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Performance testing of gamma cameras and single photon computed tomography/computed tomography (SPECT/CT) systems is not subject to regulatory requirements across states and territories in Australia. Internationally recognised testing standards from organisations such as the National Electrical Manufacturers Association (NEMA) describe methodologies for recommended tests. However, variations exist in suggested quality control (QC) schedules from professional bodies such as the Australia and New Zealand Society of Nuclear Medicine (ANZSNM). In this study, a survey was conducted to benchmark current QC programs across a selected sample of eight standalone and networked Australian public hospitals. Vendor-specific flood-field uniformity (intrinsic or extrinsic/system) verification without photomultiplier (PMT) tuning and CT QC were performed at all sites. Weekly and monthly PMT tuning followed by intrinsic flood-field verifications were performed at most sites. At least half of the sites performed monthly centre of rotation (COR) offset verifications. SPECT/CT alignment calibrations and verifications were undertaken by service engineers at all sites, and periodic verifications were performed by local staff at varying frequencies. Variations were observed for other periodic QC tests such as spatial resolution and planar sensitivity. Similarly, variations were observed for tests specific to whole-body systems and SPECT systems. Most sites checked daily and periodic QC results against pass/fail criteria set by vendors. Additional analyses of the QC results, including trend analysis and periodic reviews, were not common practice. The lack of regulatory requirements is likely to have led to variations in QC tests that are generally either harder to perform or are more labour intensive. [ABSTRACT FROM AUTHOR]

Background: Portable gamma cameras are being developed for nuclear medicine procedures such as thyroid scintigraphy. This article introduces Seracam® – a new technology that combines small field of view gamma imaging with optical imaging – and reports its performance and suitability for small organ imaging. Methods: The count rate capability, uniformity, spatial resolution, and sensitivity for 99mTc are reported for four integrated pinhole collimators of nominal sizes of 1 mm, 2 mm, 3 mm and 5 mm. Characterisation methodology is based on NEMA guidelines, with some adjustments necessitated by camera design. Two diagnostic scenarios – thyroid scintigraphy and gastric emptying – are simulated using clinically relevant activities and geometries to investigate application-specific performance. A qualitative assessment of the potential benefits and disadvantages of Seracam is also provided. Results: Seracam's performance across the measured characteristics is appropriate for small field of view applications in nuclear medicine. At an imaging distance of 50 mm, corresponding to a field of view of 77.6 mm × 77.6 mm, spatial resolution ranged from 4.6 mm to 26 mm and sensitivity from 3.6 cps/MBq to 52.2 cps/MBq, depending on the collimator chosen. Results from the clinical simulations were particularly promising despite the challenging scenarios investigated. The optimal collimator choice was strongly application dependent, with gastric emptying relying on the higher sensitivity of the 5 mm pinhole whereas thyroid imaging benefitted from the enhanced spatial resolution of the 1 mm pinhole. Signal to noise ratio in images was improved by pixel binning. Seracam has lower measured sensitivity when compared to a traditional large field of view gamma camera, for the simulated applications this is balanced by advantages such as high spatial resolution, portability, ease of use and real time gamma-optical image fusion and display. Conclusion: The results show that Seracam has appropriate performance for small organ 99mTc imaging. The results also show that the performance of small field of view systems must be considered holistically and in clinically appropriate scenarios. [ABSTRACT FROM AUTHOR]

Background: Gamma camera imaging, including single photon emission computed tomography (SPECT), is crucial for research, diagnostics, and radionuclide therapy. Gamma cameras are predominantly based on arrays of photon multipliers tubes (PMTs) that read out NaI(Tl) scintillation crystals. In this way, standard gamma cameras can localize ɣ‐rays with energies typically ranging from 30 to 360 keV. In the last decade, there has been an increasing interest towards gamma imaging outside this conventional clinical energy range, for example, for theragnostic applications and preclinical multi‐isotope positron emission tomography (PET) and PET‐SPECT. However, standard gamma cameras are typically equipped with 9.5 mm thick NaI(Tl) crystals which can result in limited sensitivity for these higher energies. Purpose: Here we investigate to what extent thicker scintillators can improve the photopeak sensitivity for higher energy isotopes while attempting to maintain spatial resolution. Methods: Using Monte Carlo simulations, we analyzed multiple PMT‐based configurations of gamma detectors with monolithic NaI (Tl) crystals of 20 and 40 mm thickness. Optimized light guide thickness together with 2‐inch round, 3‐inch round, 60 × 60 mm2 square, and 76 × 76 mm2 square PMTs were tested. For each setup, we assessed photopeak sensitivity, energy resolution, spatial, and depth‐of‐interaction (DoI) resolution for conventional (140 keV) and high (511 keV) energy ɣ using a maximum‐likelihood algorithm. These metrics were compared to those of a "standard" 9.5 mm‐thick crystal detector with 3‐inch round PMTs. Results: Estimated photopeak sensitivities for 511 keV were 27% and 53% for 20 and 40 mm thick scintillators, which is respectively, 2.2 and 4.4 times higher than for 9.5 mm thickness. In most cases, energy resolution benefits from using square PMTs instead of round ones, regardless of their size. Lateral and DoI spatial resolution are best for smaller PMTs (2‐inch round and 60 × 60 mm2 square) which outperform the more cost‐effective larger PMT setups (3‐inch round and 76 × 76 mm2 square), while PMT layout and shape have negligible (< 10%) effect on resolution. Best spatial resolution was obtained with 60 × 60 mm2 PMTs; for 140 keV, lateral resolution was 3.5 mm irrespective of scintillator thickness, improving to 2.8 and 2.9 mm for 511 keV with 20 and 40 mm thick crystals, respectively. Using the 3‐inch round PMTs, lateral resolutions of 4.5 and 3.9 mm for 140 keV and of 3.5 and 3.7 mm for 511 keV were obtained with 20 and 40 mm thick crystals respectively, indicating a moderate performance degradation compared to the 3.5 and 2.9 mm resolution obtained by the standard detector for 140 and 511 keV. Additionally, DoI resolution for 511 keV was 7.0 and 5.6 mm with 20 and 40 mm crystals using 60 × 60 mm2 square PMTs, while with 3‐inch round PMTs 12.1 and 5.9 mm were obtained. Conclusion: Depending on PMT size and shape, the use of thicker scintillator crystals can substantially improve detector sensitivity at high gamma energies, while spatial resolution is slightly improved or mildly degraded compared to standard crystals. [ABSTRACT FROM AUTHOR]

