2011 International Nuclear Atlantic Conference - INAC 2011

Belo Horizonte, MG, Brazil, October 24-28, 2011

ASSOCIAÇÃO BRASILEIRA DE ENERGIA NUCLEAR - ABEN
ISBN: 978-85-99141-04-5

CHARACTERIZATION OF A PET-NEMA/IEC BODY PHANTOM FOR

QUALITY CONTROL TESTS OF PET/CT EQUIPMENTS
Cássio M. Oliveira1, Igor F. Vieira2,5, José W. Vieira3, 5, Lídia V. de Sá4, Fernando R. A.
Lima2,5 and Teógenes A. da Silva1,6
1
Pós-Graduação em Ciências e Técnicas Nucleares – PCTN/UFMG
Universidade Federal de Minas Gerais
Av. Antônio Carlos, 6627; Campus Pampulha
31270-901 Belo Horizonte; MG
cmo@cdtn.br
2
Centro Regional de Ciências Nucleares do Nordeste do Nordeste – CRCN-NE/CNEN
Rua Prof. Luiz Freire Nº 200 - Cidade Universitária CEP: 50.740-540 Recife/PE
igoradiologia@gmail.com
3
Instituto Federal de Educação, Ciência e Tecnologia – IFPE
Av. Prof. Luiz Freire, 500 Cidade Universitária - Recife/PE - CEP: 50740-540
jose.wilson59@uol.com.br
4
Instituto de Radioproteção e Dosimetria, IRD/CNEN
Av. Salvador Allende, s/°n, Jacarepaguá
22780-160 Rio de Janeiro; RJ
lidia@ird.gov.br
5
Programa de Pós-Graduação em Ciências e Tecnologias Nucleares PROTEN/DEN - CRCN-NE
Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife - PE - CEP: 50670-901
falima@cnen.gov.br
6
Centro de Desenvolvimento da Tecnologia Nuclear, CDTN/CNEN
Av. Antônio Carlos, 6627, Campus Pampulha
31270-901 Belo Horizonte; MG
silvata@cdtn.br

ABSTRACT

The Brazilian Sanitary Agency from Ministry of Health requires that all PET/CT equipment must undergo
minimal quality control tests using manufacturer simulators. The PET-NEMA/IEC body phantom is
recommended by the IEC and NEMA to perform acceptance testing and quality control in PET/CT equipments
according to specific protocols. It is essential that all simulator components (spheres and body) are properly
characterized in relation to their size and internal structure volumes, since they are used to calculate the overall
activity concentration and the total weight. The objective of this work was characterize a PET-NEMA/IEC body
phantom for the true reconstruction in computational modeling and correct analysis of experimental results. The
simulator is basically composed of three structures: the body (simulating a portion of the chest), an inner
cylinder (simulating the lung tissue) and a top cover in which are coupled spheres of different sizes simulating
"hot" (tumors) and cold lesions. The spheres were evaluated in terms of volume. The same evaluations were
performed with the body of the simulator and the inner cylinder, beyond of analysis of their weights (filled with
water) and wall thickness. The data showed that the total weight of the simulator with all its internal structures is
12.5 kg and the volume of the "hot" and “cold” spheres are approximately equal to those presented by the
manufacturer. The inner cylinder volume showed a significant difference between the measured and the
presented in the manual. The results were used for reconstruction of the simulator in computational modeling
using the code GATE.
 1. INTRODUCTION

Improvements in quality assurance in nuclear medicine and, in particular, quality control

related equipment have been a major field of interest of the International Atomic Energy
Agency [1]. The Brazilian Sanitary Agency (ANVISA), through RDC n° 38, requires that all
positron emission tomography with computed tomography PET/CT equipments must undergo
minimal quality control tests using manufacturer simulators [2]. However, because to the
diversity of equipment from different manufacturers, with particular devices and specific
acquisition protocols, it is difficult to establish a minimum system of quality assurance
standard that produces a satisfactory image quality for the different existing equipment [3].
Thus, what happens in the world is that users follow only manufacturer’s recommendations
and do not follow, therefore, a quality control standard.

The quality control of PET scanners was proposed by Karp et al in 1991 [4]. A committee of
the National Electrical Manufacturers Association (NEMA) [5] was formed by members of
all manufacturers and members of the class societies. In parallel, the European Community
efforts focused on testing their equipment and offer basic control measures. This work
resulted in a standard International Electrotechnical Commission (IEC) [6]. NEMA and IEC
norms propose the use of phantoms suitable for acceptance testing and quality control
PET/CT equipments.

