Chapter 9 – Quality Control

This chapter provides detailed instructions for performing the Infinia II

quality control procedures, and specifies their regular performance schedule.
The following procedures and utilities are included in this chapter.

Description Section Page #

QC Reports and Images Section 9.1 page 9-3

Printing QC Test Results Section 9.2 page 9-4

Reviewing QC & System Setup Reports Section 9.3 page 9-6

Accessing the Quality Control Utilities Section 9.4 page 9-8

QC Overview Section 9.5 page 9-10

Image QC Tests Section 9.6 page 9-12

• Preparation for Image QC Procedures Section 9.6.1 page 9-12

• NM Daily QC Procedure Section 9.6.3 page 9-14

• HE NM Daily QC Section 9.6.4 page 9-31

• Periodical NM Calibration & QC Section 9.6.5 page 9-32

• HE Periodical NM Calibration & QC Section 9.6.6 page 9-38

• X-ray Daily QC (Hawkeye Option) Section 9.6.7 page 9-39

• CoDe Daily QC Procedure Section 9.6.10 page 9-46

C.O.R. QC Test Section 9.7 page 9-51

Performance (Acceptance) Tests Section 9.8 page 9-66

• Required Sources and Equipment Section 9.8.1 page 9-66

• Performance Tests Acceptable Results Section 9.8.2 page 9-73

• Uniformity Test Section 9.8.3 page 9-75

• Resolution And Linearity Tests Section 9.8.4 page 9-78

• Energy Test Section 9.8.5 page 9-87

• SPECT Count Density Test Section 9.9 page 9-90

• Jaszczak Phantom Test Section 9.9.3 page 9-92

X-ray QC Tests Section 9.10 page 9-98

X-ray to NM Registration Test (QC) Section 9.11 page 9-124

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Quality Control

WARNING

Failing to perform the QC procedures as specified in this chapter may cause

serious deterioration in image quality, resulting in misinterpretation of the
acquired images.

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Quality Control QC Reports and Images

9.1 QC Reports and Images

z The QC report is automatically saved on the Infinia and can be

accessed via the Service Reports sub-category in the Logs tab. Refer
to Reviewing QC & System Setup Reports on page 9-6.
z Trends for values tested during QC can be viewed via the History
Browser where they are categorized by the Isotope used and the front
end mode. Refer to QC Trend Analysis on page 9-30.
z QC reports can be printed to a Windows printer attached to the Infinia.
Alternately, a JPEG image file can be created on the Infinia which is
accessible from the Xeleris for printing. See Printing QC Test Results
on page 9-4. In order to print the QC reports from Xeleris,
z QC reports can be archived using the QC Archive utility. See
Archiving QC Reports on page 9-30.
z QC images are saved to the Infinia database and can be transferred
to Xeleris for further processing, printing and archiving. See
Archiving QC Reports on page 9-30.
z It is possible to review QC studies from the Data Management screen.
To view the study, select QC images as the Current source and press
[View Study].
z Daily QC reports are automatically saved in the Daily QC study as a
secondary screen capture and can be reviewed on Xeleris.

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Quality Control Printing QC Test Results

9.2 Printing QC Test Results

z If the Infinia computer is connected to a printer, press [Print] located

at the bottom of the QC report.
z If a printer is not available, pressing [Print] creates a JPEG image
that is saved in the directory d:Infinia\JPGExport\qc. This directory
should be accessible from the Xeleris workstation. This file can then
be printed from the Xeleris workstation. In order to print the reports
from the Xeleris workstation, a shortcut should have been defined
during System Configuration. For additional information see Creating
a Shortcut on the Xeleris Desktop to Print Infinia QC Reports on
page 4-92.

For additional printer setup information see System Preferences and

Parameters on page 4-74.

9.2.1 Printing QC Reports Using the Xeleris Desktop Shortcut

Double click on the Infinia QC Reports shortcut on the Xeleris Desktop.

z If only one Infinia station is configured for this station (i.e. the
Desktop shortcut was created from only one Infinia station), the QC
images folder opens.
z If there is more than one Infinia station configured, the following
screen appears.

Figure 9-1 Infinia QC Image Viewer Dialog

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Quality Control Printing QC Test Results

Select the Infinia station with the desired QC reports and click [OK].
The QC image folder opens.

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Quality Control Reviewing QC & System Setup Reports

9.3 Reviewing QC & System Setup Reports

Usage

The Logs panel allows the user to view, print, and export reports to HTML
for diagnostic purposes.

To access the Logs, perform the following:

Global Navigation Screen

Opens the System Set-up Non-clinical

System Utilities
Setup

Logs Tab Opens Logs panel (see Figure 9-2)

Service
Opens Service Reports Folder
Reports

Double click on the desired QC folder to

view.

Example: List of NM Daily QC reports appears

NM Daily QC

Double click on the desired QC report to

view.

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Quality Control Reviewing QC & System Setup Reports

Figure 9-2 Logs Panel

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Quality Control Accessing the Quality Control Utilities

9.4 Accessing the Quality Control Utilities

Global Navigation Screen

System Opens System Set-up Non-clinical Utilities

Setup

Procedure Selection Screen

QC Tab Select QC tab if it is not selected. Opens

QC page (see Figure 9-3)

Click the relevant QC procedure

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Quality Control Accessing the Quality Control Utilities

Figure 9-3 QC Procedures for Service Logon

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Quality Control QC Overview

9.5 QC Overview

The following QC options are available at the Service logon level:

Table 9–1:

Folder QC Procedure Section Performed

NM Daily QC Section 9.6.3 Daily

Periodically or to
Image QC Periodical NM Calibration & QC Section 9.6.5
diagnose problems

X-ray Daily QC Section 9.6.7 Daily

C.O.R. QC C.O.R. Test Section 9.7 Once/month

Uniformity Test Section 9.8.3

Resolution and Linearity Test Section 9.8.4

Energy Test Section 9.8.5

Performance
Counts Density Test Section 9.9
Tests
ECT Resolution Test Section 9.8.4

Jaszckak Phantom Test Section 9.9.3

X-ray QC Test Section 9.10

X-ray to NM
Registration Test Section 9.11
Registration

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Quality Control QC Overview

9.5.1 Daily Quality Control

The daily Quality Control procedures relevant to the scheduled clinical scans
must be performed before performing the clinical scans.

There are two Daily QC procedures, each relevant for a specific scan type,
as follows:

QC Tests Description

Basic NM Daily QC for Static, Dynamic, Tomo, Whole

Body, Gated, MUGA and Gated Tomo acquisitions
NM Daily QC
Refer to page 9-14

Daily quality procedure for Transmission Emission acqui-

X-ray Daily sitions
QC
Refer to page 9-39

Perform the relevant daily quality control procedure in the order specified
above.

The time required to perform these procedures is about one half hour.

WARNING

Failing to perform the relevant daily quality control procedure before starting the
corresponding scans may cause non-identification of serious deterioration in
image quality, resulting in misinterpretation of the acquired images.

9.5.2 Periodical NM Calibration and QC Test Procedures

Periodic NM Calibration and QC tests should be performed when there is a
slight deterioration in image quality.

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Quality Control Image QC Tests

9.6 Image QC Tests

9.6.1 Preparation for Image QC Procedures

9.6.1.1 Preparing the Radionuclide Source

Table 9-2 shows the radionuclide sources, source activity, and collimator that
should be used, depending on the QC procedure to be performed.

Source activity units are mCi:

1 mCi=37 MBq

or

27µCi=1 MBq

Table 9-2: Required Sources, Source Activity, and Collimators

Rec.
Source
Count Usage
Activity
Rate
Req.
Source
Collim. HE
NM HE
NM Period. COR
mCi MBq kc/sec. Daily Period.
Daily QC Test
QC QC
QC

Tc99m ~0.5 18.5 <45 Decoy 9 9 9 9

Point Source

Co57 ~ 10 to 20 370-740 <45

LEHR or
9 9 9 9
Flood Source LEGP

Tc99m LEHR or
Flood Source ~ 10 to 20 370-740 <45 9 9 9 9
LEGP
(re-fillable)

Tc99m ~1 mCi 37 <45

LEHR or
9
Point Source LEGP

QC procedures can be performed with the detectors in either L-mode or

H-mode. Table 9-3 shows the requirements for each detector mode.

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Quality Control Image QC Tests

9.6.2 Source Positioning

Table 9-3 Detector Mode

Source
Source Collimator Start Position
Placement

H-mode LEHR or H QC D1D2 Between

Co57 or Tc99m LEGP detectors at equal
Flood with count distance, while
rate of less than 45 detectors are at
kc/s per detector. minimal Radial In
position.

L-mode Tc99m or Co57 Point Decoy • L QC D1 for

with an activity of Detector 1
At least 3.0 ma
~0.5mCi • L QC D2 for
from the active
Detector 2
detector and a
maximum
Note: Daily QC is
distance of 4 m.
activated
separately for
Rotate gantry so
each detector,
that active
creating a
detector faces the
separate study
point source.
and report for
each detector.

a. If a distance of 3.0 m is not possible, the point source can be placed closer, but not less
than 2.5m away from the active detector.

Note The minimal size of the flood source should be 440 mm x 580 mm in order to provide
adequate exposure of the entire FOV and to simplify the positioning of the flood
source between the detectors.

When required in the procedure, the point source should be placed at a

distance of at least 3.0 m from the detector, such that the radiation uniformly
covers the entire field of view.

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Quality Control Image QC Tests

9.6.3 NM Daily QC Procedure

Usage:

The Daily Quality Control (QC) procedure should be performed on a daily

basis, preferably each morning prior to performing patient scans. The Daily
QC procedure helps check system parameter stability and verifies that the
system is calibrated for non-Hawkeye scans.

9.6.3.1 Overview

The QC Report is automatically saved in the Infinia Database, categorized

by the Isotope used and the front end mode.

The Infinia system is supplied with Default QC parameters, which should not
be modified in most cases. In some cases, it may be necessary to modify
parameters based on the type of isotope or the source used and therefore, the
QC Gantry Mode. In this case, the modes can be modified. These modes are
referred to as “Home Positions”.

Special Modes have been defined to support performing QC on each detector

separately (LQC D1, LQC D2) or both together (H QC D1D2).

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Quality Control Image QC Tests

The table below shows details of a few of the user home positions for QC
supplied by the factory.
Table 9-4 Predefined QC User Home Positions/Modes
Start Positions

Gantry

Usage
Mode
Motion

Detectors - H mode Daily QC for Detector 1

and 2 simultaneously,
H QC D1D2
Detector 1 at 0°, Detector 2 at 180°. using a flood source
Table - fully out of gantry between the detectors

Detectors - L mode Daily QC for Detector 1,

using a point source
Detector 1 at 180°, Detector 2 at 270° - directly above the camera;
LQC D1
detectors meet at 225° (on GDU Rotation if source is located
display). elsewhere, this home
Table - fully out of gantry position must be updated.

Detectors - L mode Daily QC for Detector 2,

using a point source
Detector 1 at 90°, Detector 2 at 180° - directly above the camera;
LQC D2
detectors meet at 135° (on GDU Rotation if source is located
display). elsewhere, this home
Table - fully out of gantry position must be updated.

QC reports can be reviewed any time from the Logs. For more information
on the Logs, refer to Appendix B – Logs.

The NM Daily QC procedure includes three distinct steps:

z Selecting the execution parameters
z Running the scans
z Computing and displaying the measured results

The NM Daily QC procedure includes the following tests:

QC Procedure Description

Background Rate Performed without a radioisotope in the area. Checks whether there is any
Measurement test radiation in the area that could interfere with image acquisition.

Energy Peak Position Checks whether peaks are in the correct position and that energy
and Resolution test resolution is acceptable.

Uniformity Test This test checks Flood Field Uniformity Stability (not NEMA).

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Quality Control Image QC Tests

9.6.3.2 Self-healing Procedure

The NM Daily QC procedure includes a self-healing procedure which

attempts to automatically resolve image quality problems that are detected
when running this procedure. When image quality deterioration is detected,
even if the Daily QC values are not outside acceptance limits, a pop-up
appears (see Figure 9-4).

Figure 9-4 Self-healing QC Pop-up

When this pop-up appears, the user has the option of stopping Daily QC and
starting NM Periodic QC in order to diagnose (and possibly fix) the problem.
The pop-up also shows the estimated time for NM Periodic QC to finish. If
ignored, the pop-up remains and NM Daily QC continues in the background.
The popup does not close until either [OK] or [Cancel] are pressed. Any time
[OK] is pressed, the self-healing action begins (even after NM Daily QC is
completed).
z To perform NM Periodic QC, press [OK].

