Linearity of Capintec CRC-15R systems Richard Fernandez1, Laura

Linearity of Capintec CRC-15R
systems
Richard Fernandez1, Laura Wherity2
1. Dept. of Nuclear Medicine
Guy’s & St Thomas’ NHS Foundation Trust, London
2. Dept. of Medical Physics, King’s College London
NHS Foundation Trust
Nuclear Medicine - Overview
ƒ GSTT – busy teaching hospital
ƒ Nuclear Medicine – cross site
ƒ Radiopharmacy
ƒ Supply to GSTT & satellite hospitals
ƒ Dedicated therapy isolation suite
Inpatient therapy facilities
ƒ Treat up to 4 patients per week
ƒ Thyroid Ca. (3700–7400 MBq I-131)
ƒ Neuro-endocrine (11000 MBq I-131 MIBG)
Nuclear Medicine - Overview
ƒ GSTT – busy teaching hospital
ƒ Nuclear Medicine – cross site
ƒ Radiopharmacy
ƒ Supply to GSTT & satellite hospitals
ƒ Dedicated therapy isolation suite
ƒ In-vitro investigations (GFR, RCM)
ƒ Diagnostic imaging
Diagnostic imaging
ƒ GSTT: 7 gamma-cameras …
Stress Fracture
Stress Fracture
Radionuclide calibrators
Measured activity
ƒ
Radionuclides
ƒ
ƒ
ƒ
Tc-99m, I-131, In-111, Ga-67, I-123, Cr-51,
Cs-137, Y-90, P-32, Sr-89, …
Maximum: 30 GBq Tc-99m
Minumum: <1MBq Tc-99m
Q. Do we really measure over such a large
range?
High activity limit
Lower activity limit
SPECT-CT ALIGNMENT
GSTT Radionuclide calibrators
ƒ
ƒ
ƒ
ƒ
Nuclear Medicine:
Medical Physics, PET
Satellite (UHL, PRUH…)
TOTAL
9
3
3
15
RC Guidelines: GPG 93
ƒ Recommend for
linearity…
ƒ Measured annually
ƒ Over activity range used
ƒ Measured for each
radionuclide used !
Calibrator linearity
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ƒ
ƒ
ƒ
‘Decaying source’ method used
Tc-99m only
High activity source in vial
Measured at intervals over 3-4 days (~12 halflives)
ƒ Log-linear graph of results obtained, straight line
fitted in ‘linear’ region (range 1000-50 MBq),
extrapolated
ƒ Obtain % difference between measuredcalculated activity
ƒ Tolerance: Field instrument <5%
Linearity results
Calibrator linearity: Problems
ƒ # of calibrators
ƒ Logistical complications
ƒ e.g. Radiopharmacy isolators, production run
ƒ Labour intensive task
ƒ prioritise scientific support, cross-site cover
ƒ
ƒ
ƒ
ƒ
Operator finger dose
Potential for contamination
Source positioning error, timing error
Clinical error – wrong factor selected
Trial of NPL software
ƒ Developed by John Keightley (NPL)
ƒ LabVIEW ver8
ƒ Windows GUI, XP compatible
ƒ Direct communication with CRC-15R
ƒ Automated !
