1. Joe O’Brien & Bill Thomson, City Hospital, Birmingham
A Survey of Current Acquisition & Analysis Techniques for Myocardial Perfusion Imaging Using Philips Gamma Cameras
Joe O’Brien & Bill Thomson, City Hospital, Birmingham
&
Cariss Bird, Priory Hospital, Birmingham

2. Introduction Decided to provide a survey for Philips NMUG Meeting.
Aware of some variation amongst Philips users in acquiring and analysing Myocardial Perfusion Imaging (MPI) studies.
Decided to provide a survey for Philips NMUG Meeting.
The survey would be beneficial:
Forms a basis of discussion at UG Meeting.
Allows users to compare their technique with others.

3. Marconi & Picker Systems
Survey & Presentation
ADAC Systems
Cariss Bird
Marconi & Picker Systems
Joe O’Brien
Due to work commitments and time constraints, just the Marconi & Picker users have been surveyed.

4. The Survey 30 customers on Philips NM customer list
Contacted via telephone for anonymous survey
12 customers do not perform MPIs
1 customer did not participate
So 17 customers surveyed
Completed surveys available

5. The Survey Radio-pharmaceutical Gamma Camera Acquisition
Basic Questions
e.g. how many patients per year?
Radio-pharmaceutical
e.g. type of RP, activity per test,
delay time?
Gamma Camera
e.g. which camera and collimator
do you use?
Acquisition
e.g. matrix size & zoom (pixel size),
orbit setup, gated or non-gated?
Reconstruction
e.g. FBP or iterative reconstruction,
Pre-filter or 3D Post filter ?

6. Basic Questions

7. Radiopharmaceutical
Most commonly used:
MIBI
(5)
Tetrofosmin
(12)

8. Radiopharmaceutical
Protocol:
1 Day
1000MBq
(2)
2 Day
400MBq
(15)

9. Radiopharmaceutical
Imaging Delay Time:
MIBI
Tetro

10. Cameras Included in Survey
(11)
(4)
(2)
(1)
Dual headed AXIS most common
Exclude others from presentation

11. Acquisition Settings Used By All AXIS Users
Orbit settings:
Non-Circular
Head Orientation at 102°
102° of rotation per head
34 projections per head
Acquisition based on TIME per step
Factory set energy window

12. Variable Acquisition Settings
Orbit setting
Step & Shoot Continuous - 8
Gating
Gated Non-Gated - 6
BEACON
Used Not Used - 8

13. Variable Acquisition Settings
Time per step

14. Variable Acquisition Settings
Collimator
LEGAP
(6)
LEHR
(5)

15. Variable Acquisition Settings
Matrix & Zoom (i.e Pixel Size)

16. Reconstruction Settings Used By All AXIS Users
Routinely Check for Patient Motion
No Pre-filtering of data
All use 3D Post-filter

17. Variable Reconstruction Settings
Reconstruction Method
Iterative
(3)
Don’t Know
(1)
FBP
(7)

18. Variable Reconstruction Settings
Diameter
Left as Default
(8)
Don’t Know
(2)
Varied between patients
(1)
Effectively zooms data and alters pixel size.

19. Variable Reconstruction Settings
Filter
All used ‘Low Pass’ but with variable settings:

20. Variable Reconstruction Settings
Gated Analysis Programs
QGS
(4)
Emory
(1)

21. Conclusions Survey of Philips NM Users performing MPI.
Majority using AXIS system.
Users have some similar methods of acquisition and analysis.
But overall there are significant differences e.g. 1/2 use LEHR, the other 1/2 use LEGAP
Worthy of discussion at UGM!

22. Effect of Collimator
Local standard protocol for MPI uses LEGAP collimator.
We considered the effect on lesion detectability using a LEHR collimator instead.
Scanned a torso phantom fitted with a cardiac insert
Installed a large 100% and small 50% defect.
Filled with 8MBq Tc-99m

23. Effect of Collimator HR GP Short Axis Images
Qualitatively, there is no discernable difference in lesion detectability

24. Effect of Collimator HR GP HLA Images
Qualitatively, no discernable difference in lesion detectability.
But up to 40% more counts.