Abstract

223 Ra is a promising α-emitting radionuclide for prostate cancer metastasis palliative treatment. Post-injection scintigraphy is of major importance to verify the concentration of the radiopharmaceutical in the targeted sites. Given the low activity administered to patients, the choice of acquisition parameters, including the collimator type, the energy window's width and the photopeak energy to be used, is primordial for the image quality. The purpose of our work was to select the SPECT configuration suitable for 223 Ra post-injection scintigraphy. We conducted simulation studies with a Symbia T6 Siemens SPECT-CT, available in our department. 223 Ra photons energy spectra were assessed for low energy high resolution (LEHR), medium energy (ME) and high energy (HE) collimators. Then, depending on the energy window, we calculated the scatter fraction, the sensitivity and the spatial resolution. Scatter fraction was low for all collimators; however, the contribution of photons that scattered more than twice under the low energy photopeaks was important in the case of LEHR. Sensitivity's best values were obtained in the case of the LEHR collimator; nevertheless, the spatial resolution was very low for this collimator. The latter was best for ME and HE collimators. A combination between a good sensitivity, a high spatial resolution and a low scatter fraction has been determined in the case of the ME collimator, followed by HE collimator as an alternative. To increase the image acquisition statistics with ME collimator, we recommend to use simultaneous energy windows: 20% centered at 82 keV, 20% centered at 154 keV and 20% centered at 270 keV.

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