Nuclear Medicine Imaging Systems: The Scintillation Camera

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Radiation Detection and Measurement Range of charged particles (e.g.,!: µm; ": mm) Range of high energy photons (cm) Two main types of interactions of high energy photons Compton scatter Photoelectric absorption Types of radiation detectors gas-filled detectors solid state (semiconductor) organic scintillators (liquid plastic) inorganic scintillators (imaging systems) Modes of operation (pulse mode, current mode) Counting statistics (mean, variance) Poisson distribution (mean = variance) Confidence intervals (standard deviation from mean) Error propagation (adding in quadrature) Please turn in your evaluation forms for Drs. Kanal and Stewart. Nuclear Medicine Imaging Systems: The Scintillation Camera The Planar Gamma Camera Robert Miyaoka, PhD University of Washington Department of Radiology rmiyaoka@u.washington.edu Siemens e.cam List of Nuclear Medicine Radionuclides Tc99m 140.5 kev 6.03 hours I-131 364, 637 kev 8.06 days I-123 159 kev 13.0 hours I-125 35 kev 60.2 days In-111 172, 247 kev 2.81 days Th-201 ~70, 167 kev 3.044 days Ga-67 93, 185, 300 kev 3.25 days PMT LG Gamma Camera Instrumentation Electronics boards acquisition and processing computer crystal collimator From: Physics in Nuclear Medicine (Sorenson and Phelps) 1

The Scintillation Camera: Detector System Light Guide Crystal and light guide 3/8 thick NaI(Tl) Density 3.67 g/cm 3 Attenuation Coefficient (@140 kev) 2.64 cm -1 PE fraction ~80% Light output 40K/MeV Decay time 230 nsec Wavelength 410 nm Crystal Detection Efficiency Light response function versus position (spatial resolution) E x ˆ = x i! E i " i " E i i x 1 x 2 x 3 x 4 x 5 x 6 x 7 x 0.64 PMT LG Crystal Spatial Positioning Energy Resolution From: Physics in Nuclear Medicine (Sorenson and Phelps) 2

Scatter Gamma Camera Energy Spectra PMTs detector - NaI(Tl) All scatter counts are within the object (unlike in PET) Counts Gamma Camera Energy Spectra Nai(Tl) Energy Spectra (140 kev) 6 10 4 10% ER 20% ER 5 10 4 4 10 4 3 10 4 2 10 4 1 10 4 Standard Performance Specifications Detection efficiency approaching ~85% for 140 kev photons (10 mm thick NaI(Tl)) Energy resolution better than 10% for 140 kev photons Intrinsic spatial resolution of better than 4 mm FWHM for 140 kev photon source 0 0 50 100 150 200 energy (kev) 140 kev photons, 9.5 mm crystal Parallel Hole Collimator The Scintillation Camera: Collimators l e PMTs detector - NaI(Tl) 3

Collimators - Septal Penetration Collimator Efficiency l Detector Collimator septa Collimators typically absorb well over 99.95% of all photons emitted from the patient. d t Trade-off between spatial resolution and detection efficiency. Minimum septa thickness, t, for <5% septal penetration: From: Physics in Nuclear Medicine (Cherry, Sorenson and Phelps) 6d µ t! l " 3 µ ( ) LEGP, LEHR, MEGP, High Energy. Collimator Resolution Gamma Camera - spatial resolution R s = R 2 2 ( i + R c ) From: Physics in Nuclear Medicine (Cherry, Sorenson and Phelps) Types of Collimators Collimator: Resolution and Sensitivity magnification From: Physics in Nuclear Medicine (Cherry, Sorenson and Phelps) 4