NM Periodic QC begins automatically. The Iterative PM Calibration

screen appears after a few seconds.
z To continue with the NM Daily QC procedure, press [Cancel].

NM Daily QC continues.

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Quality Control Image QC Tests

9.6.3.2.1 NM Periodic QC Performed

If NM Periodic QC is performed, at the end of the procedure there are two

possible scenarios:
z The procedure does not solve the problem and a pop-up recommends
calling a Service Engineer (see Figure 9-5).

Figure 9-5 NM Periodic Test Not Acceptable Pop-up

z The image quality problem is resolved.

The NM Daily QC continues. In the event that problems are detected

during the Uniformity Test (part of NM Daily QC), the following
pop-up appears.

Figure 9-6 NM Daily QC Uniformity Test Failure Pop-up

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Quality Control Image QC Tests

To rebuild the uniformity map (for Tc99m only), perform the following:
1. Press [OK].

The Key Parameters screen for Uniformity Maps appears. Verify that the
value is 120,000 kcts for Stop on counts.

Note The Self-healing procedure only builds a Uniformity Map for Tc99m.

2. Press [Apply].
3. Press [Start].

Uniformity map creation begins. Wait until Uniformity Map Creation is

completed.
4. Press [Next] and review the report.
5. Press Uniformity Map Creation (left side of screen).
6. Press [Apply]. A new uniformity map is built.
7. To close this screen, press [Close Uniformity Map Creation].
8. Return to NM Daily QC and run the test again.
z Press [Cancel] to continue with the NM Daily QC procedure.

If pressed, NM Daily QC continues.

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Quality Control Image QC Tests

9.6.3.3 Performing NM Daily QC

Usage

NM Daily QC is used to test image uniformity, peak position and energy

resolution.

Note The Uniformity test done during NM Daily QC uses a ROI of 1.55 x 1.55 cm2
for the uniformity calculation. The uniformity value received after this procedure
should be used to monitor the uniformity stability of the system.
To run the Uniformity Test according to NEMA Standards Publication
NU 1-2001, refer to Performance (Acceptance) Tests on page 9-66.

During execution of the procedure, look for instructions in the prompt area
(at the top) of the Daily QC screen.

The procedure can be executed simultaneous for both detectors, during a

single execution, or for each detector separately, in the distinct execution.

The NM Daily QC Test consists of two tests which are part of the NM Daily
QC flow:

QC Procedure Description

Performed without a radioisotope in the area. Checks whether

Background Test there is any unnecessary radiation in the area that could
interfere with system performance.

Checks whether peaks are in the correct position and that

Image Quality Test energy resolution is acceptable. This test checks Flood Field
Uniformity Stability.

Although it is possible to skip the Background Test, it is not recommended.

The Image Quality Test should be done only after verifying the background
level.

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Quality Control Image QC Tests

Setup

For Co57
Source

Go to Gantry
Go to Gantry
Mount the collimators to be used (either
LEHR or LEGP, see Table 9-2).

For Tc99m Source

Go to Gantry

Mount the Decoy collimators on the

detectors (see Table 9-2).

Procedure Selection Screen

QC Tab Select QC tab if it is not selected

Double-click
Image QC

The system displays the Daily QC

[NM Daily
Parameters Dialog for the Background Test
QC]
(see Figure 9-8).

Background Test

Verify that the correct detector(s) is selected

(Both Detectors, Detector 1 or Detector 2).
Verify that correct Start Position is selected.

Note: The duration of the Background Daily

QC Test is directly related to the
Termination Criteria selected.

[Apply]

Go to Gantry

<SET> on The detectors move to the relevant position

the RCU (in H or L mode). Wait for motion to stop.

The Background Test starts. It is possible to

view the X, Y, or Energy Spectrum.
[Start] or
<Start>
When the test is completed, confirmation
appears in the prompt area.

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Quality Control Image QC Tests

[Next] at The Background Test Report appears.

bottom of Review the report (see Reviewing QC Test
screen Results on page 9-26).

Background Test Report

Image
Quality Test The NM Daily QC input dialog opens (see
on left side of Figure 9-8).
screen

Image Quality Test

Verify that the correct Energy Session is

used (either Tc99m or Co57).

Verify that the correct Start Position is

selected (see Table 9-5). It is recommended
to use the same Start Position that was
used for the Background test.

Verify that the correct Detector parameter

(Both Detectors, Detector 1 or Detector 2) is
selected. The detector that is selected must
be the detector that is radiated by the
source.

Verify that the Stop Condition is 4000 kc.

To modify the default Stop Condition value

(4000 kc), type in the new value and press
<Enter>.

[Apply]

Go to Gantry

The Detectors move to the relevant position

Press <SET> (the position was probably reached when
on the RCU. performing the Background Test). Wait for
motion to stop.

Position the radiation source.

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Quality Control Image QC Tests

The system starts to acquire data for the QC

Test.

A progress indicator is displayed below the

images.
The test functions are implemented
automatically in the following sequence:
• PHA and Flood STATIC acquisition
begins.
• Peak position, energy resolution and
[Start] or CFOV integral uniformity calculation for
<Start> each Detector.

Notes:

The time required for the Daily QC Test is

directly related to the parameters selected
for Acquisition Total Counts and to the
intensity of the radioactive source.

Acquisition manual stop is provided by

pressing [Stop] or <GO/PAUSE>. The Daily
QC procedure continues to the next step.

QC Report

The QC results appear on the screen. The

input parameters and Detector results are
displayed.

Review the QC report (see Reviewing QC

Test Results on page 9-26).

If NM Daily QC is done for each detector

separately, click on Background Test
(Detector 2).

[Close NM
Daily QC] or To be pressed when NM Daily QC is
[Close completed.
Session]

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Quality Control Image QC Tests

Figure 9-7 Daily QC Background Test Parameters Dialog

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Quality Control Image QC Tests

Figure 9-8 Daily QC Parameters

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Quality Control Image QC Tests

Table 9-5 NM QC Start Positions

Detector
Usage Gantry Mode
Configuration

Used for point source for Detector 1 L QC D1

D1

Used for point source for Detector 2 L QC D2

D2

D1
Used for both detectors with Flood Source H QC D1D2
D2

Used for manual positioning of gantry Manual

Maps

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Quality Control Image QC Tests

9.6.3.4 Reviewing QC Test Results

The QC Report - Daily QC screen displays the following:

z Input Parameters: Displays parameters selected by user.
z Detector Results: Displays all of the test results for each detector.
z Log: Displays system information on start and stop time of tests and
system errors.
z Comments: The user can add comments relevant to the test.
Comments are not saved unless [Save Modifications] is pressed.

Figure 9-9 Daily QC Test Results

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Quality Control Image QC Tests

9.6.3.5 Acceptable Results

Table 9-6 Background Test Acceptable Results

Acceptable
Detector Status
Results

L-mode without collimator < 2.5 kc/s

H-mode with collimator < 0.6 kc/s

Table 9-7 Image Quality Test Acceptable Results

Isotope Tc99m Co57

Peak Position (keV): 140 ± 3 122 ± 3

Energy resolution (%) < 11.0 < 12.0

CFOV Integral Uniformity (%) <5 <5

Note In case of high background level use a source with a rate 10 times higher than the
background level but not higher than 45 kc/s.

1. Review all the test results. Results that appear in black have passed the
acceptance criteria, i.e. are within the limits indicated in the right column
of the results table. Results that appear in red have not passed the
acceptance criteria. The NM Daily QC procedure is successful only if all
of the tests have passed.
2. If any of the of the tests failed, refer to NM Daily QC Test Failure on
page 9-29.
3. The name that appears in the name field at the top of the screen is the
user login name. To change the name (e.g. if a default logon was used),
type a new name in this field. Click [Save] when done.

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Quality Control Image QC Tests

4. To add comments to the Comments area, place the cursor in the

comments area and type in comments. Click [Save] when done.

The test results can be accessed at any time from the Logs panel. Refer to
Reviewing QC & System Setup Reports on page 9-6.

Note If Daily NM QC was performed for each detector separately, a separate report is
created for each detector.

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9.6.3.6 NM Daily QC Test Failure

If the NM Daily QC test fails, check which test failed, use the recovery
suggested below and repeat the QC procedure.

If the procedure still fails, review the Logs (located in bottom right area of
QC Report Results). If significant error messages appear, contact qualified
GE Service Personnel for assistance.

QC Test Recovery

Verify that the Source is not leaking or that there is not

another source of radiation in the immediate area
Background
(such as an injected patient waiting behind the wall or
an open radioactive source).

If the Peak Position (Energy Peak) test fails, verify that

Peak Position the correct isotope parameter was selected. If the test
fails, perform the Periodical QC test.

If the test fails, perform the Periodical NM Calibration

FWHM
and QC test.

If the Uniformity Test fails, examine the images for

Uniformity Test Detector 1 and Detector 2 and verify that the radiation
source is positioned properly.

If the reason for test failure is not found, perform Periodical NM Calibration
& QC on page 9-32.

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9.6.3.7 QC Trend Analysis

It is possible to use the History Browser to compare system QC reports for

diagnostic purposes. For additional information refer to History Browser on
page B-3.

9.6.3.8 Archiving QC Reports

It is recommended to archive QC reports as necessary to clear the computer

for more space. To save QC reports for later reference, refer to Archive QC
Data on page B-11.

9.6.3.9 Restoring QC Data

To review QC data no longer saved on the disk or analyze trends including

QC data no longer saved on disk, refer to Restore QC Data on page B-14

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9.6.4 HE NM Daily QC

The HE NM Daily QC procedure is identical to the NM Daily QC procedure

(see NM Daily QC Procedure on page 9-14) with the exception that Co57
HE or Tc99m HE should be the Energy Session selected for the Image Quality
Test.

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9.6.5 Periodical NM Calibration & QC

Usage:
z Periodically used to re-calibrate the photomultiplier gain and to verify
the image uniformity.
z Should be performed only if NM Daily QC is close to the failure limit
or when recommended by the Self-healing mechanism during Daily
QC (see Self-healing Procedure on page 9-16).

9.6.5.1 Description

Periodical NM Calibration & QC is a crucial procedure which permits the

user to obtain full performance from the Infinia II system. This procedure
should be performed periodically with an adequate source.

The Periodical NM Calibration & QC performs all of the tests in the NM

Daily QC procedure plus Iterative Gain Calibration. During Iterative Gain
Calibration (Iter) the photo-multipliers gain is recalibrated. This calibration
is automatically performed when Calibration and Image Quality test is started.
The test time varies between ten minutes (Maps mode with Tc99m source)
to approximately 1/2 hour (H-mode with Co57 source).

The Periodical NM Calibration and QC utility includes three distinct stages:

z Background Test
z Source Positioning Acquisition
z Calibration and Image Quality Test

The last stage runs automatic functions in the following sequence:

z Iterative Radioactive Calibration.
z PHA and Flood STATIC acquisition
z Peak position, energy resolution and CFOV integral uniformity
calculation

This procedure is performed for each detector independently or for both

detectors simultaneously.

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9.6.5.2 Periodical NM Calibration & QC Execution

To access the Periodical NM Calibration and QC procedure, double click on

the Periodical NM Calibration & QC sub-category in the Image QC folder.
For additional information refer to Accessing the Quality Control Utilities on
page 9-8.

Follow instructions provided in the prompt area.

The isotope selected during system installation will be selected by default.

Important
Changing this selection can cause calibration problems.

Do not change this selection without consulting your service representative.

This procedure can be run with a Tc99m source or with a Co57 source. However,
Important
it is strongly recommended to always use the same isotopes (Tc99m or Co57) and
not to switch between the isotopes.

Tc99m is the preferable isotope to use with the Decoy Collimators.

The recommended count rate should be less than 45 kc/s.

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Quality Control Image QC Tests

Setup

For Co57
Source

Go to Gantry

Mount the collimators to be used (either

LEHR or LEGP, see Table 9-2).

For Tc99m Source

Go to Gantry

Mount the Decoy collimators on the

detectors (see Table 9-2).

Procedure Selection Screen

QC Tab Select QC tab if it is not selected

Double-click
Image QC

Periodical NM The system displays the Periodical NM

Calibration & Calibration & QC Parameters Dialog for the
QC Background Test

Background Test

Verify that the correct detector(s) is

selected. (Both Detectors, Detector 1 or
Detector 2).

Note: The duration of the Background Daily

QC Test is directly related to the
Termination Criteria selected.

[Apply]

Go to Gantry

<SET> on the The detectors move to the relevant position

RCU (in H or L mode). Wait for motion to stop.

