PET CT

Daily QC
Quality Assurance

To ensure high image quality, you must perform quality measurements regularly.
Quality tests are usually performed in several steps:
• Daily quality measurements
• Monthly quality measurements (constancy test)
• Camera test
• CTDI test (once every six months)
• System Preventive Maintenance and Inspection.
PET CT QC
Quality Control Schedule PET/CT systems

Daily Weekly
• Clear queues (4 times daily) • System Clean-Up and Shutdown
• Remove unneeded patient data • PET Partial Setup
• System Restart
• CT Check-Up / Calibration
• CT Quality Quarterly
• PET Daily Quality Check • PET Full Setup and Time Alignment
• PET/CT Gantry Offset (Mobile Only)
PET CT Daily QC
System functional check

check the following functions:

• Radiation warning lamps
• Room door switch
• Stop buttons
• Laser light markers
• Gantry operator panels
• Patient intercom system
• Patient handling system
PET CT Daily QC
Clear queues

Clear Exam Job Status, Scheduler, Local, Film and Network queues(four times per day)
PET CT Daily QC
Clear queues

Clearing the Scheduler

When the scheduler contains too many completed or idle jobs,
overall system performance may degrade. To avoid this situation,
you should clear the Scheduler at the end of each work day.
PET CT Daily QC
Clear queues

Clearing the Scheduler

To clear the Scheduler:
1. Access the Patient Browser.
2. Click the Scheduler icon.
3. From the main menu, select Edit > Clear Scheduler.
PET CT Daily QC
Clear queues

Clearing Network, Local, and Film Queues

When the system queues contain too many completed and failed jobs, overall system
performance can be degraded. To avoid this situation, you should clear all queues of
completed and failed jobs daily.
PET CT Daily QC
Clear queues

Clearing Network, Local, and Film Queues

To clear the network queue:
1. Access the Patient Browser (select Patient > Browser).
2. Select Transfer > Network Job Status.
3. Click Clear to clear all jobs.
PET CT Daily QC
Clear queues

Clearing Network, Local, and Film Queues

To clear the local queue:
1. Select Patient > Browser.
2. Select Transfer > Local Job Status.
3. Click Clear to clear all jobs.
PET CT Daily QC
Clear queues

At times, the Local Job Status may show a status message of "restoring." To avoid this
situation, you should clear the network and local job queues before rebooting the system.
PET CT Daily QC
Clear queues

Clearing Network, Local, and Film Queues

To clear the film queue:
1. Select Patient > Film Task Status in any task card or in the Patient Browser (Patient >
Browser),
or
Click the Film Task Status icon button in the Filming task card or in the Film
Preview window.
2. Click Select All then Delete to clear all jobs.
PET CT Daily QC
Remove unneeded patient data

1. Select Local Database on the Patient

Browser.
2. Select the unneeded patient data by
selecting Ctrl button for multiple data.
3. Right mouse click and select delete
-or-
4. Select the delete button from the
icons bar.
System Restart
PET CT Daily QC
Daily System Restart

Restart the computer systems at the start of each day as instructed below:
1. Exit all examinations and applications. Ensure that the PET and CT gantries are
powered on.
2. On the syngo MI Workplace menu, select System > End from the main menu and then
select Shutdown System. Click Yes.
3. On the syngo Acquisition Workplace menu, select System > End from the main menu
and then select Restart System. Click Yes.
PET CT Daily QC
Daily System Restart

4. When the Checkup window appears on the syngo Acquisition Workplace screen, turn
on the power to the syngo MI Workplace (if present).
5. The system is ready for scanning when the disk icons in the lower right corner of the
syngo Acquisition Workplace screen are visible and show the space remaining on each
computer disk.

6. Proceed with the Biograph daily quality control procedures.

CT Daily Quality
Check
CT Daily QC
X Ray Tube

Electric current (≈ A) goes through the

filament producing free electrons.