Collimator: Resolution and Sensitivity Raphex Question D67. A patient with a history of thyroid cancer has suspected bone marrow metastases in the cervical spine. It is recommended to perform both an I-131 radioiodine scan as well as a bone scan using the Tc-99m-MDP. Which would be the optimum sequence to perform unambiguous scans in the shortest time? A. Administer the I-131 and Tc-99m simultaneously. Perform the bone scan first and recall the patient after 24 hours for the radioiodine scan. B. Administer the I-131 first. Perform the I-131 thyroid scan at 24 hours, then inject Tc- 99m MDP and perform the bone scan shortly afterwards. C. Administer the I-131 first. Perform the I-131 thyroid scan at 24 hours, then ask the patient to wait 3 to 6 weeks until the I-131 has fully decayed before performing the bone scan. D. Administer the Tc-99m MDP first. Perform the bone scan. Then administer the I- 131, and perform the thyroid scan after 24 hours. E. Administer the Tc-99m MDP first, followed shortly thereafter by the I-131. Then perform the bone scan followed by the thyroid scan after 24 hours. Raphex Question Raphex Question D75. In an anterior spot image of the thyroid, a starburst artifact may be seen. The cause of this artifact is: A. Contamination of the coilimator. B. Imperfections in the evenness of the collimator holes. C. An image reconstruction artifact caused by filtered back projection. D. Local photomultiplier tube dead time. E. Septal penetration. D64. What would be the appearance of a gamma camera image if a Tc-99m isotope scan were performed for the same duration but with the wrong collimator: a mediumenergy general-purpose instead of a low-energy general-purpose collimator? A. There would be absolutely no effect. B. The image will be more noisy, but probably clinically acceptable. C. The image quality would be poor due to septal penetration. The study would need to be repeated. D. There would be so few counts that the study would need to be repeated. E. This mistake could never happen, because instrument interlocks would prevent a Tc- 99m study being performed with the wrong collimator. The Scintillation Camera: Corrections and QA Gamma Camera Processing Electronics (energy correction) 19 8 9 Energy channel vs. event location 6 10 4 5 10 4 18 7 2 10 4 10 4 With corrections Without corrections 17 16 6 15 5 1 14 4 3 13 12 11 Counts 3 10 4 2 10 4 1 10 4 10% ER (between) 10% ER (over) 0 0 50 100 150 200 energy (kev) 5

Gamma Camera Processing Electronics (with and without energy correction) Gamma Camera Processing Electronics (linearity correction) 19 8 9 18 7 2 10 17 6 1 3 11 16 5 4 12 15 14 13 From: Physics in Nuclear Medicine (Cherry, Sorenson and Phelps) Gamma Camera Processing Electronics (linearity correction) Additional Gamma Camera Correction (sensitivity / uniformity correction) Acquired from long uniform flood after energy and linearity corrections have been applied Multiplicative correction Adjusts for slight variation in the detection efficiency of the crystal Compensates for small defects or damage to the collimator Should not be used to correct for large irregularities Daily Gamma Camera QA Tests Multienergy spatial registration (e.g., Ga-67 (93-, 185-, and 300 kev) gamma rays) Flood uniformity Photopeak window properly adjusted improperly adjusted 6

Spatial Resolution Test Pulse Pile-up FWHM of LSF = 1.7 x (size of smallest bar resolved) Energy spectra From: Physics in Nuclear Medicine (Sorenson and Phelps) and (Cherry, Sorenson and Phelps) Pile-up in image Image Acquisition The Scintillation Camera: Image Acquisition Frame mode (data stored as an image) - static - single image acquisition - can have multiple energy windows - dynamic - series of images acquired sequentially - gated - repetitive, dynamic imaging - used for cardiac imaging List-mode (data stored event by event) - time stamps are included within data stream - allows for flexible post-acquisition binning - can result in very large data files Gated Acquisition Region of Interest (ROI) and Time-Activity Curves (TAC) 7

Raphex Question Raphex Question D81. A cold spot artifact appears in a scintillation camera image. The artifact could be caused by all of the following except: A. The camera is incorrectly peaked for the radionuclide in the study. B. The photomultiplier tube is defective. C. The patient is wearing metallic jewelry. D. An out-dated uniformity correction is used. E. The wrong collimator was used. 2-4. In nuclear medicine imaging, match the following quality control procedures with the relevant choice: a. Gamma camera resolution b. Gamma camera field uniformity c. Photopeak window of the pulse height analyzer 2. Checked daily using a uniform flood source. 3. Checked daily by placing a small amount of a known source of radioisotope in front of the camera. 4. Checked weekly using a bar phantom. 8