Efficient and secure decommissioning of nuclear facilities demands advanced technologies. In this context, gamma-ray detection and imaging are crucial in identifying radioactive hotspots and monitoring radiation levels. Our study is dedicated to developing a gamma-ray detection system tailored for integration into robotic platforms for nuclear decommissioning, offering a safe and automated solution for this intricate task and ensuring the safety of human operators by mitigating radiation exposure and streamlining hotspot localization.Our approach integrates a Compton camera based 3D reconstruction algorithm with a single Timepix3 detector. This eliminates the need for a second detector and significantly reduces system weight and cost. Additionally, combining a 3D camera with the setup enhances hotspot visualization and interpretation, rendering it an ideal solution for practical nuclear decommissioning applications.In a proof-of-concept measurement utilizing a 137Cs source, our system accurately localized and visualized the source in 3D with an angular error of 1° and estimated the activity with a 3% relative error. This promising result underscores the system's potential for deployment in real-world decommissioning settings. Future endeavors will expand the technology's applications in authentic decommissioning scenarios and optimize its integration with robotic platforms.The outcomes of our study contribute to heightened safety and accuracy for nuclear decommissioning works through the advancement of cost-effective and efficient gamma-ray detection systems.

Abstract Background Portable gamma cameras are being developed for nuclear medicine procedures such as thyroid scintigraphy. This article introduces Seracam® – a new technology that combines small field of view gamma imaging with optical imaging – and reports its performance and suitability for small organ imaging. Methods The count rate capability, uniformity, spatial resolution, and sensitivity for 99mTc are reported for four integrated pinhole collimators of nominal sizes of 1 mm, 2 mm, 3 mm and 5 mm. Characterisation methodology is based on NEMA guidelines, with some adjustments necessitated by camera design. Two diagnostic scenarios – thyroid scintigraphy and gastric emptying – are simulated using clinically relevant activities and geometries to investigate application-specific performance. A qualitative assessment of the potential benefits and disadvantages of Seracam is also provided. Results Seracam’s performance across the measured characteristics is appropriate for small field of view applications in nuclear medicine. At an imaging distance of 50 mm, corresponding to a field of view of 77.6 mm × 77.6 mm, spatial resolution ranged from 4.6 mm to 26 mm and sensitivity from 3.6 cps/MBq to 52.2 cps/MBq, depending on the collimator chosen. Results from the clinical simulations were particularly promising despite the challenging scenarios investigated. The optimal collimator choice was strongly application dependent, with gastric emptying relying on the higher sensitivity of the 5 mm pinhole whereas thyroid imaging benefitted from the enhanced spatial resolution of the 1 mm pinhole. Signal to noise ratio in images was improved by pixel binning. Seracam has lower measured sensitivity when compared to a traditional large field of view gamma camera, for the simulated applications this is balanced by advantages such as high spatial resolution, portability, ease of use and real time gamma-optical image fusion and display. Conclusion The results show that Seracam has appropriate performance for small organ 99mTc imaging. The results also show that the performance of small field of view systems must be considered holistically and in clinically appropriate scenarios.

Calibration of 22 gamma camera units was performed at 15 hospitals in southern and western Sweden to estimate 137Cs contamination in humans in a supine static geometry, with a new developed calibration protocol and phantom. The minimum detectable activities (MDAs) and the estimated committed effective doses (CEDs) were calculated for each calibration. Generic calibration factors were calculated for five predetermined groups based on the detector type and manufacturer. Group 1 and 2 included NaI-based gamma cameras from General Electrics (GEs) with a crystal thickness of 5/8′′ and 3/8′′ respectively. Group 3 and 4 included NaI-based gamma cameras from Siemens Healthineers with a crystal thickness of 3/8′′, with a similar energy window as the GE NaI-based cameras and a dual window respectively. Group 5 included semiconductor-based gamma cameras from GE with a CdZnTe (CZT) detector. The generic calibration factors were 60.0 cps kBq−1, 52.3 cps kBq−1, 50.3 cps kBq−1, 53.2 cps kBq−1 and 48.4 cps kBq−1 for group 1, 2, 3, 4, and 5 respectively. The MDAs ranged between 169 and 1130 Bq for all groups, with measurement times of 1–10 min, corresponding to a CED of 4.77–77.6 μ Sv. A dead time analysis was performed for group 1 and suggested a dead time of 3.17 μ s for 137Cs measurements. The dead time analysis showed that a maximum count rate of 232 kcps could be measured in the calibration geometry, corresponding to a CED of 108–263 mSv. It has been shown that semiconductor-based gamma cameras with CZT detectors are feasible for estimating 137Cs contamination. The generic calibration factors derived in this study can be used for gamma cameras of the same models in other hospitals, for measurements in the same measurement geometry. This will increase the measurement capability for estimating internal 137Cs contamination in the recovery phase following radiological or nuclear events. [ABSTRACT FROM AUTHOR]

Objectives The purpose of a parallel-hole collimator in a scintillation camera system is to transmit only those photons that have an emission angle close to the direction of the hole. This makes it possible to receive spatial information about the origin of the emission, that is, radioactivity decay. The dimension, shape, and intrahole thickness determine the spatial resolution and, by a tradeoff, sensitivity. The composition of the collimator material also plays an important role in determining a proper collimator. In this study, we compared tungsten alloys as a potential collimator material replacement for the conventional lead antimony material used in most of the current camera systems. Materials and Methods Monte Carlo simulations of a commercial scintillation camera system with low energy high resolution (LEHR), medium-energy (ME), and high-energy (HE) collimators of lead, tungsten, and tungsten-based alloy were simulated for different I-131, Lu-177, I-123, and Tc-99m sources, and a Deluxe rod phantom using the SIMIND Monte Carlo code. Planar images were analyzed regarding spatial resolution, image contrast in a cold source case, and system sensitivity for each collimator configuration. The hole dimensions for the three collimators were those specified in the vendor's datasheet. Results Using Pb, W, and tungsten alloy (Wolfmet) as collimator materials, the full width at half maximum (FWHM) measures for total counts (T) for LEHR with Tc-99m source (6.9, 6.8, and 6.8 mm), for ME with Lu-177 source (11.7, 11.5, and 11.6 mm), and for HE with I-131 (6.2, 13.1, and 13.1 mm) were obtained, and the system sensitivities were calculated as 89.9, 86.1, and 89.8 cps T /MBq with Tc-99m source; 42.7, 17.4, and 20.9 cps T /MBq with Lu-177 source; and 40.1, 69.7, and 77.4 cps T /MBq with I-131 source. The collimators of tungsten and tungsten alloy (97.0% W, 1.5% Fe, 1.5% Ni) provided better spatial resolution and improved image contrast when compared with conventional lead-based collimators. This was due to lower septal penetration. Conclusion The results suggest that development of a new set of ME and HE tungsten and tungsten alloy collimators could improve imaging of I-131, Lu-177, and I-123. [ABSTRACT FROM AUTHOR]

