CLRS 322 Nuclear Medicine Physics and Instrumentation II
Spring 2023

Required text and reading will come from

Nuclear Medicine Instrumentation, 2nd edition, by Jennifer Prekeges

• Chapter 4 - Factors Relating to Radiation Measurements (statistics and photopeaks)
• Chapter 5 - Gamma Camera
• Chapter 6 - Image Digitalization and Display
• Chapter 7 - Collimation
• Chapter 8 - Image Characteristics and Performance Measures in Planar Imaging
• Chapter 9 - QA/QC of Gamma Cameras
• Chapter 10 - SPECT
• Chapter 11 - Image Characteristics and Effect of Acquisition Parameters in SPECT
• Chapter 12 - Improving SPECT Imaging
• Chapter 13 - QC of and Artifices in SPECT

Background and Additional Materials from Nuclear Medicine Technology and Techniques, Christian, Waterstram-Rich , Eighth Edition; Mosby, 2012.

• Section 1.1 - Mathematics and Statistics, pages 22 to 34
• Section 3.10 - 3.11 - Physics and Instrumentation, pages 223 to 295

Evaluation and Grading

Content

Course Outline

• The above Chapters are from your Nuclear Medicine Instrumentation textbook.
• Lecture content and dates may very and the above schedule is an estimation.
• Final exam will be scheduled by the Department Chair.

This course follows the MCV campus schedule.

Exams/Quizzes and Assignment Policy

1. Exams will encompass information discussed during lectures, handouts given in class, and homework/reading assignment.  Failure to take an exam on a scheduled exam day will automatically cause a 7% deduction from the total letter grade.  Make-up must be scheduled and completed ASAP, so that the entire class has the opportunity to review the results.  The only exception given to this policy will be if the student has made prior arrangements with the instructor.
2. Kahoot will continue this semester as part of a "pop quiz" but will only be recorded as an attendance grade
3. To receive full credit on attendance all Kahoots must be completed
4. The Department Chair establishes policies and schedules for the CLRS final exams. The Department Chair must approve any changes regarding scheduling the course final exam. A penalty may be imposed for missing a scheduled final exam.

5. Any assignment or homework given in class must be completed in a time designated by the instructor.  Late assignments will not be accepted.
6. This is one of the professional courses in which the lowest passing grade is “C”.

Attendance Policy
Attendance is mandatory for all classes. See quizzes. Please note that the deadline for students to provide written notification to instructors of intent to observe religious holidays is January 27,2023

Policy Regarding Calculators
The Department of Radiation Sciences will only allow use of non-programmable (non-graphing) calculators.  Students will not be allowed to use programmable (graphing) calculators during any type of examination.  In addition, students will not be allowed to share calculators during any examination.

Policies Regarding the Academic Calendar and Course Schedule

• The Department of Radiation Sciences abides by the VCU academic calendar for the MCV campus (see http:www.vcu.edu/academic calendars/)

• Add following statement:  The Department of Radiation Sciences abides by the VCU academic calendar for the MCV campus (see http://www.vcu.edu/academiccalendars/)

UNIVERSITY POLICIES:

The updated statements for syllabi and blackboard pages are available at https://uploads.provost.vcu.edu/syllabus.pdf

How to Prepared for Emergencies at VCU

1. Sign up to receive VCU text messaging alerts (https://alert.vcu.edu/signup/). Keep your information up-to-date.
2. Know the safe evacuation route from each of your classrooms. Emergency evacuation routes are posted in on-campus classrooms.
3. Listen for and follow instructions from VCU or other designated authorities.
4. Know where to go for additional emergency information (http://www.vcu.edu/alert).
5. Know the emergency phone number for the VCU Police (828-1234).
6. Report suspicious activities and objects.