ƒ Æ overcome logistical disadvantages,
minimise dose, contamination, errors
Trial of NPL software
ƒ Software uploaded to laptop
ƒ CSV files created Æ imported to Excel
ƒ Tested on 3 CRC-15R calibrators…
I. Background measurement
ƒ Investigate background fluctuation
ƒ Measured on calibrator in I-131 therapy
suite – adjacent to Radiopharmacy
ƒ Measurement interval
ƒ Friday 15:00 Æ 9:00 Monday
Activity (MBq)
-0.05
-0.1
-0.15
-0.2
-0.25
10
SATURDAY 11:00
0
SATURDAY 09:00
0
SATURDAY 06:00
Tim e of reading (hours)
20
30
40
50
60
MONDAY 07:00
Linearity measurements of I-131 lab calibrator - Background reading
70
II. Linearity: I-131 Suite
% Difference in Actual and Measured Activity
Measured Activity versus Time
% Difference (Predicted - Measured)/
Predicted
Measured Activity (MBq)
2.5
30000
2.0
True
25000
1.5
Predicted
Expon. (True)
1.0
20000
0.5
15000
0.0
100000
-0.5
5000
10000
15000
20000
25000
30000
5000
-1.0
-1.5 0
-2.0
0
16
32
48
Time (hours)
Activity (MBq)
64
80
% Difference in Actual and Measured Activity
2.5
II. I-131 Suite
% Difference (Predicted - Measured)/
Predicted
2.0
1.5
1.0
0.5
0.0
9
10
11
12
13
14
15
-0.5
-1.0
-1.5
-2.0
12 MBq
Activity (MBq)
% Difference in Actual and Measured Activity
1.0
2.0
0.9
1.5
1.0
0.5
0.0
1500 1550 1600 1650 1700 1750 1800 1850 1900 1950 2000
-0.5
-1.0
% Difference (Predicted - Measured)/
Predicted
% Difference (Predicted - Measured)/
Predicted
% Difference in Actual and Measured Activity
2.5
0.8
11,900 MBq
0.7
0.6
0.5
0.4
0.3
0.2
0.1
-1.5
1,700 MBq
-2.0
Activity (MBq)
0.0
11500
11700
11900
12100
Activity (MBq)
12300
12500
III. Linearity: Radiopharmacy Support
Measured Activity versus Time
Measured Activity (MBq)
20000
18000
True
16000
Predicted
Expon. (True)
14000
12000
10000
8000
6000
4000
2000
0
0
16
32
48
Time (hours)
64
80
% Difference in Actual and Measured Activity
4.0
12 MBq
III. Radiopharmacy
Support
% Difference (Predicted - Measured)/
Predicted
3.5
3.0
2.5
2.0
1.5
1.0
0.5
0.0
-0.5
10
11
12
13
14
15
-1.0
Activity (MBq)
% Difference in Actual and Measured Activity
% Difference in Actual and Measured Activity
% Difference (Predicted - Measured)/
Predicted
1.4
1,700 MBq
1.2
1.0
0.8
0.6
0.4
0.2
% Difference (Predicted - Measured)/
Predicted
0.4
11,900 MBq
0.4
0.3
0.3
0.2
0.2
0.2
0.1
0.1
0.0
0.0
1500 1550 1600 1650 1700 1750 1800 1850 1900 1950 2000
Activity (MBq)
0.0
11500
11700
11900
12100
Activity (MBq)
12300
12500
Linearity results
ƒ Auto-ranging
ƒ 12 MBq, 1700 MBq, 11900 MBq
ƒ Consistent across CRC-15Rs
ƒ Æ repeat with Tc-99m for other calibrators,
ƒ Æ repeat with other radionuclides
ƒ ? Anomalous result on Radiopharmacy
CRC-15R …
Radiopharmacy Support Æ anomalous result?
%%
Difference
Difference
(Predicted
(Predicted
- Measured)/
- Measured)/
Predicted
Predicted
Measured Activity (MBq)
% Difference in Actual and Measured Activity
12.0
20000
11.0
18000
10.0
10.0
16000
9.0
8.0
14000
8.0
Measured Activity versus Time
True
Predicted
Expon. (True)
12000
7.0
6.0
10000
6.0
8000
5.0
4.0
4.0
6000
3.0
4000
2.0
2.0
2000
1.0
0.0
0
0.0 0 0
-2.01475
5000
16
32 10000 48
1525
Time (hours)
Activity (MBq)
(MBq)
Activity
15000
64
20000
80
1575
Conclusions
ƒ Software offers highly practicable solution to
inherent problems in performing linearity
measurements on CRC-15R calibrators
ƒ Issues Æ data handling in Excel
ƒ Further work…
ƒ Expand to testing of all calibrators
ƒ Investigate radionuclides other than Tc-99m
ƒ Radiopharmacy sterility
• Remote data-logging ÆBluetooth communication?