Background: Infertility is a significant aspect of reproductive health and evaluating degree of tubal pathology is essential for determining appropriate management plans. Aims and Objectives: To assess the role of hysterosalpingoscintigraphy (HSSG) as a tubal patency test in nuclear medicine and compare it with hysterosalpingography (HSG) in radiology in infertile women and study pain perception in both tests as well. Materials and Methods: A prospective study was conducted on 50 infertility patients undergoing infertility evaluation at a tertiary care hospital. Both HSG and HSSG procedures were performed during proliferative phase of menstrual cycle. Results: Our study demonstrated the potential of HSSG as a tool for evaluating tubal patency in infertility workup. It showed good accuracy in detecting tubal patency compared to HSG. Conclusion: HSG is a radiological procedure valued for its ability to provide detailed anatomical information of uterus and patency of fallopian tubes. In contrast, HSSG provides dynamic information on the functional aspects of the reproductive system using nuclear medicine techniques. Both HSG and HSSG are vital tools in the diagnostic armamentarium for assessing female reproductive health, offering complementary information that aids in comprehensive patient management. [ABSTRACT FROM AUTHOR]

Artifacts in nuclear medicine imaging are not uncommon. We are aware of some of these, for which we follow necessary protocols to avoid them. However, there are some unusual and unavoidable artifacts that we come across in daily imaging, which may be of concern and need to be detected and corrected on time. Hence, sharing a few such unusual artifacts we encountered while performing routine studies on positron emission tomography-computed tomography and gamma cameras, evaluating the cause and possible precautions. [ABSTRACT FROM AUTHOR]

Introduction: Sentinel lymph node biopsy for oral and oropharyngeal squamous cell carcinoma is a well-established staging method. One variation is to inject a radioactive tracer near the primary tumor of the patient. After a few minutes, audio feedback from an external hand-held γ -detection probe can monitor the uptake into the lymphatic system. Such probes place a high cognitive load on the surgeon during the biopsy, as they require the simultaneous use of both hands and the skills necessary to correlate the audio signal with the location of tracer accumulation in the lymph nodes. Therefore, an augmented reality (AR) approach to directly visualize and thus discriminate nearby lymph nodes would greatly reduce the surgeons' cognitive load. Materials and methods: We present a proof of concept of an AR approach for sentinel lymph node biopsy by ex vivo experiments. The 3D position of the radioactive γ -sources is reconstructed from a single γ -image, acquired by a stationary table-attached multi-pinhole γ -detector. The position of the sources is then visualized using Microsoft's HoloLens. We further investigate the performance of our SLNF algorithm for a single source, two sources, and two sources with a hot background. Results: In our ex vivo experiments, a single γ -source and its AR representation show good correlation with known locations, with a maximum error of 4.47 mm. The SLNF algorithm performs well when only one source is reconstructed, with a maximum error of 7.77 mm. For the more challenging case to reconstruct two sources, the errors vary between 2.23 mm and 75.92 mm. Conclusion: This proof of concept shows promising results in reconstructing and displaying one γ -source. Two simultaneously recorded sources are more challenging and require further algorithmic optimization. [ABSTRACT FROM AUTHOR]

Abstract Background Current guidelines of the radioiodine uptake (RAIU) test allow the use of different equipment, isotopes, activity and region-of-interest (ROI). We evaluated presence and extent of these differences in clinical practice and evaluated the effect of some of these variations on RAIU outcomes. Also, gamma camera-specific reference standards were calculated and retrospectively compared with measurements obtained during clinical RAIU tests. Materials and methods First, questionnaires were sent to Dutch nuclear medicine departments requesting information about equipment usage, isotope, isotope formulation, activity and measurement techniques. Secondly, a neck phantom containing a range of activities in capsule or water-dissolved formulation was scanned. Counts were measured using automatic ROI, square box ROI or all counts in the image. Thirdly, clinical RAIU data were collected during 2015–2018 using three different gamma cameras. Reference standards for each scanner were calculated using regression analysis between reference activity and measured counts. Uptake measurements using this gamma camera-specific reference standard were compared with original measurements. Results The survey demonstrated significant differences in isotope, isotope formulation, activity, use of neck phantoms, frequency and duration of reference measurements, distance to collimator, use of background measurements and ROI delineation. The phantom study demonstrated higher counts for the water-dissolved formulation than capsules using both automatic and square box ROI. Also, higher counts were found using a square box ROI than an automatic ROI. The retrospective study showed feasibility of RAIU calculations using camera-specific reference standards and good correlation with the original RAIU measurements. Conclusions This study demonstrated considerable technical variation in RAIU measurement in clinical practice. The phantom study demonstrated that these differences could result in differences in count measurements, potentially resulting in different dose calculations for radioactive iodine therapy. Retrospective data suggest that camera-specific reference standards may be used instead of individual reference measurements using separate activity sources, which may thus eliminate some sources of variation.