High potential difference between cathode

and anode leads to electron acceleration
towards the anode.
CT Daily QC
X Ray

I0
I0 : Incident Ray

Ia : Absorbed Ray
Ia
Object Id Id : Diffused Ray

I
I : Transmitted Ray
CT Daily QC
CT Phantom

(1) CT Quality Phantom Clamp

(2) Water Section
(3) Slice Thickness Section with etchings (highlighted
in black) for positioning with the laser markers.
(4) Wire Section
CT Daily QC

CT Check-Up Check-Up every 12 hours

CT Quality Quality Daily

CT Calibration Calibration – after 1 hour of system

idle or ring artifact
CT Daily QC
CT Check-Up

Missing CT Checkup!
Failure to perform CT Checkup daily can result in malfunction of the system including
aborted scans or reduced image quality.
◆ Perform CT Checkup Daily at startup or after extended power off.
CT Daily QC
CT Check-Up

• System prompts user to perform after restart, restart

application, or shutdown/startup
• Performs :
✓ tube warm up;
✓ Function checks;
✓ filament adaptation;
✓ air calibration
• The CT checkup procedure guarantees optimum image quality
CT Daily QC
CT Check-Up

To perform CT checkup :
1. Click the Checkup button to start system checkup.
2. Press the Start button on the control box once the system prompts you to do so.
CT Daily QC
CT Check-Up

During checkup and calibration, the patient table should be retracted. It is necessary to
press the Move button on the control box to initiate table movement.
If the patient table is not at or above scanning height, the checkup will fail.
CT Daily QC
CT Check-Up

• Checkup box will disappear when finished successfully

• If Checkup fails check gantry for items, i.e. pillows
• If a message is displayed saying that the system should not be used, it means that the
checkup failed several times.
The system is not ready for an examination. Place Call Service
CT Daily QC
CT Quality

CT number (Hounsfield)
CT Daily QC
CT Quality

You must perform calibration (checkup) before you start quality measurement.
The CT daily quality procedures must be performed daily before you start examinations.
The following steps are involved:
• Position the CT quality phantom and patient table
• Perform CT daily quality measurements

The measurements for all modes (CT value of water, pixel noise of images, and tube
voltages) are performed automatically.
CT Daily QC
CT Quality

CT Quality procedure verifies the dose and scaling of the CT system

CT Quality checks
✓ CT Value of Water
✓ Pixel Noise
✓ Tube Voltage
Uses CT Quality Water Phantom
CT Daily QC
CT Quality

Positioning the CT Daily Quality Phantom

To position the CT quality assurance phantom:
1. Using the gantry controls, set the patient table at the height where it was set for
normalization. (Normalization is performed by a service engineer at installation.)
2. Remove the patient head holder, if it is attached to the patient table.
3. Slide the L-shaped phantom bracket into the receptacle at the end of the pallet nearest
the gantry (the same receptacle used for the head holder), and screw the bracket down
tight.
4. Attach the quality assurance phantom set securely to the phantom bracket.
CT Daily QC
CT Quality

Positioning the CT Daily Quality Phantom

(1) Water phantom
(2) Reference marking
(3) Wire and ball phantom
(4) Slice thickness phantom
(5) Patient table
(6) Phantom holder bracket
CT Daily QC
CT Quality

Positioning the CT Daily Quality Phantom

5. Turn on the laser light markers.
CT Daily QC
CT Quality

Positioning the CT Daily Quality Phantom

6. Move the table forward until the etchings on the quality assurance (water) phantom are
aligned with the inner lasers. This might require adjusting the height of the phantom
using the manual adjustment on the phantom holder.
CT Daily QC
CT Quality

Positioning the CT Daily Quality Phantom

7. When the phantom is completely aligned, run the quality test.
CT Daily QC
CT Quality

Measurement
On the Examination Task card select Setup > Quality.
CT Daily QC
CT Quality

Measurement
Automatic check of phantom acceptable positioning. If the quality phantom is incorrectly
positioned, a message is displayed: Correct the position

The system displays the Daily Quality Check window.

• Click the OK button.
• Press the Start button on the control box.

System performs two measurements for each tube voltage.

