal count rate (measured without scatter) counts per
second
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 Bar phantom

Linearity pattern
Flood phantom

Flood source

Resolution pattern test Thyroid

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neck phantom
SMPTE test pattern

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 Test Frequency in routine testing
Half-
Acceptance and Reference tests Weekly Monthly
yearly
Physical Inspection Acceptance

Function of scaler-timer/Ratemeter X

Energy Calibration X
Rectilinear Scanner

Energy Resolution X

Sensitivity X

Counting Precision X

Linearity of Energy Response X

Integral Background Count Rate X

Preset Analyzer Facilities X

System Linearity X

Background Subtraction X

Contrast Enhancement X

Scanner Drive X

Total Performance x

Operational Checks
Check of Collimator and Scanner head
Mountings
Everyday before use
Check of Tapper Function
Check of Analyzer Peak Setting nath

Check of Background Count Rate

 Test Frequency in routine testing
Half-
Acceptance and Reference tests Weekly Monthly
yearly
Physical Inspection Acceptance
Scintillation Camera

Preset and Manual PHA Window Settings X

Intrinsic Flood field Uniformity X

System Flood-field Uniformity X

Intrinsic Spatial Resolution x

System Spatial Resolution X

Intrinsic Count-rate Performance X

Maximum Count rate X

System Count-rate Performance X

System Plane Sensitivity

Detector head shielding Leakage X

Spatial Resolution and Linearity x

Total Performance x

Multiple Window Spatial Registration nath x

 Test Frequency in routine testing
Scintillation Camera

Operational Checks

Check of Collimator and Detector head

Mountings

Check of Energy Calibration of PHA

Check of Flood field uniformity and Everyday before use

Sensitivity

Check of Background Count rate

Checvk of Oscilloscope

Check of Film handling and Processing

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Thank you !

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 SCINTILLATION PROCESS

Higher
energy
level

Lower
energy
level

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 SCINTILLATION PROCESS

Higher
energy
level

Lower
energy
level

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 SCINTILLATION PROCESS

Higher
energy
level

Lower
energy
level

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