Background: Current guidelines of the radioiodine uptake (RAIU) test allow the use of different equipment, isotopes, activity and region-of-interest (ROI). We evaluated presence and extent of these differences in clinical practice and evaluated the effect of some of these variations on RAIU outcomes. Also, gamma camera-specific reference standards were calculated and retrospectively compared with measurements obtained during clinical RAIU tests. Materials and methods: First, questionnaires were sent to Dutch nuclear medicine departments requesting information about equipment usage, isotope, isotope formulation, activity and measurement techniques. Secondly, a neck phantom containing a range of activities in capsule or water-dissolved formulation was scanned. Counts were measured using automatic ROI, square box ROI or all counts in the image. Thirdly, clinical RAIU data were collected during 2015–2018 using three different gamma cameras. Reference standards for each scanner were calculated using regression analysis between reference activity and measured counts. Uptake measurements using this gamma camera-specific reference standard were compared with original measurements. Results: The survey demonstrated significant differences in isotope, isotope formulation, activity, use of neck phantoms, frequency and duration of reference measurements, distance to collimator, use of background measurements and ROI delineation. The phantom study demonstrated higher counts for the water-dissolved formulation than capsules using both automatic and square box ROI. Also, higher counts were found using a square box ROI than an automatic ROI. The retrospective study showed feasibility of RAIU calculations using camera-specific reference standards and good correlation with the original RAIU measurements. Conclusions: This study demonstrated considerable technical variation in RAIU measurement in clinical practice. The phantom study demonstrated that these differences could result in differences in count measurements, potentially resulting in different dose calculations for radioactive iodine therapy. Retrospective data suggest that camera-specific reference standards may be used instead of individual reference measurements using separate activity sources, which may thus eliminate some sources of variation. [ABSTRACT FROM AUTHOR]

Introduction: Performing lymphoscintigraphy in a separate room, frees up the conventional gamma camera, coupled with the desire to directly localize sentinel lymph nodes (SLN) in the operating theatre has led to the development of high‐resolution semiconductor‐detector based handheld gamma‐cameras, CrystalCam. Methods: This work consists of phantom and clinical studies. For the first part, a Jaszczak phantom with hollow spheres of various volumes were filled with the 99mTc and the camera's sensitivity was measured at various distances to assess the possibilities and limitations of the device. The clinical study evaluates the effectiveness of CrystalCam in localizing SLN in 40 consecutive malignant melanoma patients compared to both conventional planar lymphoscintigraphy and hybrid SPECT/CT. SLNs detected by planar lymphoscintigraphy were marked on the patients' skin using a UV‐marker. CrystalCam images were acquired in another room by another examiner and the SLNs were marked with a felt pen. The detected nodes by both camera systems were evaluated using UV‐lamp and normal light to visualize the UV‐ and felt pen marks respectively. The concordance rate of the SLNs and higher‐echelon nodes localized by both planar scintigraphy and CrystalCam imaging with respect to the total SLNs and higher‐echelon nodes detected by SPECT/CT imaging are compared and statistically analyzed. Results: The results of the phantom study show a good correlation between activity and count‐rates for all distancesSPECT/CT, CrystalCamm, and planar lymphoscintigraphy detected 69, 58, and 61 SLNs respectively. The concordance rate of 95.65% by the CrystalCam and planar scintigraphy implies both cameras are statistically coequal in preoperative SLN detection of malignant melanoma. For the higher‐echelon nodes, SPECT/CT, planar and CrystalCam imaging systems identified 82, 48, and 13 respectively; thus, CrystalCam was statistically inferior to planar imaging. Conclusion: The handheld CrystalCam is a reliable instrument for localizing SLNs in surgical centers without an on‐site nuclear medicine department. [ABSTRACT FROM AUTHOR]

The quantitative accuracy and precision of brain positron emission tomography (PET) studies can be considerably improved using dedicated brain PET scanners with a uniform high resolution and a high sensitivity across the brain volume. One approach to building such a system is to construct the PET scanner using depth-of-interaction (DOI) encoding detectors with finely segmented and thick crystal arrays. In this paper, the performance of a DOI PET detector based on two 16 × 16 arrays of 2 × 2 mm2 SiPMs coupled to both ends of a 44 × 44 array of 0.69 × 0.69 × 30 mm3 polished LYSO crystals was evaluated at different temperatures (-9°C, 0°C, 10°C, and 20°C) for brain PET applications. The pitch size of the LYSO array is 0.75 mm. The flood histograms show that all the crystal elements in the LYSO array can be resolved except some edge crystals, due to the limited light sharing. The average energy resolution, average DOI resolution, and average timing resolution across crystal elements are 21.1 ± 3.0%, 3.47 ± 0.17 mm, and 1.38 ± 0.09 ns, respectively, which were obtained at a bias voltage of 56.5 V and a temperature of 0°C.

In our previous studies, we demonstrated that the Compton PET module, a layer structure PET detector with side readout, can provide high performance in terms of spatial/energy/timing resolution, as well as high gamma ray detection efficiency. In this study, we investigate how to translate the high performance of the detector module into good quality reconstructed tomographic images. This study is performed using GATE simulation, as well as with physical experiments. Similar detector geometry is used in the simulation and experiment: two identical 4-layer detector modules are placed with face to face distance of 56 mm. In the simulation study, each layer consists of a 1-mm-pitch pixelated crystal array. In the experimental study, each layer is a monolithic crystal, which is virtually binned into 1 mm2 cells to group single events according to the gamma ray interaction locations. A customized Derenzo phantom was placed between the two detector modules. By rotating the phantom using a motorized rotary stage, data along lines of response (LORs) at different angles were collected for reconstructing the tomographic image. The same reconstruction algorithm was used for both simulation and experimental studies. The results demonstrate that the simulation study could resolve 0.8 mm rods while the experimental study was able to resolve 1.0 mm rods.

Purpose: Gamma cameras are one of the most promising technologies for in-vivo range monitoring in proton therapy. Monte Carlo (MC) simulation is a common calculation-based technique to design and optimize gamma cameras. However, it is prohibitively time-consuming. Analytical modeling speeds up the process of finding the optimal design. Materials and Methods: We proposed an analytical method using the efficiency-resolution trade-off for optimizing a knife-edge collimator based on the range retrieval precision of protons. Monte Carlo simulation was used for validation of obtained collimator efficiencies. Results: The model predicts that for the optimal range retrieval precision, the ratio of the source-to-detector distance to the source-to-collimator distance should be ranging from . For a special case, it was found that assuming an ideal detector , the falloff retrieval precision is optimal at independent of the collimator resolution. Moreover, using the optimized camera, the difference between the MC calculated range and the absolute range was 0.5 cm (the relative error is about 3%). Conclusion: It was found that the collimator parameters are in good agreement in comparison with that of the MC results reported in the literature. The analytical method studied in this work can be used to design and optimize imaging systems based on KE collimators in combination with new detectors in a fast and reliable way.