The Background Test starts. It is possible to

[Start] or view the X, Y, or Energy Spectrum.
<GO/PAUSE>
on the RCU When the test is completed, confirmation
appears in the prompt area.

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[Next] at The Background Test Report appears.

bottom of Review the report (see Reviewing QC Test
screen Results on page 9-26).

Source
Positioning
The system displays the Source Position
Acq.
Acq. Parameters Dialog.
on left side of
screen

Verify that the correct Start Position is

selected (see Table 9-5).

Verify that the correct Detector parameter

(Both Detectors, Detector 1 or Detector 2) is
selected. The detector that is selected must
be the detector that is radiated by the
source.

[Apply]

Go to Gantry

Press <SET> The Detectors move to the relevant

on the RCU position. Wait for motion to stop.

Position the radiation source.

The system starts to acquire data for PHA

and Flood STATIC acquisition.

The purpose of this image is to ensure

adequate exposure of the entire FOV. If
[Start] or necessary, modify the position of the source
<Start> and press [Clear].

When FOV exposure is considered

satisfactory, press [Stop].

The procedure continues to the next step.

[Next] at
bottom of Ignore the results of this report.
screen

Calibration &
Image
The system displays the Calibration &
Quality Test
Image Quality Test Parameters Dialog
on left side of
screen

Verify that the correct Start Position is

selected (see Table 9-5).

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Verify that the correct Detector parameter

(Both Detectors, Detector 1 or Detector 2) is
selected. The detector that is selected must
be the detector that is radiated by the
source.

[Next] at
bottom of The [Start] button is enabled.
screen

The utility performs an automatic sequence:

• Iterative Radioactive Calibration.
[Start] or
<Start> • PHA and Flood STATIC acquisition
• Peak position, energy resolution and
CFOV integral uniformity calculation

If the calibration is done for each detector

separately, repeat the procedure for
Detector 2.

When completed, the Calibration and Image

Quality Test Results appear. Review test
results.

[Close NM
Daily QC] or To be pressed when Periodical NM
[Close Calibration is completed.
Session]

9.6.5.3 Periodical NM Calibration Test Results

Review the QC report that appears at the end of the test. The test report that
appears has the same format as the NM Daily QC Test.

Table 9-8 Periodical NM Calibration Acceptable Results

Isotope Tc99m Co57

Peak Position [keV] 140 ± 2 keV 122 ± 2 keV

Energy Resolution [%] < 11.0 < 12.0

CFOV Integral Uniformity [%] <5 <5

Note The tolerance for the Peak Position is different from NM Daily QC tolerance.

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For additional information refer to Reviewing QC Test Results on page 9-26

and QC Reports and Images on page 9-3.

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9.6.6 HE Periodical NM Calibration & QC

The HE Periodical NM Calibration & QC procedure is identical to the
Periodical NM Calibration & QC procedure (see Periodical NM Calibration
& QC on page 9-32) with the exception that Co57 HE or Tc99m HE should
be the Energy Session selected for the Source Positioning Acq.

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9.6.7 X-ray Daily QC (Hawkeye Option)

Only relevant for systems with Hawkeye option.

9.6.7.1 Overview

It is mandatory to perform the X-ray Daily QC procedure at least once a day,

before acquiring X-ray data. Warm-up must precede Air Table Creation. The
Quality Control check should be performed after Warm-up and Air Table
Creation.

The Hawkeye QC phantom is used to measure the X-ray image quality. The
phantom is a plastic container in the form of a 20 cm diameter cylinder
containing water and a set of plastic test objects. For additional information
on the Hawkeye QC phantom, refer to QC Phantom on page 9-101.

Note X-ray Daily QC verifies slice uniformity only. The X-ray QC Tests under Performance
Tests (see X-ray QC Tests on page 9-98) uses all of the sections of the phantom.

To run the Uniformity Test according to NEMA Standards Publication

NU 1-2001, refer to Performance (Acceptance) Tests on page 9-66.

The X-ray Daily QC procedure consists of four steps:

Table 9-9 Steps of X-ray QC Procedure

Step Description

XRAY Warm-up Warm up of the X-Ray Tube by acquiring a few slices in low Voltage
(120 KV). Lasts approximately 3 minutes.

Air Table Acquisition of a single full rotation slice, using the nominal X-ray values.
Creation This slice is used to create the Air Table.

Scout Used to define the Phantom edges for QC Analysis

Acquisition

Water Used to check the quality of the X-ray image by acquiring the water
Uniformity section of the QC Phantom and analyzing image uniformity.

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9.6.7.2 Operation

To access the X-ray Daily QC procedure, double click on the X-ray Daily
QC sub-category in the Image QC folder. For additional information refer to
Accessing the Quality Control Utilities on page 9-8.

Once activated, the system performs the entire QC procedure.

Action Messages/Events

1. Double-click X-ray Daily QC X-ray Daily QC parameters appear

2. Press [Apply].

Note: Do not modify X-ray Daily QC Parameters.

3. Go to the acquisition area. Place the phantom

holder on the Pallet (without the mattress) with
the small tips attached to the end of the Pallet
(see Figure 9-10).

4. Place the phantom on the holder with the

rectangular support bracket inserted over the
right-angled protrusion on the holder, facing
away from the Gantry and the small alignment
line at the top (see Figure 9-11). Make sure that
the phantom is not tilted or skewed.

5. Press <SET> on the RCU. For additional

Gantry moves to Home Position. Wait until
information on positioning phantom, refer to QC
motion is fully stopped.
Phantom on page 9-101

The X-ray Confirmation Dialog for warm-up

6. Press <GO/PAUSE> on the RCU. Leave the appears (the pop-up will disappear after five
x-ray exposure area. Return to the operator
minutes if not responded to). Press [OK] to
console.
start the warm-up.

The warm-up acquisition begins (three slices

7. Press [OK] at the acquisition console to with full rotation). When completed, the X-ray
confirm start of X-ray warm-up. confirmation dialog for Air Table Creation
appears

The Air Table acquisition begins (1 slice with

full rotation) and the Air Table data is
8. Press [OK] to begin. processed. When completed, the X-ray
confirmation dialog for Scout acquisition
appears.

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Action Messages/Events

The Scout acquisition begins (50 cm) and

the Scout image appears on the screen. At
9. Press [OK] to begin. the end of the acquisition, the Scout image is
displayed with a rectangular ROI on top as
shown in Figure 9-12.

10.Adjust the ROI over the phantom image, so that The Gantry moves to position. The X-ray
the ROI is positioned exactly on the phantom confirmation dialog for Water Uniformity
upper edge that points toward the gantry, as appears (the pop-up will disappear after five
shown in Figure 9-12 and press [Next]. minutes if not responded to).

The Water Slice acquisition begins. The

11.Press [OK].
Water Slice appears on the screen.

12.Verify that the ROIs are located in the correct

position as described below. If they are not
properly positioned, drag them to the correct
position. See Figure 9-13

ROI
Position on Phantom
Color

Green Top

Blue Bottom

Cyan On left side

Pink On right side

Red In center

Over the whole water area inside

Yellow the phantom, not including the air
bubble

5. Press [Next] The X-ray Daily QC report appears. Review

the report.

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Attach to end
of Pallet

Position
rectangular
support bracket
over this

Figure 9-10 Phantom Holder

Alignment
Rectangular Circumferential
Support Bracket Top Alignment Line Line

To Gantry

Lateral
Alignment
Table Line

Figure 9-11 QC Phantom Placed on Pallet for Imaging

(Rectangular Bracket Faces Away From Gantry)

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ROI positioned
exactly on the edge
of the phantom

Figure 9-12 Slice Selection on Scout Image

Plastic Wall

Water

Figure 9-13 Water Phantom with Measuring ROIs

The X-ray Daily QC report appears (see Figure 9-14). Review the report.
Results that are outside the acceptance criteria are displayed in red.

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Figure 9-14 X-ray Uniformity Test Results

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9.6.8 Performing CoDe Daily QC

Usage

This utility allows the operator to check if the system is performing according
to imaging specifications. Data is analyzed for energy shift, energy resolution
and spatial resolution.

Radioactive Source Activity Collimator

Point or Line (F18 or Ge68) 0.5-2.5mCi Septa

During execution of the procedure, look for instructions in the prompt area
(at the top) of the CoDe Daily QC screen.

9.6.9 Source Positioning

If a point source is used, the source must be aligned to the center of the
detector.

If a line source is used, the source must be aligned to the center of the detector
situated on the Y axis.

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9.6.10 CoDe Daily QC Procedure

[ /Dest /CoDeSetup /View [/Fit] /DEST pdfmark

Setup

Go to Gantry Mount the Septa collimators

Procedure Selection Screen

QC Tab Select QC tab if it is not selected

Double-click
Image QC

The system displays the CoDe Daily QC

CoDe Daily
Parameters Dialog for the Background Test
QC
(see Figure 9-7).

Verify that the correct Start Position is selected

(see Table 9-5). It is recommended to use the
default Start Position.

Verify that the correct Energy Session is used

(either F18 HE coin or Ge68 HE coin).

Verify that the Emission Time is 4 minutes.

Persistence phase begins (see Figure 9-17).

[Apply]

Press <SET> on the RCU.

Go to Gantry
The Detectors move to the relevant position.
Wait for motion to stop.

Rotate the gantry to 90°.

Place the radiation source on the table as

close as possible to the center of the field of
view. Adjust the table height and position of the
source on the table (in/out) to center the image
of the source on the cross of the display.

Rotate the gantry to 0°.

Look at the display and move the source to be

aligned with the cross (see Figure 9-16).

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If the source is not positioned correctly,

reposition the source as described above and
press [Clear] to clear the previous images.
When the source appears in the center of
rotation, continue to next step.

The system starts to acquire data for the CoDe

Daily QC Test.
<GO/
A progress indicator is displayed at the bottom
PAUSE> on
of the Key Parameters area.
RCU
During the acquisition, cross sectional images
from the COSEM on the fly algorithm appear.

When the acquisition is completed

(approximately four minutes) a magnified
cross-sectional image appears with an ROI and
a x resolution measured in the ROI.

When completed, an image of the source

appears with a green ROI. Move the mouse
pointer over the ROI and left click to modify the
size or to move the ROI.

When the ROI is modified, the resolution that

appears at the bottom of the screen changes.
To reset the ROI to the default calculation,
press [Reset ROI].

A summary screen of the analyses for all the

critical parameters appears. The final
measurements appear in black, unless they are
[Next] out of the allowed range.

The graphs are intermediate results of the

analyses

The CoDe Daily QC report appears on the

screen (see Figure 9-18)
[OK]

CoDe Daily QC Report

Review the CoDe Daily QC report (see

Reviewing QC Test Results on page 9-26).

[Close CoDe
Daily QC] or To be pressed when CoDe Daily QC is
[Close completed.
Session]

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Figure 9-15 CoDe Daily QC Parameters

Source mis-aligned with cross Source properly aligned with cross

Figure 9-16 Source Positioning

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Figure 9-17 CoDe Daily QC Acquisition

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Figure 9-18 CoDe Daily QC Report

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9.7 C.O.R. QC Test

Usage:

In order to reconstruct tomographic images, it is essential that the multiple

views be accurately back projected to the location of origin. Rather than
require perfection of mechanical motion, a method is provided to calibrate
the projection location based on observed image location. This calibration is
referred to as Center of Rotation (C.O.R.) Test.

This test is used to check the Center of Rotation correction of the gantry and
the detectors.

The purpose of the COR Test is to check the consistency of the COR
calibration parameters measured during the calibration phase and is provided
to the customer to test the stability of the COR in both H and L modes.

During the test, a 360° Tomo acquisition is performed with COR correction
applied. The acquisition radius (or Lateral) should be in the middle of the
radius (lateral) range. The Sinus fit is implemented in order to exclude the
point source position effect on resulting data.

The following source and collimator should be used:

Radioactive Source Activity Collimator

Tc99m or Co57 Point Source 0.8 – ~1 mCi LEHR or LEGP

The test should be performed once a week or according to local regulations.

The test is performed once for H-mode and once for L-mode, with Collimators
mounted on the detectors.

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9.7.1 Setup for C.O.R. Test With Detectors in H-mode

Go to Gantry

Select the H mode Start Position using the up/

down arrows on the RCU.

Press <SET>. When the detectors are at

rotation 0° at maximum RADIAL OUT and the
pallet starts moving in, press any RCU key to
stop movement.

Move the table to the maximum UP position.

Mount the point source on a rod. Place the rod

on the pallet or position it on the rod holder.

Continue to C.O.R. Test Procedure With

Detectors in H-mode on page 9-54

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9.7.2 Source Positioning for C.O.R. Test With Detectors in H-mode

Procedure Selection Screen

Select QC tab if it is not selected

QC Tab

Opens the folder.