One of the NEMA/IEC phantoms is PET-NEMA/IEC body phantom, model ECT/IEC-

BODY/P NEMA, and its mains applications are: simulation of whole-body imaging
especially using PET and camera-based coincidence imaging techniques; evaluation of
reconstructed image quality in whole-body PET and camera-based coincidence imaging;
determination of the coincidence count rate characteristic in body imaging; evaluation of the
relationship between true coincidence count rate and radioactivity; determination of the
address errors caused by address pile up; evaluation of the count loss correction scheme and
research [7]. Figure 1 demonstrates PET-NEMA/IEC body phantom filled with water and all
components. The phantom components are:

- Six spheres (fillable compartments); their diameters area from manual are: 10, 13, 17,
22, 28 and 37 mm. Ideal manufactured volumes are: 0.52, 1.15, 2.57, 5.57, 11.49 and
26.52 mL, respectively. The first four spheres (smaller) are filled with radioactive
material (“hot”) while the larger ones are filled with water (“cold”).
- Screws to seal the spheres;
- Lung inserted; the lung insert is water-fillable. It simulates lung density when filled
with water and the molded expanded polystyrene beads. The lung insert is filled
through hole in the top plate/lid assembly. Lung insert volume from manual is 194
mL.
- Torso background (fillable compartment); Torso cavity is 9.7L.
- Lid, with twelve hold-down screws and attached spheres; twelve screws secure the
torso lid in place and filled with non-radioactive water.
- Filler caps on top and bottom plates of torso [7];

INAC 2011, Belo Horizonte, MG, Brazil.

 Figure 1. PET-NEMA/IEC body phantom filled with all your components

Specifically, some parameters for which measurements can be made (or determinate the
presence of) with this phantom are:
- Contrast;
- Background variability
- Resolution (qualitative);
- System sensitivity;
- Prompt counts;
- True event rate;
- Count loss; etc [7].

The Geant4 Application for Emission Tomography (GATE) code was used for computational
modeling of PET-NEMA/IEC body phantom. GATE is a dedicated code specifically for PET
and/or single photon emission tomography (SPECT). One of the GATE advantages, in
addition to its library of physical processes is the possibility of 4D-fourth dimension
reconstruction models (where the 4D is the time) by using the OpenGL graphics library
integrated to the installation GATE package, and a functions set implemented in the core
program to manage time-dependent phenomena such as rotating gantry, table, radioactive
decay, dead time, time-of-flight etc [8].

The objective of this work was to characterize a PET-NEMA/IEC body phantom in relation
to their size and internal structure volumes, since they are used to calculate the overall
activity concentration and the total weight. The results of characterization were used for
reconstruction of the body phantom in computational modeling using the code GATE.

2. MATERIALS AND METHODS

The simulator is basically composed of three structures: the body (simulating a portion of the
chest), a top cover in which are coupled spheres of different sizes simulating "hot" (tumors)
and “cold” (no tumors) lesions and an inner cylinder (simulating the lung tissue), as
demonstrated in Figure 2. The spheres were evaluated in terms of volume. The same
evaluations were performed with the body (torso) of the simulator and the inner cylinder

INAC 2011, Belo Horizonte, MG, Brazil.

(lung insert), beyond of analysis of their weights (filled with and without water) and wall
thickness.

Figure 2. the body phantom (torso); top cover (lid), and inner cylinder

The spheres were filled with non-radioactive water using syringe (10, 20 and 60 mL) and
spinal needles. Were performed ten measurements in each sphere. Figure 3 demonstrate an
syringe and needle used, the fillable spheres and the maximum volume filled is indicated by
the red arrow.

Figure 3. fillable spheres, syringe and needle used

The inner cylinder (lung insert) was filled with non-radioactive water using a glass becker of
the 500 mL. Three sequential measurements were performed. Measurements of height and
inner and outer diameter of the cylinder were also made.

The body (torso) was also filled with water. Was used to fill a 1L becker. The body (torso)
was measured with internal structures and their total weight was also evaluated. Furthermore,
wall thicknesses and diameter of the body phantom (torso) were recorded.

For reconstruction in code GATE the phantom was defined as a clear hierarchy: name of the
geometry, shape (cube, sphere, cylinder, etc...), material (air, water, vacuum, etc...) and
display type (if solid or wireframe) [8]. GATE script language was used for construction of
the phantom. The process of building the PET-NEMA/IEC body phantom was divided into
three steps: (1) construction and location of the spheres, (2) body phantom and (3) inner
cylinder.

The inner spheres, and capillaries associated with each, were placed inside a cube (called of
"world” in the GATE) where will be built as “children” all other geometries. The body

INAC 2011, Belo Horizonte, MG, Brazil.

phantom was built in sub-steps: a) a semi-cylinder (anterior) and; b) a semi-cylinder
(posterior) separated by a parallelepiped; c) other semi-cylinder divided: in the lower left and
lower right; d) finally, was added a inner cylinder (white) in the center, empty house with a
duct.