Sentinel lymph node biopsy (SLNB) is a standard practice for staging cutaneous melanoma. High false-negative rates have an increased interest in adjunctive techniques for localizing SLNs. Mobile gamma cameras (MGCs) represent potential tools to enhance SLNB performance. An institutional review board approval was obtained for this study (ClinicalTrials.gov ID NCT01531608). After obtaining informed consent, 20 eligible melanoma patients underwent 99mTc sulfur colloid injection and standard lymphoscintigraphy with a fixed gamma camera (FGC). A survey using a 20 cm square MGC, performed immediately preoperatively by the study surgeon, was used to establish an operative plan while blinded to the FGC results. Subsequently, SLNB was performed using a gamma probe and a novel 6 cm diameter handheld MGC. A total of 24 SLN basins were detected by FGC. Prior to unblinding, all 24 basins were identified with the preoperative MGC and the operative plan established by preoperative MGC imaging was confirmed accurate by review of the FGC images. All individual sentinel lymph nodes were identified during intraoperative MGC imaging, and in 5/24 (21%) cases, surgeon-reported additional clinically useful information was obtained from the MGC. Preoperative MGC images provide information consistent with FGC images for planning SLNB and in some cases provide additional information that aided in surgical decision-making. [ABSTRACT FROM AUTHOR]

Background: Estimation of the thyroid gland volume is generally considered important in several pathologic situations. The main objective of this study was to evaluate the thyroid uptake (TU) of 99mTcO4- in Sudanese people, using gamma camera and dose calibrator methods and comparing the results with international TU levels. Methods and Results: The study was conducted in 2020 at the National Cancer Institute (Wad Madani state, University of Gezira, Sudan). This study included 64 patients (58 females and 6 males) aged 13-81 years (37.25±14.58 years) with normal TU. Most patients (43.8%) were in the age subgroup of 31-48 years, followed by 39.1% in the age subgroup of 13-30 years.Two calibration methods were used to calculate full and empty syringes before and after radiopharmaceutical injection: a) using a dose calibrator measuring in MBq; b) with gamma camera images of the full and empty syringes for 1 minute (counts). In the dose calibrator, the activity and time of a 99mTc point source in a syringe were monitored, the point source was precisely aligned with the center of the camera, and a static image was obtained with static parameters at a distance of 5cm and 7cm between source and pinhole collimator (265×265 matrix). The study showed that the TU values using the dose calibrator method were more consistent with radiation protection principles of minimizing the exposure to radiation for staff. The method also had higher values than those measured with a gamma camera due to the scatter radiation. The relationship between TU of 99mTcO4- with syringe measured by dose calibrator and gamma camera at a distance of 5cm and 7cm, given a coefficient of determination (R2) of 0.9937 and 0.9591, respectively Conclusion: There was no big change in the TU between the two methods, especially at 5cm object-to-pinhole distance, where it gave the best result for optimum imaging in the 99mTcO4- TU test.

Purpose: Preclinical aerosol studies using animals are essential for evaluating toxic or therapeutic effects on human respiratory tract. Macaques are relevant animal models for respiratory studies, but they are sensitive, expensive and difficult-to-access. Methods: In the context of preliminary studies before animal experiments, we set up an alternative in vitro anatomical model of macaque airways to reduce, refine and replace (3Rs) the animals. We printed an in vitro anatomical cast until the third bronchial division from X-ray computed tomography data of a healthy cynomolgus macaque. This in vitro model was then connected to a respiratory pump to mimic macaque's breathing. We assessed the relevance of this in vitro model, by comparing aerosol deposition patterns obtained with the anatomical model and in three macaques using planar gamma camera imaging. DTPA-99mTechnetium aerosols were produced using three jet nebulizers, generating three different particle sizes: 13.1, 3.2 and 0.93 µm in terms of the mass median aerodynamic diameter (MMAD). Results: The data showed no statistical differences between the animal and anatomical in vitro models in terms of total aerosol deposited in the airways. However, the distribution of the deposition in the airways showed a higher deposited fraction in the upper respiratory tract in the animals than the in vitro model for all particle sizes. Conclusions: The anatomical printed model appears to be a relevant in vitro tool to predict total aerosol deposition in macaque airways. [ABSTRACT FROM AUTHOR]

The enormous advances in sensing and data processing technologies in combination with recent developments in nuclear radiation detection and imaging enable unprecedented and "smarter" ways to detect, map, and visualize nuclear radiation. The recently developed concept of three-dimensional (3-D) Scene-data fusion allows us now to "see" nuclear radiation in three dimensions, in real time, and specific to radionuclides. It is based on a multi-sensor instrument that is able to map a local scene and to fuse the scene data with nuclear radiation data in 3-D while the instrument is freely moving through the scene. This new concept is agnostic of the deployment platform and the specific radiation detection or imaging modality. We have demonstrated this 3-D Scene-data fusion concept in a range of configurations in locations, such as the Fukushima Prefecture in Japan or Chernobyl in Ukraine on unmanned and manned aerial and ground-based platforms. It provides new means in the detection, mapping, and visualization of radiological and nuclear materials relevant for the safe and secure operation of nuclear and radiological facilities or in the response to accidental or intentional releases of radioactive materials where a timely, accurate, and effective assessment is critical. In addition, the ability to visualize nuclear radiation in 3-D and in real time provides new means in the communication with public and facilitates to overcome one of the major public concerns of not being able to "see" nuclear radiation.