C.O.R. QC

The Source Positioning Key Parameters screen

C.O.R. Test appears. Verify that the correct parameters are
selected. Start position should be H QC D1D2.

Source Positioning Key Parameters Screen

Energy Verify that the correct parameters (energy session

Settings tab & collimators) are selected.

The C.O.R. Calibration Source Position screen

[Apply] appears.

<SET> Wait until automatic motion is completed.

on RCU

Adjust the source position so that its image is

inside the red circle (ROI) on both detectors.

Verify that radial position of both detectors is

20.0 cm. and then rotate fully. This will verify that
the source does not collide with the detectors.

Source Position Acquisition begins.

[Start]
The purpose of this acquisition is to confirm
adequate source position. In addition you may
need to determine the time per projection in the
following Tomo Acquisition.
If the source is very strong, you can use a lower
time per projection value.

When done, press [Cancel] to stop and discard

[Cancel] the acquisition.

Continue to C.O.R. Test Procedure With Detectors

in H-mode on page 9-54

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9.7.3 C.O.R. Test Procedure With Detectors in H-mode

Source Positioning Key Parameters Screen

COR Test
Acquisition The Acquisition Key Parameters screen
(left side of appears (see Figure 9-19).
screen)

Verify that the correct parameters are

selected. Modify parameters, if necessary
(e.g. set Stop on Time per projection
according to: for about 5 kc/s rate per
detector set 5 sec per projection)
Select the correct energy session (Co57 or
Tc99m)
Note: The radius will be automatically set
later.

[Apply]

<GO> on Acquisition begins. Wait until acquisition

RCU ends (Progress Bar shows 100%).

COR Test The C.O.R. Test Processing screen

Processing appears (see Figure 9-20). Select the
(left side of appropriate image. The default is the latest
screen) acquired image.

The C.O.R. Test Results are displayed (see

Figure 9-21 and Figure 9-22). See
[Next]
Reviewing C.O.R. Test Results on
page 9-64

The next C.O.R. Test Results Report

appears. See Figure 9-23. Results that are
[Next]
outside the allowed values are marked in
red.

Note The Source Positioning Acquisition stage can be skipped if the operator is
experienced with the appropriate positioning of the source for achieving a
favorable calibration.

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Figure 9-19 C.O.R. Test Acquisition Key Parameters

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Figure 9-20 C.O.R. Test Processing

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Figure 9-21 C.O.R. Test Processing–Graphs

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Figure 9-22 C.O.R. Test Processing–Tables

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Figure 9-23 COR Test Processing Results

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9.7.4 Setup for C.O.R. Test With Detectors in L-mode

Go to Gantry

Mount the Collimators on the two

detectors

Select the L mode Start Position using the

up/down arrows on the RCU.

Press <SET>. When the detectors reach

L-mode and are located at maximum radial
out, press any RCU key to stop the
positioning movement.

With a digital level, check that detectors are

at 45o position. If not, re-calibrate the
SWIVEL as per Section 6.1.1.2 – Automatic
Swivels Calibration (Swivels 0°) on
page 6-9

Mount the point source on a rod. Place the

rod on the pallet, or position it on the rod
holder.

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9.7.5 Source Positioning for C.O.R. Test With Detectors in L-mode

Procedure Selection Screen

Select QC tab if it is not selected

QC Tab

Opens the folder.

C.O.R. QC

The Source Positioning Key Parameters

C.O.R. Test screen appears. The Start position should
be L QC D1.

Source
Positioning
Acq. under
Verify that the correct parameters are
COR Test
selected.
L-mode (left
side of
screen)

Source Positioning Key Parameters Screen

Corrections Verify that the correct parameters (energy

Tab session & collimators) are selected.

The C.O.R. Calibration Source Position

[Apply] screen appears.

<SET> Wait until automatic motion is completed.

on RCU

Adjust the source position so that its image

is inside the red circle (ROI) on both
detectors.

Verify that the detectors are positioned at

lateral =20 cm. and then fully rotate. This
will verify that the source does not collide
with the detectors.

Source Position Acquisition begins.

The purpose of this acquisition is to confirm

adequate source position. In addition you
[Start]
may need to determine the time per
projection in the following Tomo Acquisition.
If the source is very strong, you can use a
lower time per projection value.

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When done, press [Cancel] to stop and

[Cancel] discard the acquisition.

Continue to C.O.R. Test Procedure With

Detectors in L-mode on page 9-63

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9.7.6 C.O.R. Test Procedure With Detectors in L-mode

Source Positioning Key Parameters Screen

COR Test
Acquisition
under COR The Acquisition Key Parameters screen
Test L-mode appears (see Figure 9-19).
(left side of
screen)

Verify that the correct parameters are

selected. Modify parameters, if necessary
(e.g. set Stop on Time per projection
according to: for about 5 kc/s rate per
detector set 5 sec per projection)
Select the correct energy session (Co57 or
Tc99m)
Note: The radius will be automatically set
later.

[Apply]

<GO> on the Acquisition begins. Wait until acquisition

RCU ends (Progress Bar shows 100%).

COR Test
The C.O.R. Test Processing screen
Processing
appears. Select the appropriate image. The
(left side of
default is the latest acquired image.
screen)

The C.O.R. Test Results are displayed (see

Figure 9-21 and Figure 9-22). See
[Next]
Reviewing C.O.R. Test Results on
page 9-64

The next C.O.R. Test Results Report

appears. See Figure 9-23. Results that are
[Next]
outside the allowed values are marked in
red.

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9.7.7 Reviewing C.O.R. Test Results

9.7.7.1 Graphs Tab

The graphs of x and y deviations are displayed on the Graphs tab (see
Figure 9-21 and Figure 9-23). The yellow lines represent a visual reference
range. The graphs of Detector 1 appear in blue while the graphs of Detector
2 appear in red. The graphs show COR X/Y Offset Residual for each
projection where Cor X/Y Offset Residual reflects the inaccuracy of the
applied COR correction. It represents imperfection of the measured data
caused by the following factors:
z Acquisition Statistics–the weaker the source and the shorter the
acquisition time, the graphs are noisier;
z Gantry Mechanics– changes in detector sagging during rotation and
collimator attachment instability

The horizontal yellow lines represent maximal allowed spikes and jumps
caused by deficiency in acquisition statistics or/and gantry mechanics. The
vertical axis has a scale multiplied by 0.1 mm, so the limits are +/- 3mm in
X and +/- 1mm in Y.

9.7.7.2 Tables Tab

A table with measured COR Residual values, derived by computation from

the above graphs appears on the Tables tab. The value in the table is the
average of CorX/Y Offset Residual (average of all the points in the graph).

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9.7.7.3 Acceptance Criteria

There are two parts to the COR acceptance criteria:

z Graphs should be within the yellow lines (see Figure 9-21 and
Figure 9-23).

The numbers in the table are within the acceptance limits. All numbers should
appear in black (not red). See Figure 9-23.

The following results are acceptable for both H-mode and L-mode:

| Delta X1 | = < 0.5 mm

| Delta X2 | = < 0.5 mm

| Delta Y2 | = < 0.5 mm

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9.8 Performance (Acceptance) Tests

Note Delta Y1 is always 0 (i.e. Delta Y for Detector 1).

The specifications for Delta Y2 that appear are correct only when the source is
positioned in the axial center of the Field of View. When the source is positioned
at the axial edges of Field of View, the specifications for delta Y should be 2mm.

The tests described in this section are performed according to NEMA Standards
Publication NU 1-2001.

9.8.1 Required Sources and Equipment

9.8.1.1 Radioactive Sources

The following radioactive sources are required for various Performance Tests.

Source activity units are mCi:

1 mCi=37 MBq

or

27µCi=1 MBq

Table 9-10: Required Sources, Source Activity, and Collimators

Source Activity Usage

Source
Resolution Jaszczak
mCi MBq Uniformity Energy
& Linearity Phantom

Tc99m Point Source ~0.5 ~18.5 9 9

Tc99m Point Source ~2.5 ~92.5 9

Co57 Point Source ~0.5 ~18.5 9

Co57 Flood Source ~ 10 to 20 ~370-740 9

Tc99m Flood Source 20 740 9

(re-fillable)

Tc99m Source 25 925 9

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9.8.1.2 Phantoms
z Two Standard Line Slit Phantoms, one in X and one in Y direction
(see Figure 9-26) as described below.

The Infinia Line Slit X and Y Phantom Kit consists of two cases:
 Case 1 – PAS000153 (see Figure 9-24) contains:

Item Part Number Weight kg (lbs)

X Phantom ASM001302 15 kg (33 lbs)

High Energy FOV

ASM001295 6 kg (13 lbs)
Assembly

FOV Front Assembly ASM001297 1.5 kg (3 lbs)

 Case 2 – PAS000154 (see Figure 9-24) contains:

Item Part Number Weight kg (lbs)

Y Phantom ASM001303 15 kg (33 lbs)

High Energy FOV

ASM001295 6 kg (13 lbs)
Assembly

FOV Front Assembly ASM001297 1.5 kg (3 lbs)

z Jaszczak Phantom (see Figure 9-27)

z Bar Phantom (see Figure 9-28).
z NEMA ECT Resolution 3-Line Phantom (see Figure 9-29).

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High Energy FOV Assembly

X Phantom

Foam
Insert

FOV Front Assembly

Figure 9-24 X Phantom Kit (PAS000153)

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High Energy FOV Assembly

Y Phantom

Foam
Insert

FOV Front Assembly

Figure 9-25 Y Phantom Kit (PAS000154)

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30mm

CFOV

UFOV

Middle slit
over center
of UFOV

All slits are

1 mm wide

Figure 9-26 Line Slit Y-Direction Phantom

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Figure 9-27 Jaszczak Phantom

Figure 9-28 Bar Phantom

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Figure 9-29 NEMA ECT Resolution 3-Line Phantom

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9.8.2 Performance Tests Acceptable Results

Details of the Low Energy QC Performance Tests and the acceptable test
results are listed in Table 9-11.

The test are done according to the NEMA Standard NU1-2001, for UTEST
only in case the frame size is 512.

Note Perform the tests in the given order.

Table 9-11: Low Energy Tests and Acceptable Test Results

Parameter Acceptable Results 3/8"

Energy Resolution ≤ 9.8%

Spatial Resolution
Average UFOV FWHM ≤ 3.9 mm TBD
Average UFOV FWTM ≤ 7.2 mm TBD
Average CFOV FWHM ≤ 3.8 mm TBD
Average CFOV FWTM ≤ 7.1 mm TBD
Spatial Linearity
UFOV Absolute Linearity ≤ 0.5
UFOV Differential Linearity ≤ 0.1
CFOV Absolute Linearity ≤ 0.4
CFOV Differential Linearity ≤ 0.1
Intrinsic Flood Field Uniformity Tests
UFOV Integral Uniformity ≤ 3.6%
UFOV Differential Uniformity ≤ 2.3%
CFOV Integral Uniformity ≤ 3.0%
CFOV Differential Uniformity ≤ 2.1%
COR Stability
DEV X2, X1 ≤ 0.5 mm
DEV Y2 ≤ 0.5 mm
ECT Resolution (VPC-45)
Central Resolution ≤ 9.9 mm

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Table 9-11: Low Energy Tests and Acceptable Test Results (Continued)

Parameter Acceptable Results 3/8"

Tangential Resolution ≤ 9.9 mm

Radial Resolution ≤ 7.5 mm
Jaszczak Phantom The rods can be seen in at least
four (up to five) segments

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9.8.3 Uniformity Test

9.8.3.1 Description

This test checks the response of the camera to a uniform flux of radiation.
Uniformity is characterized by the count density variation caused by a
uniform input gamma flux over a defined large area of the detector.

There are two steps in the Uniformity Test:

1. Uniformity Test Acquisition - Used to acquire flood field image.
2. Uniformity Test - Used to calculate the integral and the differential
uniformity within both CFOV and UFOV in accordance with NEMA
2001 requirements.

Note The results will be according to NEMA NU1-2001 only for frame size 512 after
applying all of the corrections to the image.

The Utest can also be done on acquisition without uniformity correction.

Usually these acquisitions are done on a frame size of 256 x 256 and are used
to create the uniformity correction map. The processing of the Utest on these
acquisitions (frame size 256) is not according to NEMA.