CT Daily QC
CT Quality

Measurement
After the first measurement, a CT-image of the slice phantom displays in the active
segment.
CT Daily QC
CT Quality

Measurement
The next measurements start automatically. An image displays with the following
evaluations:
• ROIs in image center and 3, 6, 9, and 12 o'clock position
• Mean value of the CT value
• Standard deviation
CT Daily QC
CT Quality

Measurement
The homogeneity is calculated by evaluating a central and four different outer ROIs. For
the noise measurement, the difference between the first and the second measurement is
calculated and displayed.
The following evaluations are shown:
• ROIs
• Mean value of the CT value
• Sigma value (measure for pixel noise)
CT Daily QC
CT Quality

After all measurements have been performed and evaluated, the test result is displayed in
the Daily Quality Check dialog box.
• Check to make sure results are In Tolerance
• Click Ok to end
• Results are stored in Local Service
CT Daily QC
CT Quality

After all measurements have been performed and evaluated, the results are displayed in
the Quality dialog window.

All the results of this test are saved in the Daily Quality Report, which is accessible via File
Browser (H:\SiteData > Constancy Reports > Quality Daily).
CT Daily QC
CT Calibration

CT calibration is an air calibration that measures air temperature and humidity.

Should be performed if CT system is idle for 60min or ring artifact.
1. Open up Calibration from Setup dropdown
2. Click Ok and Press Start from CT Control Box
If Calibration is successful box will automatically close
 PET Daily
Quality Check
PET Daily QC

The PET Quality Check is a maintenance procedure performed daily to normalize

variations in PET detector responses. The results determine the readiness of the system for
scanning or whether service is needed.
The procedure includes:
• daily normalization based on a phantom scan or background LSO (QualityGuard)
• computation and verification of the PET calibration factor (ECF)
• normalization results display and sinogram inspection
• system quality report that can be saved and printed

Daily at startup (prior to scanning patients), after extended power off, or after remote
access service procedures.
PET Daily QC

The mCT system quality control (DailyQC, system setup, etc.) is calibrated to use a 20 cm x
27 cm Ge-68 phantom with up to 2.5 mCi, regardless of whether the scanner is a standard
(3-ring) or TrueV (4-ring) configuration.
PET Daily QC
68Ge Phantoms Models

CS-27
• Biograph mCT
• Biograph Horizon
• Biograph Vision 450

CS-mMR
• Biograph mCT
• Biograph Horizon
• Biograph Vision 450
• Biograph Vision 600
• Biograph mMR

CS-mMR CS-27
PET Daily QC
68Ge Phantoms Source strength

Based on the half-life time the regular replacement interval is one year.
Too low phantom activity will lead to quality problems, so the system shows:
• Warning at < 0.5 mCi
• Cancellation at < 0.3 mCi
PET Daily QC
Positioning pre VG70

The Ge68-Phantom has to be placed in the center of the CT FoV.

PET Daily QC
Positioning pre VG70

• The Ge68-Phantom position is stored

in Local Service. (PET QC > Get
Positions)
• Use standard phantom brackets
• The QC procedure will move the PHS
to the stored position automatically.

mCT/ Horizon Vision

10250156 10097787
PET Daily QC

Perform a PET Full Setup and Time Alignment if the daily PET Quality Check fails.
PET Daily QC

1. Select Options > Configuration from the main menu. Within the Configuration
window, select PET QC Configuration.
2. Enter your phantom information in the Phantom tab of the PET QC Configuration
window.
PET Daily QC
Configuration

pre VG70
• Combined UI for configuration and execution
• Too low phantom activity will lead to
warning/ cancellation.
PET Daily QC
Configuration

since VG70
PET Daily QC

3. Select Setup > PET Quality Check from the main menu to display the PET Quality
Check window.

Biograph mCT, Vision

Biograph Horizon
PET Daily QC

4. Click Start to start the PET QC.

The selected quality procedures execute in the following order:
• sinogram acquisition
• sinogram inspection
• normalization generation and ECF computation
• report generation
Acquisition statistics and a reconstruction progress bar display in the PET Quality Check
window.
PET Daily QC
Execution pre VG70
PET Daily QC
Execution since VG70
PET Daily QC

An Emission Scan of Ge-68 phantom is acquired

1. Ensure the integrity of the detector system.
• Provides a judgement of system
usability(Pass/Fail).
• Creates an enhanced PET Quality Report.