3. RESULTS AND DISCUSSION

The data showed that the total weight of the body (torso) phantom with all its internal
structures is 12.5 kg and the volume was 9.7 L. The body (torso) phantom wall thicknesses
were: lateral (0.3 cm); superior (1 cm), bottom (1.1 cm); top lid (2 cm). The dimensions of
the body phantom and top cover are presented schematically in Figure 5 along with body
phantom picture (top view).
30 cm

11.5 cm

15 cm 15 cm 23 cm

11.5 cm

D = 11.4

Figure 5. Dimensions cross-section of body phantom and top cover

The volumes of the “hot” and “cold” spheres are approximately equal to those presented by
the manufacturer (manual), according to Table 1.

INAC 2011, Belo Horizonte, MG, Brazil.

 Table 1. Ideal volume versus Measured Volume
Compartment (spheres) Ideal (manufactured) volume Measured Volume
(mL) (mL)
10 mm ± 0.5 0.52 0.525 ± 0.01
13 mm ± 0.5 1.15 1.17 ± 0.02
17 mm ± 0.5 2.57 2.52 ± 0.03
22 mm ± 1.0 5.57 5.58 ± 0.03
28 mm ± 1.0 11.49 11.51 ± 0.04
37 mm ± 1.0 26.52 26.54 ± 0.05

The greatest difference was 1.94%, sphere of 17 mm. However, when it is inserted
radioactivity in the sphere, can be calculated its concentration taking into account the ideal
manufactured volume (manual).

The inner cylinder that simulates the lung presented significant difference in the volume
described by manufactured (manual). The volume presented in manual is 194 ± 1mL, and the
measured volume is 273.3 ± 1.6 mL. The cylinder weight was 444.8 g and its height 20.3 cm.
The inner and external diameters were 4.4 cm and 5.1 cm, respectively.

Through the characterization of the PET-NEMA/IEC body phantom was possible to

reconstruction in computational modeling (GATE), as presented in Figure 6. The
reconstruction of the PET-NEMA/IEC body phantom in GATE will serve to compare the
results with the experimental results obtained.

Figure 6. PET-NEMA/IEC body phantom reconstructed in GATE; (a) inner spheres;

(b) body (torso) phantom and (c) inner cylinder (white)

The role of PET and PET/CT in oncology, as well as in cardiology and neurology, associated
with an increased use of PET for multiple purposes has induced the need to update specific
guides for PET and PET/CT in terms of acceptance tests and also in terms of Quality Control
and Quality Assurance [1]. Thus, this work is part of a larger project that aims to promote
awareness and standardization of tests for quality control of PET/CT equipments in Brazil.
The radioactive material used for the tests with the phantom is Fluorine-18 (18F). Care to fill
the phantom with radioactive material must be taken to avoid contamination. The activity
concentration inserted in phantom should trail NEMA/IEC norms recommendations. Thus,
analysis of measurements results can be analyzed consistently.

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 4. CONCLUSION

The measurements performed will be used for reliable assessment of the experimental data.
PET-NEMA/IEC body phantom characterization was successfully for computational
modeling in GATE.

ACKNOWLEDGMENTS

This work was supported by the National Institutes of Science and Technology (INCT) –
Metrology in Radiation Medicine. Cássio Miri Oliveira thanks CAPES by doctorate
scholarship.

REFERENCES

1. International Atomic Energy Agency (IAEA) – Human Health Series N°1. Quality
Assurance for PET and PET/CT Systems. Vienna (2009).
2. Agência Nacional de Vigilância Sanitária (ANVISA) – Resolução da Diretoria Colegiada
RDC N° 38 (2008).
3. BEYER T., “Acquisition Protocol Considerations for Combined PET/CT Imaging”, The
Journal of Nuclear Medicine, v. 45, n°1 (2004).
4. KARP, J.S., DAUBE-WITHERSPOON, M.E., HOFFMAN, E.J., et al, “Performance
Standards in Positron Emission Tomography”, Journal of Nuclear Medicine, v. 32, pp.
2342-2350 (1991).
5. National Electrical Manufactures Association–NEMA, “Standards Publications NU-2
2007: Performance Measurements of Positron Emission Tomographs”, Rosslyn, VA,
(2007).
6. International Electrotechnical Commission – IEC, “International Standard IEC 61675-1:
Radionuclide Imaging Devices – Characteristics and Test Conditions. Part 1: Positron
Emission Tomographs”, Geneva, Switzerland, 1998.
7. NEMA IEC Body Phantom SetTM User`s Manual (2008).
8. S. JAN, G. SANTIN, D. STRUL, S. STAELENS, et al. GATE User Guide, Versão 6.1,
Janeiro de 2011, disponível em http://www.opengatecollaboration.org.

INAC 2011, Belo Horizonte, MG, Brazil.