Photomultiplier Tube Artifacts on 67Ga-Citrate Imaging Caused by Loss of Correction Floods Due to an Off-Peak Status of One Head of a Dual-Head -Camera

Abstract

γ-cameras use flood-field corrections to ensure image uniformity during clinical imaging. A loss or corruption of the correction data of one head of a dual-head camera can result in an off-peak artifactual appearance. We present our experience with the occurrence of such an incident on a (67)Ga scan. A patient was referred for a whole-body (67)Ga scan to evaluate for causes of neutropenic fever. Whole-body planar and static images of the head, chest, abdomen, pelvis, and lower extremities in multiple projections were obtained. Whole-body images showed decreased image quality on the anterior view obtained with detector 1 and an unremarkable posterior image obtained with detector 2. A problem with detector 2 was suspected, and additional static images were obtained after rotation of the detector heads. The posterior images taken with detector 1 showed photomultiplier tube outlines. The anterior images taken with detector 2 showed improved count and image quality. It was later found that the uniformity map for detector 2 had been lost and that this software malfunction led to the resulting imaging problem. When artifacts with an off-peak appearance are seen on scintigraphic images, evaluation of possible causes should include not only isotope window settings but also an incorrect or corrupted uniformity map.