9.8.3.2 Radioactive Source

z Tc99m point source of ~ 0.5 mCi
z Co57 Flood Source of ~ 10 to 20
z Tc99m Flood Source (re-fillable) of ~20

9.8.3.3 Uniformity Test Conditions

Table 9–12: Uniformity Test Conditions

Start Position Collimator Source Position Count Rate

Centered to the UFOV of the tested < 45 ± 5 kc/s

L-Cardiac Decoy
detector, at a distance of at least 3 m per detector

< 45 ± 5 kc/s
H-WB LEGP or LEHR Centered between the Detectors
per detector

Centered between the Detectors, at a < 45 ± 5 kc/s

Maps Decoy
distance of at least 3 m per detector

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9.8.3.4 Uniformity Test Execution

To access the Uniformity Test, double click on the Performance folder. For
additional information refer to Accessing the Quality Control Utilities on
page 9-8.

This test must be performed on both detectors, either simultaneously or

separately, depending on the Start position used.

Action Messages/Events

Opens the Uniformity Test Acq Key

1. Double-click Uniformity Test
Parameters screen.

2. Select a detector according to the Start Position

as described below:
• LQCD1 or LQCD2—Detector that faces the
source
• H QC D1D2 (with LEGP or LEHR collimator)—
Detector 1 and 2 if using a flood source
• Maps—Detector 1 and 2
• Manual–

3. Verify the remaining Key Parameter variables

and values as shown in Table 9-13.

4. Click on the Corrections tab and enter/verify the

variables and values shown in Table 9-14.

A PHA histogram appears on the

5. Press [Apply]
screen.

Acquisition begins. Wait until

acquisition is completed.
6. Press [Start]
If desired, press [Next] to review
report.

The Uniformity Test screen appears

7. Press Uniformity Test on left side of screen with Study Name

When the test is completed, the test

8. Press [Start]. report appears. Review the results and
compare to Table 9.8.3.5.

9. Repeat the procedure for the other detector if

only one detector was selected in Step 2.

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Table 9-13: Utest Acq. Key Parameters

Acq. With Uniformity Acq. Without

Correction Uniformity Correction

Stop on counts 60,000 per Detector 30,000 per Detector

Reached on:

Matrix 512x512 256x256

Zoom 1 1

All other parameters 0 0

Table 9-14: Utest Acq. Corrections Parameters

Energy session Tc99m or Co57 Flood Tc99m or Co57 Flood

Energy corrections Checked Checked

Linearity corrections Checked Checked

Uniformity corrections Checked Un-Checked

9.8.3.5 Uniformity Test Acceptable Results

For each detector:

Table 9–15: Uniformity Test Acceptance Criteria For Uniformity Corrected Images

3/8" 1"
Parameter Name Acceptance Acceptance
Criteria Criteria

_CFOV Integral Uniformity < 3.0% < 3.5%

_CFOV Differential Uniformity (X & Y) < 2.1% < 2.1%

_UFOV Integral Uniformity < 3.6% < 4.5%

_UFOV Differential Uniformity (X & Y) < 2.3% < 2.5%

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9.8.4 Resolution And Linearity Tests

9.8.4.1 Description

This test checks the system's ability to accurately resolve spatially separated
radioactive sources.

This test consists of four steps as follows:

Step Description

Used to acquire X-direction Line Slit phantom

mounted on Detector 1 and Y-direction Line Slit
1. First Acquisition phantom mounted on Detector 2 simultaneously (for
Gantry in Maps Mode). At the end of this step,
phantoms must be changed.

Used to acquire Y-direction Line Slit phantom

mounted on Detector 1 and X-direction Line Slit
2. Second Acquisition
phantom mounted on Detector 2 simultaneously (for
Gantry in Maps Mode).

3. Resolution Resolution Test processing

4. Linearity Linearity Test processing

9.8.4.2 Radioactive Source

Source Activity
Radioactive Source Collimator
mCi MBq

Tc99m Point Source ~2.5 ~92.5 None

9.8.4.3 Phantoms
z Standard Line Slit Phantom in X-direction
z Standard Line Slit Phantom in Y-direction

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9.8.4.4 Test Conditions

z Count rate - less than 20 kc/s per detector.
This measurement is done with a special energy setting with energy
session Tc99m.15 (Tc99m with an energy window of +/- 7.5% in
accordance with NEMA NU1-2001)
z For L-mode:
Source position - centered to the UFOV of the tested Detector, at a
distance of at least 2.5 m.
z For Maps-mode:
Source position - centered between Detectors. The source distance
depends on the maps mode start position detector angle as shown in
Table 9–16.
Table 9–16: Maps Mode Start Position Detector Angle

Maps Mode Distance from

Start Position Source to Calibration/QC
Angle Detectors Plane

85° 520 cm All

84° 430 cm All

83° 370 cm All

82° 320 cm All

81° 285 cm All

80° 255 cm Not applicable for Utest

79° 235 cm Not applicable for Utest

78° 215 cm Not applicable for Utest

Ceiling

Distance
Angle

Dete 2
ctor ctor
1 Dete

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9.8.4.5 Resolution and Linearity Test Execution

To access the Resolution and Linearity Test, double click on the

Performance folder and select Resolution and Linearity Test. For
additional information refer to Accessing the Quality Control Utilities on
page 9-8.

Separate procedures are described below for performing the test in L-Cardiac
mode and Maps mode.

Table 9–17: Resolution and Linearity Test in L-Cardiac Mode

Action Messages/Events

1. Shut the system down and insert the new IPS

PSD bypass cable. Power ON the system.

2. Remove collimators from the detectors (if

Follow the procedure for Preparing the
mounted). Place the X-direction Line Slit
Linearity Phantom for Map Creation on
phantom on Detector 1 and the Y-direction Line
page A-24.
Slit phantom on Detector 2.

3. Select the L QC D1 or L QC D2 User Home

Position and click [Set] from the Gantry
Handler Home Position page.

4. Position the radioactive source.

5. Double click on the Resolution and Linearity Opens First Acquisition Key Parameters (see
Test. Figure 9-30).

6. Verify that Detector 1 is selected (deselect

Detector 2).

7. Verify that X Slit Direction is selected for

Detector 1

8. Verify that the variables and values shown in

Table 9–19 are selected.

9. Click on the Corrections tab and enter/verify the

variables and values shown in Table 9–20.

10.Press [Apply] A PHA histogram appears on the screen.

The acquisition begins. Wait until the

11.Press [Start]
acquisition is completed.

12.Press [Next] at bottom of screen. The First Acquisition report appears.

13. Write down the ImageName name from the

Input Parameters Table on a piece of paper.

14.Press [Back]

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Table 9–17: Resolution and Linearity Test in L-Cardiac Mode (Continued)

Action Messages/Events

15.Rotate detectors 90° in order that the source

can be viewed by Detector 2.

16.Select Detector 2 (deselect Detector 1).

17.Verify that Y Slit Direction for Detector 2 is

selected.

18.Press [Apply]

19.Press [Start]

20.Press [Next] at bottom of screen. The First Acquisition report appears.

21. Write down the ImageName name from the

Input Parameters Table on a piece of paper.

22.Remove the radioactive source.

23.Remove the phantoms from the detectors using

the collimator exchange procedure (for
additional information refer to Appendix A).

Place the X-direction Line Slit phantom on

Detector 2 and the Y-direction Line Slit phantom
on Detector 1.

Interchange between the X and Y slit phantom

through the collimator exchange procedure.

24.Re-position the radioactive source.

25.Select Second Acquisition on the left side

of the screen.

26.Repeat Steps 5 through 20. Be sure to select X

When completed, review Second Acquisition
Slit Direction on Detector 2 and Y Slit Direction
report.
on Detector 1.

27.Select Resolution Test on the left side of This opens the Resolution panel.
the screen.

28.Select Detector 1 and X Slit and Detector 2

and Y Slit (so that a check mark appears).

In the drop down lists next to X Slit and Y Slit,

verify that the image name that was recorded
above appears.

Wait for the Resolution test to end. When the

29.Press [Start] test is completed, the results are displayed
on the screen. Review results.

30.Select Linearity Test on the left side of the

screen. button.

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Table 9–17: Resolution and Linearity Test in L-Cardiac Mode (Continued)

Action Messages/Events

31.Select Detector 1 and X Slit and Detector 2

and Y Slit (so that a check mark appears).

In the drop down lists next to X Slit and Y Slit,

verify that the image name that was recorded
above appears

Wait for the Linearity test to end. When the

32.Press [Start] test is completed, the results are displayed
on the screen.

Maps Mode

Table 9–18: Resolution and Linearity Test in Maps Mode

Action Messages/Events

1. Shut the system down and insert the new IPS

PSD bypass cable. Power ON the system.

2. Remove collimators from the detectors (if

mounted). Place the X-direction Line Slit
phantom on Detector 1 and the Y-direction Line
Slit phantom on Detector 2 (see Appendix A).

3. Select the MAPS User Home Position and click

[Set] from the Gantry Handler Home Position
page.

4. Go to the gantry and press <SET> on the

RCU.

5. Position the radioactive source.

6. Double click on the Resolution and Linearity Opens First Acquisition Key Parameters (see
Test. Figure 9-30).

7. Verify that Detector 1 and Detector 2 are

selected.

8. Verify that X Slit Direction for Detector 1 and Y

Slit Direction for Detector 2 are selected

9. Verify the variables and values shown in

Table 9–19.

10.Click on the Corrections tab and enter/verify the

variables and values shown in Table 9–20.

11.Press [Apply] A PHA histogram appears on the screen.

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Table 9–18: Resolution and Linearity Test in Maps Mode (Continued)

Action Messages/Events

The acquisition begins. Wait until the

12.Press [Start]
acquisition is completed.

13.Press [Next] at bottom of screen. The First Acquisition report appears.

14. Write down the ImageName name from the

Input Parameters Table on a piece of paper.

15.Remove the radioactive source.

For additional information refer to

16.Swap the phantoms.
Appendix A.

17.Re-position the radioactive source.

18.Select Second Acquisition on the left side

of the screen.

19.Repeat steps 6 through 13. Be sure to select X

Slit Direction on Detector 2 and Y Slit Direction
on Detector 1.

20.Select Resolution Test on the left side of This opens the Resolution panel.
the screen button.

21.Select Detector 1 and X Slit and Detector 2

and Y Slit (so that a check mark appears).

In the drop down lists next to X Slit and Y Slit,

verify that the image name that was recorded
above appears

Wait for the Resolution test to end. When the

22.Press [Start] test is completed, the results are displayed
on the screen. Review test results.

23.Select Linearity Test on the left side of the

screen. button.

24.Select Detector 1 and X Slit and Detector 2

and Y Slit (so that a check mark appears).

In the drop down lists next to X Slit and Y Slit,

verify that the image name that was recorded
above appears

Wait for the Linearity test to end. When the

25.Press [Start] test is completed, the results are displayed
on the screen. Review results.

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Figure 9-30 First Acquisition Key Parameters

Table 9–19: Resolution and Linearity Test Key Parameters—First Acquisition

• X for Detector 1 (where the X_Slit

Phantom is mounted)
Slit Direction
• Y for Detector 2 (where the Y_Slit
Phantom is mounted)

Stop on counts 4000

Matrix 1024 x 1024

Zoom 1

All other
0
parameters

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Table 9–20: Resolution and Linearity Test Corrections—First Acquisition

Use corrections All checked

Tc99m.15 (with energy window at

Energy session
±7.5%)

Rotate Handle Clockwise

to simulate Collimator
Cart in Place

Cart IN Place Position

Cart OUT of Place Position

Figure 9-31 Cart In Place Simulation Handle

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9.8.4.6 Resolution Test Acceptable Results

For each detector:

3/8" 1"
Parameter Name Acceptance Acceptance
Criteria Criteria

Average CFOV: FWHM ≤3.8 ≤4.5

Average CFOV: FWTM ≤7.1 ≤8.3
Average UFOV FWHM ≤3.9 ≤4.5
Average UFOV FWTM ≤7.2 ≤8.5

9.8.4.7 Linearity Test Acceptable Results

For each detector:

3/8" 1"
Parameter Name Acceptance Acceptance
Criteria Criteria

CFOV Differential Linearity < 0.1 mm < 0.1 mm

CFOV Absolute Linearity < 0.5 mm < 0.5 mm
UFOV Differential Linearity < 0.1 mm < 0.1 mm
UFOV Absolute Linearity < 0.5 mm < 0.5 mm

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9.8.5 Energy Test

9.8.5.1 Description

This test checks the system ability to distinguish between photons of different
energies.

9.8.5.2 Radioactive Sources and Collimators

Source Activity
Radioactive Source Collimator
mCi MBq

Tc99m and Co57 Point Source ~0.5 ~18.5 Decoy Collimators

9.8.5.3 Energy Test Conditions

For each source:

z Source position - centered to the UFOV of the tested Head, at a
distance of 3 m at least.
z Count rate - less than 20 kc/s per head.

