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The Joint Commission's Requirements for Annual Diagnostic Physics Testing of Nuclear Medicine Equipment, and a Clinically Relevant Methodology for Testing Low-Contrast Resolution

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D Gray

W. Geoffrey West, David Clinton Gray, West Physics Consulting, Atlanta, GA


SU-E-I-65 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: To introduce the Joint Commission’s requirements for annual diagnostic physics testing of all nuclear medicine equipment, effective 7/1/2014, and to highlight an acceptable methodology for testing low-contrast resolution of the nuclear medicine imaging system.

Methods: The Joint Commission’s required diagnostic physics evaluations are to be conducted for all of the image types produced clinically by each scanner. Other accrediting bodies, such as the ACR and the IAC, have similar imaging metrics, but do not emphasize testing low-contrast resolution as it relates clinically. The proposed method for testing low contrast resolution introduces quantitative metrics that are clinically relevant. The acquisition protocol and calculation of contrast levels will utilize a modified version of the protocol defined in AAPM Report #52.

Results: Using the Rose criterion for lesion detection with a SNRpixel = 4.335 and a CNRlesion = 4, the minimum contrast levels for 25.4 mm and 31.8 mm cold spheres were calculated to be 0.317 and 0.283, respectively. These contrast levels are the minimum threshold that must be attained to guard against false positive lesion detection.

Conclusion: Low contrast resolution, or detectability, can be properly tested in a manner that is clinically relevant by measuring the contrast level of cold spheres within a Jaszczak phantom using pixel values within ROI’s placed in the background and cold sphere regions. The measured contrast levels are then compared to a minimum threshold calculated using the Rose criterion and a CNRlesion = 4. The measured contrast levels must either meet or exceed this minimum threshold to prove acceptable lesion detectability.

Funding Support, Disclosures, and Conflict of Interest: This research and development activity was performed by the authors while employed at West Physics Consulting, LLC. It is presented with the consent of West Physics, which has authorized the dissemination of the information and/or techniques described in the work.

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