2. Update of normalization file

• Compensate for different detector
efficiencies and spatial distortions
• Can be used to normalize regular scans
• Calculate ECF factor to calibrate measured
counts to activity concentrations
PET Daily QC
Normalization

Normalization file is stored in each PET Raw

Data series for future reconstructions.
PET Daily QC
Results

When the PET Quality Check procedure is complete, the results display in the PET Quality
Check Results window.
PET Daily QC
Results pre VG70

The following results are available:

• status: pass / failed
• computed ECF value
• view ECF Trend graph
• view Sinograms
• display Report
• store results

Using the Load button you can also display and postprocess
older QCs.
PET Daily QC
Results since VG70
PET Daily QC
Results

1. You can select the following options to view the results of your PET Quality Check.
• View Sinogram - Click to display the normalization sinogram in the Sinogram Viewer.
Visually inspect the sinogram for obvious artifacts such as dark diagonal streaks and
report unusual patterns or structure to your Siemens Service representative.
• View/Print Report - Click to view and print the System Quality Report, which contains
the detailed results of the PET Quality Check.
• View - Click to select and view previously saved QC sinograms and QC reports from the
QC Results window.
• ECF Trend - Click to display the ECF trend graph.
• Plane Efficiency - Click to display the plane efficiency profile.
PET Daily QC
Results

The system automatically generates and saves a PDF of the System Quality Report in
H:\SiteData\DailyQC every time the system runs a PET Quality Check procedure.

Note: The System Quality Report is accessible on the system for 90 days.
PET Daily QC
Results

2. Examine the Computed ECF value.

If the ECF value calculated during normalization is within the typical range for your system
type, the system quality result is PASS.
If the ECF value is out of range, the system quality result is FAIL.
PET Daily QC
Why is the ECF Value Important?

The PET Calibration Factor, or ECF, is a numeric value used to convert non-quantitative
PET images (counts/pixel/sec) to quantitative images (Bq/ml). A correct ECF is a necessary
condition to generate quantitative regions of interest and Standard Uptake Values (SUVs)
using various viewing applications (e.soft, 3D, TrueD, Fast Review MultiSeries Viewer, etc.)
During Normalization one can obtain an ECF value by scanning a radioactive source,
usually the Ge-68 solid phantom provided with the Biograph, which contains a known
assay date, assay time, assayed activity, and volume.
PET Daily QC
ECF Values
PET Daily QC
Results

If the ECF value is incorrect, the quantification of patient data (SUV values) will be affected.
PET Daily QC
Results

3. If the PET Quality Check is successful, click Save & Close to save the normalization.
If you choose not to save a successful normalization click Cancel.
4. If the PET Quality Check fails, you do not have the option to save the normalization.
Click Cancel to close the PET Quality Check window.
Repeat the PET Quality Check with a Full Setup. If problems persist, contact your Siemens
Service representative.
PET Daily QC
Using the Sinogram Viewer

(1) Detector Information shows the DEA numbers and

block numbers of the currently selected detector
pair.
(2) Plane Display shows the currently selected plane.
(3) Fansum Display shows all planes with green and
yellow indicators marking the physical location of the
currently selected detector pair.
(4) Plane Numbers displayed on the left and right
edges of the window (number of columns and rows
starting at 0).
PET Daily QC
Using the Sinogram Viewer

To use the Sinogram Viewer:

1. Use the vertical scroll bar, up and down arrows, or Page Up and Page Down keys to
control which plane is displayed (first plane at top).
2. Click in the Plane Display to activate cross-hairs.
3. Drag the cross-hairs, and the corresponding detector indicators are displayed in the
Fansum Display.
PET Daily QC
Using the Sinogram Viewer

diagonal streaks indicate 2 failed detectors

PET Daily QC
Using the Sinogram Viewer

Match green or yellow line to diagonal

streak to identify block
PET Daily QC
Using the Sinogram Viewer

Detector Block counting Biograph mCT