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9.8.5.4 Energy Test Execution

1. Remove the Collimators from both detectors and mount the Decoy
Collimators. (Refer to Appendix A).
2. Position the Gantry in L-Cardiac Mode.
3. Rotate the Gantry so that the UFOV of the tested detector will be
centered to the designated position of the radioactive source.

Procedure Selection Screen

QC Tab Select QC tab if it is not selected

Performance
Tests

Energy Test Opens the Tc99m Acquisition Key

Parameters screen.

Tc99m Acquisition Key Parameters Screen

Select the detector to be tested (1 or 2)

Verify that the Stop on Counts value is at

least 1500 Kcts

[Apply] A PHA histogram appears on the screen.

Tc99m Acquisition

[Start] Wait until acquisition is completed.

Replace the Tc99m source with a Co57

source at the center of the UFOV of the
tested detector at a distance of at least 3 m.

Co57 Opens Co57 Acquisition screen

Acquisition
(left side of
screen)

Co57 Acquisition Key Parameters Screen

Select the detector to be tested (1 or 2)

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Verify that the Stop on Counts value is at

least 1500 Kcts

[Apply] A PHA histogram appears on the screen.

Co57 Acquisition Screen

[Start] Wait until acquisition is completed.

Energy Test
Etest Report appears. Compare report to
(left side of
Section 9.8.5.5
screen)

Repeat the procedure for the other detector.

9.8.5.5 Energy Test Acceptable Results

Energy Resolution value: < 9.8%

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9.9 SPECT Count Density Test

The purpose of this test is to check the acquisition stability during SPECT
acquisitions.
 The test is done with a CO57 flood source that should be fastened
to the detector enabling the rotation motion.
 The test could be done in L Mode or in H Mode. In either case
the Flood source should be secured to one of the detectors.
 The test is performed with LEHR collimator and CO57
flood source.

9.9.1 System Set-up for SPECT Count Density Test in H Mode:

 Bring the Gantry to H Mode home position.
 Secure the CO57 Flood source to one of the detectors.
 Close both radials as much as possible.
 Make sure that the distance between the source to both heads is
equal.

9.9.1.1 Spect Count Density Test Acquisition

1. Open System Set-up.t

a.

Navigation:

b. QC >> Performance tests >>Counts density test

2. In the opened Key Parameters panel verify the following:

 In the Scan Mode section verify that Step and shoot is checked.
 Enter time that will give 1000 K counts per step.
 Click the Energy setting Tab and verify:
„ Energy session:CO57
„ Selected collimator: LEHR
„ COR Corrections: Checked.
„ Peak: 122
„ +/- (%):10

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3. Press Apply and start the acquisition by pressing the <enable>+<GO>

buttons.
4. When the acquisition is complete a report will be opened.
5. Verify that the value do not exceed +/- 0.3%

9.9.2 System Set-up for SPECT Count Density Test in L-Mode:

 Bring the Gantry to L Mode home position.
 Secure the CO57 Flood source to one of the detectors.

9.9.2.1 SPECT Count Density test acquisition in L-Mode:

1. Open System Set-up

a.

Navigation:

b. QC >> Performance tests >>Counts density test

2. In the opened Key Parameters panel verify the following:

z In the Scan Mode section verify that Step and shoot is checked.
z Enter time that will give 1000 K counts per step.
z Click the Energy setting Tab and verify:
 Energy session:CO57
 Selected collimator: LEHR
 COR Corrections: Checked.
 Peak: 122
 +/- (%):10

3. Press Apply and start the acquisition by pressing the <enable>+<GO>

buttons.
4. When the acquisition is complete a report will be opened.
5. Verify that the value do not exceed +/- 0.3%

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9.9.3 Jaszczak Phantom Test

System performance in ECT Acquisition can be demonstrated with the Data
Spectrum SPECT Phantom (Jaszczak Phantom).

This test refers to the phantom with six segments of rods, with diameter of
4.8, 6.4, 7.9, 11.1 and 12.7 mm, and six spheres with diameters of 9.5, 12.7,
15.9, 19.1, 25.4 and 31.8 mm; for example, Data Spectrum deluxe SPECT
phantom # 043-750.

Uniformity

Contrast

Resolution

Figure 9-32 Jaszczak Phantom

9.9.3.1 Prerequisites

The system must be well adjusted, both mechanically and electrically.

In particular, verify the following points:

A high statistics sensitivity map acquired for both detectors with LEHR
Collimators. The statistics suggested for the maps is at least 120 Mc per Head.
The map should be acquired either with a Co57 flood source or Tc99m refillable
flood source with the “right” amount of water inside, so that neither hot nor
cold center is observed.

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9.9.3.2 Preparations
1. Fill the Jaszczak phantom with distilled water, leaving a volume of about
10 ml of air.
2. With the table retracted to maximum OUT position, place the phantom
holder on the table frame and secure with a single screw.
3. Put the phantom in the holder with the off-centered filling screw facing
up.
Then make the following adjustments with reference to the main
symmetry axis:
a. Set the pitch angle of the phantom to 0o, using a small spirit level on
the phantom. The adjustment should be made with the screw in the
holder below the securing screw.
b. Set the yaw angle of the phantom to 0o. This adjustment is best
performed by setting the Gantry to 90o in H-Shape Mode, and
position the Heads close to the phantom (RADIAL IN). Make sure
that the sides of the phantom are parallel to the Collimators.
You may put a ruler between the phantom and the Heads to improve
the accuracy of our estimation of parallel lines.
The change in the phantom yaw angle is made with the two screws
on the sides of the security screw.
c. Check again the pitch angle to ensure that the yaw adjustment did
not affect it.Readjust if necessary.
4. Set the minimum possible rotation radius (RADIAL IN) for both
detectors, as follows:
a. Start with Gantry set to H-WB Mode, rotation = 90o, and the two
detectors positioned a few centimeters from the phantom.
Move Detector 1 IN until it is a few millimeters away from the
phantom. Rotate the Gantry slowly, ensuring that the Collimator
never touches the phantom. If necessary, change the Up/Down
position of the Table. Note the location of the critical point and
adjust the clearance between the collimator and the phantom with the
holder to 1 - 2 mm.
b. Measure the distance between Detector 1 and the phantom at two
rotation angles: 0o and 180o. The two distances should be equal. If
not, change the Table’s height.
c. After Detector 1 is properly positioned, adjust the position of
Detector 2.
The quickest way is to set Detector 2 at the critical point and then
move it IN until the Collimator is 1 - 2 mm away from the phantom
and its holder.

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d. Rotate the Gantry, ensuring a marginal clearance of 1 - 2 mm for

each detector over the entire 360o range.
5. When all adjustments are completed, leave the Gantry in rotation angle
of 90o. Remove the phantom from its holder by lifting it very gently,
ensuring that it will not bump into the Collimator.

6. The phantom is now ready for filling with Tc99m. To calculate the activity
needed, bear in mind that, due to the phantom absorption, the output is
about 40% of the inserted Tc99m activity.
The suggested rate at the beginning of acquisition is about 30 kc/s (15 kc
per detector).

7. Inject into the phantom Tc99m with an activity (A) of approximately:

15 kc/s 1 2250
A = ---------------------- * --- = -------- [mCi]
S*1/60 (kc/s)/mCi 0.4 S

Where S is the sensitivity of the Collimator in cpm/μCi.

The best technique is to measure the activity with a Dosimeter. if

this is not available, take in a syringe an amount of Tc99m that
will yield a rate of ~ 30 kc/s in both detectors. Then put 2.5 times
as much Tc99m as in the syringe into the phantom.
The activity for the LEHR Collimator should be 20 mCi.

The amount of liquid injected into the phantom should leave a

few millimeters of air in the phantom.
8. After injecting the isotope, close the phantom and mix the liquid inside
as follows:
a. Keep the phantom with the filling screws facing up.
b. Lift the phantom upward so that the filling screw will face
downward and wait for the bubbles to rise.
c. Turn the phantom back to its original position and wait again for the
bubbles to rise.
d. Repeat the process for about one minute.
9. Place the phantom carefully in the holder. As the phantom can be moved
slightly in its holder, rotate the Gantry a full circle, ensuring that the
Collimators do not touch it. Rotate the Gantry to 0o.

The system is now ready for acquisition.

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9.9.3.3 Acquisition
1. Open the To Do List.
2. Select the [New Study...] button to schedule a new Tomo study (see
Figure 9-33).
3. Type details of test (for assistance, refer to Figure 9-33. Press [Select
Study Protocol...]. Select Tomo protocol from the Factory\Basic
folder.
4. In the opened Tomo Key Parameters panel, select/verify the following
parameters:
Table 9–21: Tomo Key Parameters

Rotation: Total
360 (Arc per Detector: 180)
Angular Range:

View Angle: 3 (Views #: 120)

Stop on Time per 30 sec (in order to receive 200 kc per

Projection: frame

ECT Type: S&S

Zoom: 2

Y Offset: Checked (to get the Jasczak)

image in the center of the

frame)

Matrix: 128 x 128

5. Click Correction Parameters. Verify the following:

Table 9–22: Tomo Correction Parameters

Use corrections: All checked

Isotope: Tc99m

Collimator LEHR

6. Start Acquisition using the RCU <GO/PAUSE> key.

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9.9.3.4 Processing
1. Select the Jaszczak Planar Study from the Xeleris Data management
panel.
2. Select General SPECT protocol residing within General SPECT
Applications container on the Xeleris Data Management panel and press
[Start].
3. Select the SPECT options.
4. Select the correction reconstruction filter as shown below and click
[Proceed].

Figure 9-33 Reconstruction Filter Selection

5. The expected result after the filter changes is the following (compare to
the previous results).

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Figure 9-34 Results after Filter Change

6. Select the Transversal Output Group load in a new workspace.

7. From Analysis select the Image Processing option and click on Reframe
and on Step.
8. Sum the slice as following:
z Mark the input quarter and the output quarter
z Set the frame range
z Set the number of frame
z Set the frame step - 1
9. Rename and the save the new group as Jasczak-final.

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9.10 X-ray QC Tests

The quality control of the Hawkeye subsystem is performed by analyzing
scans of the QC Phantom (see Section 9.10.2). If any test fails, the system
should be re-calibrated using the calibration procedures described in
Chapter 7 – X-ray Calibration. If the problem persists, the cause should be
identified by performing the Diagnostic tests in

There are five test procedures performed in the X-ray QC dialog. It is possible
to select all of the procedures to be performed or just some of them.
z Uniformity
z Low Contrast
z Density
z High Contrast
z Slice Thickness

The table below shows the various X-ray QC tests and when they should be
performed.

Table 9-23: QC Usage

After
Replacement of
After System Image Quality
During PM Source or
Installation Deterioration
Detector
Assembly

Uniformity 9 9 9 9

Low Contrast Resolution 9 9 9 9

Density Scale 9 – 9 9

High Contrast Resolution 9 9 9 9

Slice Thickness 9 – 9 9

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9.10.1 X-ray QC Tests Description

9.10.1.1 Uniformity

The Uniformity test is the primary method of assessing CT image quality.

This test acquires scans of the water section in the QC phantom. The mean
CT number and the pixel noise (measured by the standard deviation of the
CT numbers in a ROI) are measured on the images. This is the most sensitive
test of system performance, since in a well-calibrated system, the mean CT
number of water should be uniform and the noise should be uniform random
noise inversely proportional to the square root of the number of X-ray photons
detected. Any loss of Tube output or Detector efficiency will be detected as
an increase in noise. A change in the Tube High Voltage will change the CT
number of water. Poor calibration of the Detector will cause ring artifacts,
which increase the measured image noise.

The Uniformity test is the primary method of assessing CT image quality.

The remaining tests measure parameters which should be measured on system
installation or after replacement of X-ray Source or X-ray Detector.

9.10.1.2 Low Contrast

The detectability of small low contrast objects depends both on the noise and
the resolution of the system. It is assessed by imaging a pattern of holes in a
thin sheet of plastic.

Low contrast resolution is assessed using Section 2 which contains a thin

plastic plate which is designed to have an image density 2.5% greater than
water when imaged with a 10 mm slice thickness. The plate has several holes
of different diameter which are filled with water.

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9.10.1.3 Density

This test measures the densities of different materials such as water, air and
perspex. It can be used to confirm that the effective energy of X-ray scanning
is unchanged and is therefore important in quantitative uses of the CT images.

Additional Usage:

Perform this test after measuring the water CT levels in the Noise and
Uniformity Test.

This test measures the densities of different materials such as water, air and
perspex. It can be used to confirm that the effective energy of X-ray scanning
is unchanged and is therefore important in quantitative uses of the CT images.
It should be performed after measuring the water CT levels in the Noise and
Uniformity Test.