Purpose: Measurement of the dwell time and moving speed of a high‐activity iridium‐192 (Ir‐192) source used for high‐dose‐rate (HDR) brachytherapy is important for estimating the precise dose delivery to a tumor. For this purpose, we used a cerium‐doped yttrium aluminum perovskite (YA1O3:YAP(Ce)) gamma camera system, combined with a list‐mode data acquisition system that can acquire short‐time sequential images, and measured the dwell times and moving speeds of the Ir‐192 source. Methods: Gamma photon imaging was conducted using the gamma camera in list mode for the Ir‐192 source of HDR brachytherapy with fixed dwell times and positions. The acquired list‐mode images were sorted to millisecond‐order interval time sequential images to evaluate the dwell time at each position. Time count rate curves were derived to calculate the dwell time at each source position and moving speed of the source. Results: We could measure the millisecond‐order time sequential images for the Ir‐192 source. The measured times for the preset dwell times of 2 s and 10 s were 1.98 to 2.00 s full width at half maximum (FWHM) and 10.0 s FWHM, respectively. The dwell times at the first dwell position were larger than those at other positions. We also measured the moving speeds of the source after the dwells while moving back to the afterloader and found the speed increased with the distance from the edge of the field of view to the last dwell position. Conclusion: We conclude that millisecond‐order time sequential imaging of the Ir‐192 source is possible by using a gamma camera and is useful for evaluating the dwell times and moving speeds of the Ir‐192 source. [ABSTRACT FROM AUTHOR]

Coded Aperture (CA) imaging has recently been used in nuclear medicine, but still, there is no commercial SPECT imaging camera based on CA for cancer detection. The literature is rich in examples of using the CA for planar and thin 3D imaging. However, thick 3D reconstruction is still challenging for small lesion detection. This paper presents the results of mosaic modified uniformly redundant array (MURA) mask/antimask CA combined with a maximum-likelihood expectation-maximization (MLEM) algorithm. The MLEM is an iterative algorithm applied to a mosaic MURA CA mask/antimask for 3D anthropomorphic breast phantom reconstruction, slice by slice. The difference between the mask and the antimask suppresses the background noise to enhance the quality of reconstructed images. Furthermore, all reconstructed slices are stacked to form a 3D breast phantom image from single-projection data. The results of phantom reconstruction with 8 mm, 6 mm, 4 mm, and 3 mm lesions are presented. Moreover, the proposed SPECT imaging camera can reconstruct a 3D breast phantom from single-projection data of the patient's scanning. To assess the quality of lesions in the reconstructed images, the contrast-to-background ratio (CBR), the peak signal-to-noise ratio (PSNR) and mean square error (MSE) were measured. [ABSTRACT FROM AUTHOR]

This report is of an unusual case of radioactive contamination of a gamma camera after scanning two individuals who had been treated 3 days prior with ablative doses of radioiodine (131I) for thyroid cancer. A combination of observed half-life and pulse-height spectroscopy were employed to identify the radio-contaminant. The source of the contamination was eventually found to be a single human hair, presumably contaminated by the individual sucking her hair while waiting for the scan to start. This case demonstrates that hair can be contaminated by saliva and potentially other bodily fluids in the post-ablation setting and that using physical characteristics, in this case the observed half-life and pulse-height spectroscopy, can be useful in identifying the radio-contaminant. [ABSTRACT FROM AUTHOR]

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Purpuse: The SPECT/CT gamma camera is the most commonly used imaging device in nuclear medicine. It is used to detect photons emanating from radioactive material. For its proper functioning, it is necessary to perform quality control tests regularly. One of the most important tests is extrinsic uniformity, which must be performed every day before starting work. We wanted to determine how extrinsic uniformity varies if we change the number of counts and the matrix size. Methods: The measurements were carried out on SPECT/CT, where we placed a cobalt flood source between the two detectors. We used the protocol for uniformity where we used the different number of counts (3 million, 4.5 million, and 10 million) and different matrix sizes. Uniformity was calculated with the IAEA application in the program Image. Results: The uniformity values are improved if we increase the number of counts (p<0.01). In most cases was determined that the matrix size does not affect uniformity (p>0.01). An exception was shown at integral uniformity with the useful field of view on detector one (p<0.01) and detector two (p<0.01). Conclusion: By increasing the number of counts, the uniformity of the detector system improves. The matrix size does not have a significant effect on the uniformity of the detector system. [ABSTRACT FROM AUTHOR]

The mask parameters of a coded aperture are critical design features when optimizing the performance of a gamma-ray camera. In this paper, experiments and Monte Carlo simulations were performed to derive the minimum detectable activity (MDA) when one seeks a real-time imaging capability. First, the impact of the thickness of the modified uniformly redundant array (MURA) mask on the image quality is quantified, and the imaging of point, line, and surface radiation sources is demonstrated using both cross-correlation (CC) and maximum likelihood expectation maximization (MLEM) methods. Second, the minimum detectable activity is also derived for real-time imaging by altering the factors used in the image quality assessment, consisting of the peak-to-noise ratio (PSNR), the normalized mean square error (NMSE), the spatial resolution (full width at half maximum; FWHM), and the structural similarity (SSIM), all evaluated as a function of energy and mask thickness. Sufficiently sharp images were reconstructed when the mask thickness was approximately 2 cm for a source energy between 30 keV and 1.5 MeV and the minimum detectable activity for real-time imaging was 23.7 MBq at 1 m distance for a 1 s collection time.

Boron–neutron capture therapy (BNCT) is a cancer treatment method that exploits the high neutron reactivity of boron. Monitoring the prompt gamma rays (PGs) produced during neutron irradiation is essential for ensuring the accuracy and safety of BNCT. We investigate the imaging of PGs produced by the boron–neutron capture reaction through Monte Carlo simulations of a gamma camera with a SrI2 scintillator and parallel-hole collimator. GAGG scintillator is also used for a comparison. The simulations allow the shapes of the energy spectra, which exhibit a peak at 478 keV, to be determined along with the PG images from a boron–water phantom. It is found that increasing the size of the water phantom results in a greater number of image counts and lower contrast. Additionally, a higher septal penetration ratio results in poorer image quality, and a SrI2 scintillator results in higher image contrast. Thus, we can simulate the BNCT process and obtain an energy spectrum with a reasonable shape, as well as suitable PG images. Both GAGG and SrI2 crystals are suitable for PG imaging during BNCT. However, for higher imaging quality, SrI2 and a collimator with a lower septal penetration ratio should be utilized.

