ABSTRACT
Poor sensitivity and poor signal to noise ratio because of low injected thallium dose and presence of scattered photons are the main problems in using thallium in scintigraphic imaging of the heart. Scattered photons are the main cause of degrading the contrast and resolution in SPECT imaging that result in error in quantification. Thallium decay is very complicated and photons are emitted in a wide range of energies of 68-82 keV. It seems possible to achieve better primary to scattered radiation ratio and better image sensitivity simultaneously if the energy window setting is carefully selected. This investigation was performed in three steps: Monte Carlo simulation, phantom experiment and clinical study. In simulation step, the new 4D digital NCAT phantom was used to simulate the distribution of activity [201Tl] in patient torso organs. The same phantom was used to simulate the attenuation coefficient of different organs of the typical patient's body. Two small defects on different parts of left ventricle also were generated for further quantitative and qualitative analysis. The simulations were performed using the SimSET simulator to generate images of such patient. The emissions arising from Tl-201 decay were simulated in four steps using the energies and relative abundances. Energy spectra for primary and scatter photons were calculated. Changing the center and width of energy windows, optimum energy window characteristics were determined. In next step jaszczak phantom was prepared and used for SPECT imaging in different energy windows. In last step SPECT images of 7 patients who had angiographic data were acquired in different energy windows. All of these images were compared qualitatively by four nuclear medicine physicians independently. The optimum energy window was determined as a wider asymmetric window [77keV?30%] that its center is not placed on photo-peak of energy spectrum. This window increased the primary counts rate and PTSR considerably as compared with the conventional symmetric energy window [67keV%]. In a comparison which performed between clinical images acquired in suggested 77-30% window with conventional 67-20% window, a considerable increase was found in myocardial to defect contrast [1.541 +/- 0.368] and myocardial to cavity contrast [1.171 +/- 0.099]. A negligible increase was also found in total counts of images using this window. We found that conventional symmetric energy window [67keV +/- 10%] couldn't be a suitable choice for thallium heart imaging; furthermore three energy windows, 73keV-30%, 75keV-30% and 77keV-30%, were determined as optimum window options. For further analysis the images from such windows were compared in each three steps of this investigation. In all steps conventional symmetric energy window [67keV-20%] was introduced as the worst case and the asymmetric 77keV-30% was determined as the most suitable
ABSTRACT
Introduction: scatter radiation is one of the major sources of error in nuclear medicine data processing. Different methods of scatter correction have been introduced in order to improve the quality of data. However the best method is to avoid recording of scatter photons in acquisition. The only difference between scattered and non-scattered photons is the energy. Pulse height analyzer is the only option available to discriminate primary photons from scattered ones. Energy resolution of the gamma camera is gradually improving consequently the energy window width has to be decreased accordingly. In this study we tried to determine the most appropriate energy window width for present gamma camera systems
Methods and Materials: since it is not possible to retrieve the data spectrum from the most of the gamma camera systems, a simple method was developed to extract the data from the image of the energy spectrum. Using a scatter phantom different level of scatter and count rate were generated and corresponding energy spectrum data were analyzed. It was assumed that around the peak of the spectrum, the primary photons obey a Gaussian distribution
Results: the data were analyzed using three different methods. All methods prove that the optimum window width regarding the present gamma camera energy resolution is 15%. At this level, the scattered radiation is decreased to 5%. In comparison to the conventional widow width of 20%, the sensitivity does not change dramatically
Conclusion: at the present, for most gamma camera, the energy window width of 20% is recommended. However occasionally energy window width of 15% and 25% are also used. In this study the energy spectrum at different levels of scatter were analyzed and the most suitable energy window width was found to be 15% for the gamma camera having approximate energy resolution of 11%. At this window setting the scatter decreases to 5% of the total counts recorded. Visually the quality of the images dose not improves significantly. However accuracy of data quantification improve significantly