9.10.1.4 High Contrast

During this test five different groups of bars are scanned. The bar distance
are different from group to group. The

Scans the Resolution bars to provide a visual and quantitative assessment of

system resolution.

A visual and quantitative assessment of system resolution can be obtained by

scanning the Resolution bars.

9.10.1.5 Slice Thickness

The image’s slice thickness is measured using four inclined hole ramps.

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9.10.2 QC Phantom

A phantom is supplied with the Hawkeye option for the purpose of measuring
the X-ray image quality. The phantom is a plastic container in the form of a
20-cm diameter cylinder containing water and a set of plastic test objects.

The phantom is imaged in three slices, 30 mm apart, in order to show the

three sections of the phantom (Figure 9-35). The function of each section is
shown in the table below. Throughout this chapter, references to Section 1,
2, and 3 refer to the three sections of the phantom.

Table 9–24: Phantom Sections

Distance from
Section Function
Alignment Section

1 Slice Alignment, Spatial Resolution, CT Scale, and Slice Thickness 0

2 Low Contrast Resolution 30 mm

3 20-cm diameter, water for noise and uniformity of CT numbers 60 mm

Each phantom section is described in the following pages.

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Rectangular
Support Bracket

Water
Section

Section1 30 mm 30 mm
Slice Alignment
Slice Thickness
Resolution
Section 2
Low Contrast
Resolution
Section 3
Water

Figure 9-35 Side View of QC Phantom

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9.10.2.1 Resolution, Alignment, CT Scale and Slice Thickness (Section 1)

Section 1 of the phantom contains inserts to measure the Spatial Resolution,

Slice Alignment, CT Scale, and Slice Thickness. The inserts are labeled in
Figure 9-36.

The spatial resolution is assessed using a range of water/plastic bar patterns

which are placed diagonally across the phantom. The bar patterns represent
spatial frequencies of 2.0, 2.5, 3.0, 3.5, and 4.0 line pairs/cm.

The CT scale is measured using plastic and water in the phantom and air
outside the phantom.

The Slice Sensitivity profile is measured using the Slice Width gauge,
consisting of a set of four inclined rows of holes drilled at 63.4 degrees to the
horizontal.

Alignment of the phantom is measured by comparing the position of the center

slice marker with the slice width gauge, which is aligned with the line marked
on the exterior of the phantom.

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Line Pairs/cm
2.0

Center Slice
Marker
2.5

3.0

3.5 Slice Width

Gauge
4.0

Figure 9-36 Alignment and Resolution Section (Section 1)

9.10.2.2 Low Contrast Resolution (Section 2)

The ability of the Hawkeye to detect small objects with small differences in
density between the surrounding tissue depends on both spatial resolution
and the noise of the system. A direct measurement of the Low Contrast
Resolution can be made with the Low Contrast section of the Hawkeye QC
phantom.

The Low Contrast section contains a thin plastic plate with an image density
2.5% greater than water when imaged with a 10 mm slice thickness. The plate
has several holes of different diameter which are filled with water. The hole
location and sizes are shown in Figure 9-37.

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12 6 4 15

2 3
8 5

Figure 9-37 Low Contrast Section Showing Hole Diameters in mm (Section 2)

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9.10.2.3 Uniformity and Noise (Section 3)

The uniformity and noise of the CT image is assessed by acquiring an image

of a uniform water slice.

9.10.2.4 Positioning the Phantom

The phantom holder is placed on the stretcher (without the mattress) with the
small tips attached to the end of the stretcher. The phantom is placed on the
holder with the rectangular support bracket inserted over the right-angled
protrusion on the holder, facing out of the Gantry and the small alignment
line at the top. See Figure 9-38. Make sure that the phantom is not tilted or
skewed. After placing the phantom on the holder, make sure that the tips at
the edge of the holder come in contact with the end of the stretcher.

Attach to
End of Stretcher

Figure 9-38 Phantom Holder

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To Gantry

Top Alignment Line

Circumferential
Alignment
Line
Lateral
Alignment
Line

Rectangular
Support Bracket

Place on Holder
Table

Figure 9-39 QC Phantom Placed on Stretcher for Imaging (Rectangular Bracket Faces Out of Gantry)

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9.10.2.5 Activating X-ray QC

To activate X-ray QC:

Non-clinical Operations Screen

QC tab Opens QC Folder

X-ray Image
Quality Test

X-ray QC Tests Opens X-ray QC Tests

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9.10.2.6 X-ray QC Parameters

The following dialog opens once X-ray QC Tests is selected.

3
2

4
5

7
6
8

Figure 9-40 X-ray QC Test Dialog

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Table 9–25: X-ray QC Parameters

# Parameter Description Default

• X-ray QC Test check boxes

1 Test to Operate • The first test that is “checked” All Tests checked
will be the first test that is run.

Acquire First

Used if want to acquire a new Default. Assumes placement

2 Acquire First
scan for QC test of phantom at end of table.

3 Scout Scan Limits

4 Start Position 6000 mm

5 Range 5000 mm

Use Study

Use an existing study for QC

6 Use Study No
test.

7 Select Study

8 Select Series

• Slice 1 for Uniformity Test

• Slice 2 for Low Contrast
test.
9 Select Slice • Slice 3 for Density,
High Contrast Resolution
and Slice Thickness and
Alignments tests.

When selecting a slice, it is possible that there are more than three slices in the
Important
scan (if it was not obtained as a QC scan). In this case choose the appropriate
slice for every test before pressing [Apply].

9.10.2.7 Prerequisites

Before running the X-ray QC tests, verify that X-ray Daily QC (see X-ray
Daily QC (Hawkeye Option) on page 9-39) was performed at some time
during the day.

If X-ray Daily QC was not performed, it is necessary to do so prior to running

the X-ray QC tests. X-ray Daily QC includes the X-ray Warm Up and Air
Table Creation procedures that are required to run X-ray QC Tests.

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9.10.2.8 Acquire First

Usage:

If Acquire First is selected, a new scan is acquired.

Instructions:

Action Messages/Events

1. Select the Start Position and Range. Use arrows to increase or decrease number

2. Click [Apply] The screen displays to the Scout viewer.

3. Go to the acquisition area and position the

phantom on its holder. Press <SET> on the The table moves to the Start position. “Press
RCU. For additional information on positioning Start on the RCU” appears on the GDU.
phantom, refer to Section 9.10.2.4.

4. Press <GO/PAUSE> on the RCU to begin. The Start X-ray Confirmation Dialog appears.

Scout scan runs to completion.

5. Click [OK] to confirm start of X-ray. When completed the image is displayed on
the screen, with two locators.

6. Position the locators exactly at the top and The Start X-ray Confirmation Dialog appears
bottom of the phantom. Click [Next]. again.

7. Click [OK] to confirm start of X-ray.

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9.10.2.9 Use Study

Usage:

To choose existing study or series.

Instructions:

Action Messages/Events

1. Select Study

2. Select Series

3. Select Slice

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9.10.2.10 X-ray QC Test Execution

9.10.2.10.1 General Information

1. The first test that is selected in the X-ray QC Test dialog (see
Figure 9-40) is the first test that is run after [Apply] is pressed.
2. A test is run only if it is “checked” in the X-ray QC Test dialog.
3. Tests are run in sequential order and automatically continue to the next
selected test.
4. Once all of the selected tests are completed, a series of reports appear.
5. The individual reports for each test appear in the same sequence that the
tests were run.
6. To zoom in on an image, click on the image with the right mouse button.
7. To move an image, click on the image with the left mouse button.

Non-clinical Operations Screen

QC tab Opens QC Folder

Performance Tests Shows Performance Tests

X-ray QC Tests Opens X-ray QC Tests

The procedure described below is the flow if all X-ray tests are checked.

Look at the top of the screen for system messages.

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Action Messages/Events

1. Select desired X-ray QC tests.

2. Select “Acquire First” or “Use Study”

Can use arrows to increase or decrease

3. Select the Start Position and Range.
number

The view is changed to changed to the Scout

4. Press [Apply] viewer.

5. Go to the acquisition area and position the

The table moves to the Start position. “Press
phantom on its holder (see QC Phantom on
Start on the RCU” appears on the GDU.
page 9-101). Press <SET> on the RCU.

6. Press <Start> on the RCU to begin. The X-ray Confirmation Dialog appears.

7. Leave the acquisition area and close the door.

Scout scan runs to completion. When
completed the image is displayed on the
Press [START] at the acquisition console to screen, with two locators. See Figure 9-41.
confirm start of X-ray.

8. If necessary, position the locators exactly at the

top and bottom of the phantom by dragging one
of the locators to the edge of the phantom. The The Start X-ray Confirmation Dialog appears.
second locator moves automatically. Press
[Next].
Three slices are acquired for the QC tests.
9. Press [START] at the acquisition console to
When completed, the first Hawkeye QC test
confirm start of X-ray.
that was selected begins.

Uniformity Test
When the test starts, slice 1 of the phantom
appears with six round ROIs (see
Figure 9-42).

10.Verify that the ROIs are located in the correct

position as described in Table 9–26. If
necessary, move the ROI by clicking on it and
dragging it. It is recommended not to move the
ROI unless necessary.

11.Press [Next].

Low Contrast Test

When the test starts, slice 2 of the phantom
appears with a number of holes (see
Figure 9-43).

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Action Messages/Events

12.Type in the number of visible holes on the image

in the rectangular area below the image in the
entry field at the bottom of the screen.

If the image is not seen clearly, change the

window level (on left side of screen) to improve
the quality of the image.

13.Press [Next]

Density Test
Slice 3 of the phantom is displayed on the
screen with three round ROIs of different
colors (see Figure 9-44).

14.Verify that the ROIs are located in the correct

position as shown in Table 9–27. If necessary,
move the ROI by clicking on it and dragging it. It
is recommended not to move the ROI unless
necessary.

15.Press [Next].

High Contrast Test

Slice 3 of the phantom is displayed on the
screen with a number of sets of bars (see
Figure 9-45).

16.Type in the number of visible bar sets on the

image in the rectangular area below the image
in the entry field at the bottom of the screen.

A “visible bar set” means that the operator can

distinguish between the adjacent stripes of the
set (the set is not seen as a dark rectangle).

If the image is not seen clearly the window level

should be changed manually to improve the
quality of the image.

17.Press [Next].

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Action Messages/Events

Slice Thickness Test

Slice 3 of the phantom is displayed on the
screen with four rectangular ROIs, located so
that the long side should overlap the dark
area (thin water slice) (see Figure 9-46).

18.If the initial placement is not as described the

operator should position them as shown in
Figure 9-46 (follow instructions on the screen).

The X-ray QC reports in the order that the

19.Press [Next] tests were performed. Review the tests. See
Figure 9-47.

Table 9–26: Uniformity Test ROI Positioning

ROI Color Position on Phantom

Green Top

Blue Bottom

Cyan On left side

Pink On right side

Red In center

Yellow Over the whole water area inside the phantom.

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Figure 9-41 Locators Positioning

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Figure 9-42 Uniformity Test

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Figure 9-43 Low Contrast Test

Table 9–27: Density Test ROI Positioning

ROI Color Position on Phantom

Red On the plastic area

Green On the water area

Yellow On the air area

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Figure 9-44 Density Test

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Figure 9-45 High Contrast Test

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Figure 9-46 Slice Thickness Test

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Figure 9-47 X-ray QC Report

9.10.2.11 Reviewing Reports

See QC Reports and Images on page 9-3.

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9.11 X-ray to NM Registration Test (QC)

9.11.1 Overview
This procedure is used to measure the X-ray (CT) and Emission (NM)
images registration.
The registration test uses the Hawkeye alignment phantom, which is built
from low attenuation material with holes for placing 6 syringes filled with
radiation sources (Tc99m or other – according to the collimator used).
These sources serve as landmarks for calculating the distance between the
CT and NM images.
The processing and calculations for this test are done using a dedicated
protocol on the Xeleris workstation.
The processing protocol measures the distance between the CT and NM
images in the X, Y and Z-axes, and displays the Mean (average) of the
absolute values measured on the landmarks together with the acceptance
limits.
These values are the main outcome of this test, as they reflect the current
system’s performance, i.e.: if these values are within the acceptance limits,
then the CT – NM registration is acceptable. Otherwise, the system must be
calibrated using the X-ray to NM calibration procedure.
For a definition of the system’s axis and angles, see Figure 9-48.