This study aims to develop a variable lofthole (VL) collimator-based gamma camera with a zoom function for detecting radioactive materials in radiation disaster situations. The VL collimator comprises seven layers, each forming a square hole with four tungsten (W) plates. Each layer of a W plate was controlled using four spur gears: external, internal, and rack gears. The VL collimator had a symmetrical structure. The detector was composed of a combination of a gadolinium aluminum gallium garnet scintillator doped with cerium (Ce:GAGG) and a silicon photomultiplier in the form of a two-dimensional array. In addition, a linear actuator was designed to enable precise forward and backward driving of the detector along with driving of the collimator to realize a magnification suitable for this purpose. The experimental results demonstrated that the full width at half maximum (FWHM) for the square hole size of 10 × 10 mm2 to 2 × 2 mm2 of the VL collimator at an acceptance angle of 45 ° decreased from 58.5 to 17.5 %, respectively. When the reception angle was reduced from 45 ° to 16 ° in a VL collimator with a square hole size of 3 × 3 mm2, the magnification increased by a factor of approximately 2.6. As the magnification increased, the spatial resolution improved, and it was confirmed that the two sources were well-distinguished. The results showed that the VL collimator-based gamma camera system designed in this study can be used to image radioactive materials with high sensitivity and resolution in radiation-related disaster situations. • A variable lofthole (VL) collimator-based gamma camera for radiation disaster situations was developed. • The VL collimator comprises seven layers, each forming a square hole with four tungsten (W) plates. • The sensitivity and resolution of the VL collimator were evaluated, quantitatively. • As the acceptance angle changed from 45 ° to 16 ° in a VL collimator, the magnification increased by a factor of 2.6. [ABSTRACT FROM AUTHOR]

• We design a large field-of-view gamma detector with reduced cost while preserving image quality. • The NEMA NU 1-2018 results confirmed that the designed detector had excellent performance. • The developed detector has suitable specifications for high-end nuclear medicine imaging. Large scintillation crystals-based gamma cameras play a crucial role in nuclear medicine imaging. In this study, a large field-of-view (FOV) gamma detector consisting of 48 square PMTs developed using a new readout electronics, reducing 48 (6 × 8) analog signals to 14 (6 + 8) analog sums of each row and column, with reduced complexity and cost while preserving image quality. All 14 analog signals were converted to digital signals using AD9257 high-speed analog to digital (ADC) converters driven by the SPARTAN-6 family of field-programmable gate arrays (FPGA) in order to calculate the signal integrals. The positioning algorithm was based on the digital correlated signal enhancement (CSE) algorithm implemented in the acquisition software. The performance characteristics of the developed gamma camera were measured using the NEMA NU 1-2018 standards. The measured energy resolution of the developed detector was 8.7 % at 140 keV, with an intrinsic spatial resolution of 3.9 mm. The uniformity was within 0.6 %, while the linearity was within 0.1 %. The performance evaluation demonstrated that the developed detector has suitable specifications for high-end nuclear medicine imaging. [ABSTRACT FROM AUTHOR]

(1) Background: Concentric ring artifacts in reconstructed SPECT images indicate the presence of detector non-uniformity in gamma camera systems. The identification of these artifacts is generally visual and not quantitative. The aim of our study was to evaluate observer assessments of the presence of concentric rings in reconstructed SPECT phantom images and to verify whether quantitative texture analysis can detect such artifacts, which are detrimental to accurate tumor detection. (2) Methods: Test data were acquired as part of the quarterly quality assurance program using a standardized SPECT phantom containing solid spheres, solid rods, and a water solution of 99mTc. Forty separate SPECT acquisitions were analyzed to assess the presence of ring artifacts. Two experienced medical physicists independently reviewed transaxial images and graded the severity of artifacts on a five-point scale. Quantitative radiomic features were computed for volumes of interest located in the uniform phantom section. In addition to these, radial contrast ( R C o n t r a s t ) and radial root-mean-square contrast ( R R M S C ) were also calculated and derived from the radial profile of summed slices transformed into polar coordinates. (3) Results: Artifacts were considered sufficiently severe to warrant camera re-tuning in 10 rod sections, 17 sphere sections, and 16 uniform sections. In the uniform sections, there was "good agreement" for inter-observer and intra-rater assessments (κ = 0.66, Fisher exact p < 0.0001 and κ = 0.61, and Fisher exact p = 0.001, respectively). The two radial features agreed significantly (p < 0.001) with visual severity judgment of ring artifacts in uniform sections and were selected as informative about the presence of ring artifacts by LASSO approach. The increased magnitude of R C o n t r a s t and R R M S C correlated significantly with increasingly severe artifact scores (ρ = 0.65–0.66, p < 0.0001). (4) Conclusions: There was good agreement between the physicists with respect to the presence of circular ring artifacts in uniform sections of SPECT quality assurance scans, with the artifacts accurately detected by radial contrast and noise-to-signal ratio measurements. [ABSTRACT FROM AUTHOR]

This study tried to propose an innovated idea of solidifying the resolution of gamma camera in routine quality control and recommended a quantified index as minimum detectable difference (MDD) of gamma camera SPECT images using the Taguchi analysis and an indigenous V-shaped slit gauge. The gauge was customized to fulfill the quantitative requirement of the Taguchi analysis. The MDD among slit gauge of derived SPECT image was calculated from two overlapped peak profiles collected from a tangent slice of the V-shaped slit gauge with two nearby peaks. In particular, MDD was evaluated as minimum distance between two peak centers through the Student's t-test with a constant, 1.96, which indicates that two peak centers separated distant enough to create a 95% confidence level of separation. Eighteen combinations of six gamma camera scanned factors were organized according to Taguchi analysis. Accordingly, (A) collimator, (B) detector to targe distance, (C) total counts, (D) acquired energy width, (E) Matrix size, and (F) zoom of collected ROI with each of two or three levels were organized into 18 groups to collect the slit gauge images according to Taguchi L18 orthogonal array. Then, three well-trained radiologists were ranked the scanned gauge images to derive the fish-bone-plot of signal-to-noise ratio (S/N, dB) and correlated ANOVA. Furthermore, the quantified MDD was proposed to verify the optimal suggestion of gamma camera scanned protocol, and obtained the MDD as 8.4, 7.9, and 7.1 mm for the second group of original L18 preset, conventional, and the optimal preset, respectively. Thus, the optimal preset of gamma camera was achieved in this study. The MDD proved to be a successful index in quantifying the imaging resolution of a gamma camera. [ABSTRACT FROM AUTHOR]