Course Objectives

1. Define and calculate mean, standard deviation (and %), coefficient of variation
2. Describe, calculate, and interpret chi-square.
3. Compare Gaussian and Poisson distribution
4. Explain, calculate, and interpret sensitivity, specificity, and accuracy.
5. Complete a decay problem and determine the mL to be used based on decay. Go
6. Understand and define the different components a pulse height. Go
   1. Define scatter, determine its effect on spectrum (pulses)?
   2. Identify coincidence summing. Go
   3. Discuss crystal thickness
   4. Effects of attenuation (plastic)
   5. Effects of efficiency with crystal thickness and variation in the energy gamma
7. Details of a pixel. Go
   1. Define a LUT and discuss its applications
   2. Calculate the correct gray scale based on pixel counts
   3. Calculate the size of a pixel
   4. Determine the type of matrix size based on the procedure
   5. Compare pixel depth based on bytes and word mode
   6. Discuss the effects of PVE
   7. Determine image resolution based on matrix, pixel size, and the size of the lesion
   8. Consider the modes of image acquisition. Go
8. Define the different components of nonuniformity in a gamma camera
   1. Identify the discordances with XYZ pulses
   2. Discuss the components of energy and linearity corrections
   3. Compare and identify different forms of autotuning
   4. Brief discuss digital detectors
9. Review the concepts of collimation Go
   1. Identify septa design: cast, foil, micocast, and microlinear
   2. Apply the concepts: GF, AF, PF, and SF with collimation
   3. Compare septa length, diameter, and thickness to sensitivity and resolution with associated photon energy
   4. Apply the terms umbra and preumbra to collimator design
   5. Understand and apply different types of collimators to an imaging procedure: parallel, converging, diverging, pinhole, fan beam, and slate hole
10. Identify deadtime and its effect on a pulse height. Go
    1. Pulse clipping
    2. Pulse-tail extrapolation
    3. How does these adjustments effect image quality? Contrast
11. Apply the different elements of an image: background, scatter, attenuation, and noise
12. Determine the issues in imaging in a planar dimension (as compared to 3D)
13. Camera sensitivity. How are quality control procedure used to evaluate image performance? Go
14. Consider spatial resolution and the following components - Go
    1. Intrinsic vs. extrinsic resolution
    2. Misalignment of PMTs
    3. Crystal thickness and energy gamma
    4. Distance from the acquired source
    5. Not enough counts
    6. LSF - FWHM and FWTM (calculate the values)
    7. MTF and its relationship to the frequency domain
    8. Variation in image matrix
    9. Variation with the energy window
15. Determine %SD within a pixel and how it might effect image quality. Go
16. Apply of Quality Control in planar imaging - Go
    1. Setup and usage of flood field uniformity and Bar
    2. Integral and differential uniformity
    3. Moire pattern
    4. Pixel size calculation
    5. Collimator integrity
    6. Multi-window spatial registration
17. Understanding the following fields of view: FOV, FFOV, and CFOV - Go
18. Identify issues that occur during QC. Examples are noted here
19. Understanding and discuss Filtered Back projection in SPECT imaging
    1. Why does FBP have greater noise when compared to planar?
    2. What is the star defect?
    3. How is it eliminated?
    4. Define the role of a Fourier reconstruction
20. Assess spatial to frequency Domains
    1. Define it
    2. Define the parts of an MTF domain: noise, bkg, true counts, large/small objects
21. Nyquist Frequency
    1. Define it
    2. Calculate it
    3. Determine the causes aliasing
22. Filtering and image reconstruction
    1. Identify the need to pre-filter
    2. Define the parts of a filter: order, power, windowing, critical frequency
    3. Explain the following filters: low/high/band pass, restoration, surface rendering, dynamic triangulation
23. Iterative Reconstruction
    1. Define and compare to FBP
    2. Understand the basic steps of IR
    3. Compare OSEM to MLEM
24. SPECT acquisition
    1. Define the imaging characteristics
    2. Define particle volume effect
    3. Consider: zoom, collimation, matrix, energy window, type of orbit
25. Attenuation Correction
    1. Chang and the homogenous effect
    2. Line source - two and three heads
    3. 153Gd vs CT
    4. Outline the components of attenuation correct with the use of CT
    5. Scatter and attenuation correction
       1. Discuss how gamma-rays interact in a media at the atomic level
       2. Compare 140 keV to 511 keV
       3. Compare bone to water to air
       4. Determine the effects of scatter at depth with SPECT?
       5. Determine the role of collimation in associated scatter. Examples ultra-high resolution collimator as compared to high resolution collimator
       6. Compare rod source or CT for scatter correction and attenuation
       7. Understand the concept of resolution recovery
26. Scatter Correction - Attenuation Correction
    1. Determine the correlation between scatter and variations of count density
    2. Discuss rod/line source - TBAC
    3. Compare type of radioactive source with TBAC
    4. Apply CT to scatter correction
    1. Define down sampling
    2. Define segmentation on an AC map?
    3. Identify monochromatic vs polychromatic photons
    4. Assess the role of scaling in SPECXT and PET
    5. Determine the use of a reference scan?
    6. Defione beam hardening
27. Quality Control
    1. Compare and contrast - Intrinsic to Extrinsic uniformity
    2. Determine the advantages/disadvantages of
       1. Refillable floods
       2. 57Co sheet source
       3. Point source
       4. Review examples of flood uniformity and examine its quality
    3. Discuss the procedure COR
       1. Differentiate between COR and a AOR?
       2. Identify the X-axis offset
       3. Identify the Y-axis offset
       4. Compare COR data
    4. Discuss the procedure to determine detector head stability
    5. Jaszczak phantom
       1. Define the components of the phantom and determine how these components assess SPECT QC
       2. Calculate system volume sensitivity
28. Review types of artifacts generated on a SPECT scan
    1. Motion - 180 vs 360 degree
    2. Blending of motion and ray
    3. Truncation

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