Figure 9-48 System Axis and Angles

A secondary function of the protocol is that it enables viewing the CT – NM

registration of specific syringes, by super-imposing a threshold ROI of the
NM image of a syringe over the CT image (see Figure 9-49).
When reviewing the syringe images on the Xeleris workstation, it is
important to bear the following points in mind:

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The CT slice thickness is 1cm. This leads to the following effects:

z The position of the syringe in the axial direction might appear slightly
shifted compared to the position in the NM image. This visual effect
is amplified by the zoom x10 of the display.
z The shape of syringes # 1, 2, 4 & 5 might not appear to be circular
Both of these effects are normal and do not reflect a problem in the
QC procedure.

In order to view and archive the results of the test, the results of the
processing must be fetched back to the Infinia acquisition station.
The test must be executed separately for every collimator set that is used on
the system (similar to C.O.R. test).

Figure 9-49 Processing screen on Xeleris

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X-ray to NM registration test should be executed in the following cases:

1. Immediately after completing X-ray to NM registration calibration.
2. PM (once per year).
3. Major COR changes.
4. Major detector calibration / correction changes.

9.11.2 Pre-requisites
z If X-ray QC has not been performed within the last 24 hours, perform
X-ray QC (see X-ray QC Tests in Section 9.10).
z If C.O.R. QC Test has not been performed in the last 30 days, perform
the C.O.R. QC test (see C.O.R. QC Test in Section 9.7).
z Verify that the table is properly calibrated in relation to stretcher
support (See Section 6.2 – Table Height Calibration on page 6-21
of this manual
z Verify that stretcher motion when on the support and loaded with
weight is smooth and straight. See Installing the Table on page 4-67
of the Infinia Installation Manual
z Verify that the Infinia acquisition station and the Xeleris workstations
are mutually configured as remote DICOM stations
(see Section 4.12.3 of this manual
z Verify that the protocol Hawkeye registration QC appears under
Miscellaneous in the Xeleris Workstation.

For Xeleris version 2.* carry out the following:

z Prior to performing the X-ray to NM Registration procedure, the
Hawkeye Registration Protocol must be turned ON.

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On the Xeleris workstation:

1. Perform partial Xeleris shutdown.
2. Double-click Hawkeye Registration Application Switcher
(located in the Service folder on the Xeleris Desktop).
The following screen appears:

Figure 9-50 Hawkeye Registration is OFF

3. If the Hawkeye Registration is OFF, select Yes to turn the protocol ON.
A confirmation message appears.

Figure 9-51 Hawkeye Registration Turned On

If the Hawkeye Registration is ON, select NO to leave the protocol ON.

4. Select [OK].
5. Restart Xeleris workstation.

Once the X-ray to NM Registration procedures is completed, Hawkeye

Important
Registration should be switched OFF.

Note Once this procedure is completed, the Hawkeye Registration QC protocol is added
to the Miscellaneous group on the Xeleris workstation.

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9.11.3 Source Preparation

Required Materials:

Six 10 ml syringes with needles (supplied with the kit) see Figure 9-52. If
these syringes are not available, any similar 10ml syringe may be used,
provided that the inner radius of the syringes is at least 15mm in diameter,
and that they fit securely in their grooves in the phantom.

9.11.3.1 For All collimators except Coincidence collimators (SEPTA, FILTER...)

Prepare 3-6 mCi of the relevant radioisotope in 60 ml volume (add the
radioisotope to the required amount of water/saline solution, and mix, to
ensure uniform dispersing of the radioisotope in the solution).

9.11.3.2 For Coincidence collimators (SEPTA, FILTER, …):

Prepare 0.5-0.6 mCi of FDG in 60 ml volume (add the radioisotope to the
required amount of water/saline solution, and mix, to ensure uniform
dispersing of the radioisotope in the solution)
.

Figure 9-52 The syringe used for the calibration

Figure 9-53 Filled Syringe With Needle and Plastic Cover

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1. Fill each syringe with 10 ml of liquid. Verify that all the syringes contain
the same volume and activity.

• When filling the syringe with activity it is important to avoid bubbles in the
Important
syringe – see Figure 9-52 and Figure 9-53.
• When filling the syringes, avoid differences in activity between syringes. In
order to do so, fill all the syringes from the same pool, and verify that all the
syringes contain the same volume (and no less than 6ml in each syringe).

2. Cover the needle with the plastic cover so that the liquid does not leak
out from the syringe.
3. Insert the syringes into the numbered holes of the phantom (three
syringes on each side). See Figure 9-54 and Figure 9-55.

Figure 9-54 Phantom with Syringes Positioned on stretcher.

(Holes #1,2,& 3 facing the clutch)

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Figure 9-55 Phantom with Syringes Positioned on Stretcher.

(Holes #4,5,& 6 Facing the Gantry).

9.11.4 Positioning the Phantom

1. Make sure the stretcher is fully extracted.
2. Place the phantom on the stretcher (without mattress) in linear
position 70-90 according to stretcher side ruler. Make sure that the
holes #1,2,3 are facing the clutch. (See Figure 9-54).
3. Push down on the phantom to ensure that it is positioned correctly on
the stretcher (ensure it is secured in place).
4. Place a weight of 10-15 kg on the far end of the stretcher, close to the
gantry but not near the phantom.

Important
Locate the phantom in linear position 70-90 (according to stretcher
side ruler).

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9.11.5 Registration Test Execution

1. Load the first set of collimators on the system.
2. Perform the following to open the Registration Test utility:

Procedure Selection Screen

QC tab Select QC tab

X-ray to NM Click the relevant QC procedure

Registration

Registration Test Opens Registration Test screen

(Tomo)

Note For Coincidence - dedicated collimators (SEPTA, FILTER, …)

select ‘registration test (CoDe)

The Count Rate Measurement Parameters screen appears.

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Figure 9-56 Count Rate Measurement

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Action Messages/Events

1. Determining ‘time per projection’ - for All collimators Note: the count rate registered in the detectors
except Coincidence (SEPTA, FILTER, …) (an estimation of the average is sufficient,
a. Position the gantry in H mode, rotation angle 90. high accuracy is not required)
Move the stretcher in, so that the phantom is located See Figure 9-56.
between the detectors. Use Table 9-28 to determine the time per
b. Apply the Count Rate Measurement. projection needed during the acquisition

3. Determining ‘time per projection’ - for Coincidence Make sure that the Coincidence rate is not
collimators (SEPTA, FILTER, …): grater than 14Kcts/sec. and the singles rate are
a. Position the gantry in H mode, rotation angle 90. in the green range and not greater than
Move the stretcher in, so that the phantom is located 500Kcts/sec. (the average of the two singles
between the detectors. rate- high accuracy is not required). If it is
greater than the mentioned rates then the
b. Schedule a CoDe scan and apply it.
activity in the syringes should be decreased.
The Emission time should be 4 Min.

3. Move to Registration Test Acquisition The Registration test (Tomo) acquisition page
opens.

4. In the Key Parameters screen, Update the ‘stop on time

per projection’ parameter, according to the value
determined (see “Table 9-28 Determining time per
projection”).
Other parameters should not be changed.

5. Click the Start button The GDU prompts to press <Set>

6. Press <Set> on the RCU Gantry moves to start position and then asks to
press <Go>

7. Press <Go> on the RCU The X-ray confirmation pop-up appears (on
host).

8. Press [Start] to confirm. This part (scout acquisition) Data is acquired. The acquisition starts with a
should take 2-3 minutes. Scout scan, and when completed, the results of
the scout scan are displayed.

9. Adjust the level of the window in order to see Note: It is only possible to set a Full range
registration phantom and syringes. Move locators such FOV (40 slices) – the locators do not enable
that the syringes are located symmetrically between the setting a different FOV and the tolerance
locators (see Figure 9-57) and press [Accept]. provided is only relevant to the location of the
Important: Avoid positioning the locators near the FOV.
syringes and ensure that there are no The Hawkeye sequence continues, NM part first
objects between the locators (approximately 5-10 minutes, depending on the
selected time/projection), followed by CT Slices
part (approximately 10 minutes).

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10.After scan is completed, the header will prompt to

select Registration Processing (on left side of
screen).
The first processing screen appears (see
Important: There is a delay between the end of the
Figure 9-58)
acquisition and the prompt on the header.
Select ‘Processing’ only after the message on
the header prompts to select the processing.

11.Select the relevant study to process. Note: Studies are named according to the date
and time of creation. The study most recently
acquired should be automatically selected in the
list.
If you wish to process an old study, check the
check box ‘Show all Studies’, and select the
required study from the drop-down list.

12.Select the Xeleris processing station, where the study The application sends the selected study to the
is to be processed and verify that the workstation selected processing station.
configuration was completed. Press [Process]. Note: The [Fetch Results] button becomes
enabled after successfully sending the study to
the processing station. But fetching the results
should be done after processing the data on the
processing station.

13.Verify that the data has been successfully sent to the The study is marked as successfully sent.
selected processing station: 'data management’ Æ
transfer log tab

Table 9-28: Time per Projection

Measured Average Rate [Kcts/sec.] 5 10 15 20

Suggested Time/projection [sec.] 14 7 6 4

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Figure 9-57 Correct Positioning of the limits on the Scout Image

(syringes and phantom are located symmetrically within these limits)

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Figure 9-58 First screen of Processing Phase

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9.11.6 Processing a Registration Test study on the workstation

Processing the Registration test study is done on the Xeleris workstation.

14.Go to the Xeleris workstation. In the The protocol is launched. The result screen shows the
patient selector screen, select the following:
registration study. Find the Hawkeye A zoomed image of one of the syringes: an NM image (top
Registration QC application that appears right), a CT image (top left), and a fused image, which shows
under 'Miscellaneous', and double click on the NM image contour super-imposed over the CT image
it to launch. (bottom left).
Note: For Xeleris version 2.* the protocol An MIP image of the syringes (bottom right), with numbers
should customized to run with Fourier series next to the identified syringes.
and not IRNC in CoDe calibration and test.
The CT - NM registration mean absolute values [mm] (left
side of screen).
See Figure 9-59.

15.Compare the MIP image to Figure 9-59 The MIP image should contain 6 syringes, labeled with
numbers, exactly as seen in. Figure 9-59:
2 horizontal lines (syringes 2 & 5)
2 vertical lines (syringes 3 & 6)
2 'points' (syringes 1 & 4)

Important: If any difference is noted, or an error message

appears, then there was a problem with the acquisition. This
data is probably not valid, and should not be used for
calibration. Make sure that the source preparation and
phantom positioning instructions were carefully followed (see
sections 7.5.2 to 7.5.4), and acquire the data again.

16.Review the results. Check whether any of Pressing on each button displays both an NM and a CT
the values exceed the acceptance limits. image of a single syringe.
It is possible to view zoomed images of If any of the mean absolute values exceed the acceptance
the 6 syringes by clicking on their number limits, they should be Bold (this implies that the system must
on the left side of the screen. be calibrated).
Notes: The CT slice thickness is 1cm. This leads to the
following effects: The position of the syringe in the axial
direction might appear slightly shifted compared to the
position in the NM image. This visual effect is amplified by the
zoom x10 of the display.
The shape of syringes # 1, 2, 4 & 5 might not appear to be
circular
Both of these effects are normal and do not reflect a problem
in the QC procedure.

17.When finished reviewing the results, close The protocol is closed.

the processing protocol and return to the
Infinia acquisition station.

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Figure 9-59 Processing screen on Xeleris

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9.11.7 Transferring the results back to the Infinia Acquisition Station

In this part, the results are transferred back to the Infinia acquisition
station, and a decision is made whether the calibration results should be
saved. A final report is issued at the end of the process.

Return to the Infinia application and click The Infinia application fetches the results and displays the
the [Fetch results] button. processed information. See Figure 9-60.
Table displays the mean of the absolute CT to NM
differences, with the acceptance limits. The values in this
table are identical to the values in the table displayed on the
Xeleris workstation.
Interpreting the results: Note:
If all values in the table (absolute values) The acceptance limits for the CT to NM average absolute
are within the acceptance limit, then the difference (1) are 3mm for X and Y, and 5mm for Z. If any of
system’s performance is within the values exceed their limits, it should be marked red.
specifications. However, it is The maximum correction value allowed (limits of cumulative
recommended to accept the values. calibration values) (2.3) are: for X +/-8mm, for Y +/-5mm, for Z
This may improve the camera’s image +/-10mm, for Rotation +/-1 degree. If any of the values
quality. exceed their limits, it should be marked
If one or more values in the 1st table red.
exceed the acceptance limit (marked
red), then the system’s performance is
below specifications. CT to NM
calibration must be executed.
Press [Next] to display the final report. The application displays the final report.

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Figure 9-60 The results summary screen

(after fetching the results from the Xeleris workstation)

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