Background: Technetium-99 m (99mTc) pertechnetate thyroid uptake rate can be measured with a gamma probe or gamma camera. This study was performed to compare their diagnostic accuracy for evaluating patients with thyrotoxicosis. Methods: We retrospectively reviewed 99mTc pertechnetate thyroid uptake rate records of patients by both gamma probe and camera methods at a tertiary center in Korea from November 2019 to June 2020. We determined the normal reference ranges of thyroid uptake rate by two methods and compared both methods for differentiating Graves' disease and thyroiditis in patients with thyrotoxicosis by receiver operating characteristic curve analysis. Results: A total of 371 patients (euthyroid 89, Graves 167, and thyroiditis 115) were included. The normal reference range for thyroid uptake rate in euthyroid patients was 0.3–1.9% and 2.0–4.7% for the camera and probe methods, respectively. For differentiating Graves' disease and thyroiditis, the area under the curve of the camera method (0.988) was significantly greater than that (0.975) of the probe method (p = 0.030). The sensitivity and specificity for the probe method were 92.2% and 91.3%, respectively, with a cut-off value of 3.0%. Those for the camera method were 93.4% and 94.8%, respectively, with a cut-off value of 0.7%. Conclusion: 99mTc pertechnetate thyroid uptake rate measured by the camera method had higher diagnostic accuracy than the probe method for evaluating patients with thyrotoxicosis. Considering the diagnostic accuracy and patient convenience, the thyroid uptake rate measured by the camera method would be a good substitute for the probe method. [ABSTRACT FROM AUTHOR]

Introduction The functionality of radionuclide dose calibrator and nuclear medicine imaging systems hasa direct effect on the accuracy and preciseness of internal dosimetry evaluations. Our study, therefore, aimed to critically appraise the radionuclide calibrators and gamma cameras prior to Lutetium-177 (177 Lu) internal dosimetry in a developing country. Materials and Methods Two radionuclide calibrators' and three gamma cameras at two South African hospitals were critically appraised in preparation for internal dosimetry of 177 Lu. The radionuclide calibrators' accuracy, linearity, and sample volume abilities were appraised. For the three gamma cameras, the uniformity, energy resolution, center of rotation, and collimator sensitivity were appraised. These appraisals were performed between the years 2014 and 2019. Results The radionuclide calibrators' constancy, accuracy, linearity, and sample volume were within ± 5%. We also integrated a 177 Lu calibration factor into one radionuclide calibrator's library. The three gamma cameras' uniformity was within 2 to 5%, energy resolution within 11%, center of rotation within 2 mm, and the sensitivity recorded for all low energy high resolution collimator. Conclusion Our radionuclide calibrators passed the critical appraisal and may be confidently used for assaying 177 Lu. All three cameras also passed critical appraisal and may be used to assess organ absorbed dose. [ABSTRACT FROM AUTHOR]

Accurate localization of radioactive materials is crucial in homeland security and radiological emergencies. Coded-aperture gamma camera is an interesting solution for such applications and can be developed into portable real-time imaging devices. However, traditional reconstruction methods cannot effectively deal with signal-independent noise, thereby hindering low-noise real-time imaging. In this study, a novel reconstruction method with excellent noise-suppression capability based on a multi-layer perceptron (MLP) is proposed. A coded-aperture gamma camera based on pixel detector and coded-aperture mask was constructed, and the process of radioactive source imaging was simulated. Results showed that the MLP method performs better in noise suppression than the traditional correlation analysis method. When the Co-57 source with an activity of 1 MBq was at 289 different positions within the field of view which correspond to 289 different pixels in the reconstructed image, the average contrast-to-noise ratio (CNR) obtained by the MLP method was 21.82, whereas that obtained by the correlation analysis method was 5.85. The variance in CNR of the MLP method is larger than that of correlation analysis, which means the MLP method has some instability in certain conditions.

Aims: To explore whether the novel 360° gamma camera design of VERITON-CT adversely affects the rate of scan non-completion due to claustrophobia or other patient experience factors, when compared to a standard dual-headed gamma camera. Methods: Single centre prospective study of all nuclear medicine studies on either of two gamma cameras; the VERITON-CT (Spectrum Dynamics Medical) and Discovery NM/CT 670 (GE Healthcare). It was recorded whether the patient had completed the scan as protocoled or, due to claustrophobia, had a shortened scan or no scan. The patients were also offered a patient experience questionnaire, with domains of comfort, scan time, scan noise and claustrophobia assessed using a five-point Likert scale. Results: Over a four-month period, there were 296 patients scanned on the Discovery scanner and 274 patients scanned on the VERITON-CT scanner. There was a scan non-completion rate, due to claustrophobia, of 1.35 % for the Discovery and 1.46 % for the VERITON-CT scanner. 354/570 (62%) of all patients involved returned their questionnaires. There was no statistical difference between the responses for comfort, scan time, scan noise and feelings of claustrophobia. Conclusion: The study provides evidence that the novel 360° gamma camera design of VERITON-CT does not lead to a significantly increased scan failure rate due to claustrophobia and there is no change in the subjective experience for patients. [ABSTRACT FROM AUTHOR]

Objective: Chronic kidney disease (CKD) is evaluated based on glomerular filtration rate (GFR) using a gamma camera in the nuclear medicine center or hospital in a routine procedure, but the gamma camera does not provide the accurate stages of the diseases. Therefore, this research aimed to find out the normal or abnormal stages of CKD based on the value of GFR using an artificial neural network (ANN).Methods: Two hundred fifty (Training 188, Testing 62) kidney patients who underwent the ultrasonography test to diagnose the renal test in our nuclear medical centre were scanned using gamma camera. The patients were injected with 99mTc-DTPA before the scanning procedure. After pushing the syringe into the patient's vein, the pre-syringe and post syringe radioactive counts were calculated using the gamma camera. The artificial neural network uses the softmax function with cross-entropy loss to diagnose CKD normal or abnormal labels depending on the value of GFR in the output layer.Results: The results showed that the accuracy of the proposed ANN model was 99.20% for K-fold cross-validation. The sensitivity and specificity were 99.10% and 99.20%, respectively. The Area under the curve (AUC) was 0.9994.Conclusion: The proposed model using an artificial neural network can classify the normal or abnormal stages of CKD. After implementing the proposed model clinically, it may upgrade the gamma camera to diagnose the normal or abnormal stages of the CKD with an appropriate GFR value. [ABSTRACT FROM AUTHOR]