Quality control (QC) of single-photon emission computed tomography (SPECT) and positron emission tomography (PET) nuclear cardiology procedures is a multiple-step process that begins before the patient enters the laboratory, continues during the acquisition, and after the patient leaves the laboratory. SPECT QC and PET QC require the close attention of all personnel and physicians that are involved with the laboratory. Requirements for imaging systems QC are based on Nuclear Regulatory Commission (NRC) requirements, agreement state requirements, accepted imaging guidelines, and the Intersocietal Accreditation Commission Nuclear/PET (IAC Nuclear/PET), and American College of Radiology (ACR) Accreditation standards.1–8 The terminology used, requirements, and frequency may vary slightly between the standards, the model of scanners, and the original equipment manufacturers (OEM) recommendations. However, the basic premise of why it is necessary is the same in all situations: to ensure adequate camera performance, identify any potential sources of error or artifact within an acquisition, and ultimately provide the patient and referring physician with the best quality information possible. If QC procedures are not followed, it may lead to an equivocal or falsely interpreted study, which may result in increased downstream costs as well as poor outcomes. This chapter will review the routine QC procedures performed by the nuclear medicine technologist before, during, and after the acquisition of a nuclear cardiology study. Additional QC procedures and calibrations that are performed by camera service engineers or medical physicist will not be discussed.
QUALITY CONTROL BEFORE THE ACQUISITION
There are several required and recommended equipment QC procedures that should be performed on each imaging system.2,5–31 The frequency of the procedures may vary among equipment manufacturers; however, all are important to ensure proper system performance (Tables 5-1 and 5-2). These tasks consist of daily, weekly, monthly, and quarterly system testing.
Table 5-1Recommended Frequency for Gamma Camera Quality Control Procedures |Favorite Table|Download (.pdf) Table 5-1 Recommended Frequency for Gamma Camera Quality Control Procedures
|Test ||Frequency |
|Energy peaking ||Daily |
|Uniformity ||Daily |
|Sensitivity ||Daily or weekly |
|Resolution and linearity ||Weekly |
|Center of rotation ||Weekly or monthly |
|SPECT phantom evaluation ||Annually |
Table 5-2Recommended Frequency for PET Camera Quality Control Procedures |Favorite Table|Download (.pdf) Table 5-2 Recommended Frequency for PET Camera Quality Control Procedures
|Test ||Frequency |
|Blank scan ||Daily |
|Singles (PMT gain or Bucket setup) ||Weekly |
|Coincidence timing ||Weekly (or daily) |
|Normalization (Bucket scan) ||Monthly (or per OEM recommendation) |
|Well counters ||Quarterly |
Single-Photon Emission Computed Tomography Systems
Energy peaking (photopeak analysis) should be performed daily to verify that the camera is counting photons using the correct energy.2,3,9–11 Each imaging system should be checked before use to ensure that the camera peaking electronics are functioning properly, that ...