Influence of Positron Emitters on Standard gamma-Camera Imaging

Combined PET and SPECT scanning can give supplementary information. However, activity from PET radionuclides can cause background counts and increased dead time in g camera imaging (SPECT or planar) because the 511-keV photons can penetrate collimators designed for lower energies. This study investigated how to manage this issue, including what levels of PET radionuclides can be tolerated when a g-camera investigation is performed. Methods: Different combinations of 68Ga (PET radionuclide), 99mTc (low-energy radionuclide), and 111In (medium-energy radionuclide) were scanned by a g camera. Standard low-, medium-, and high-energy collimators were used with the g camera. Dead time and counts near and distant from the sources were recorded. Results: Down scatter from 511 keV can give rise to a considerable number of counts within the 99mTc or 111In energy windows, especially when the PET source is close to the camera head. Over the full camera head, the PET source can result in more counts per megabecquerel than the SPECT source (99mTc or 111In). Counts from the PET source were distributed over a large region of the camera head. With medium-and high-energy collimators, the sensitivity to the PET radionuclide was found to be about 10% of the sensitivity to 99mTc and about 20% of the sensitivity to 111In, as measured within a 3-cm-radius region of interest. Conclusion: If PET radionuclides of activity 1 MBq or higher are present in the patient at the time of SPECT, a medium-energy collimator should be used. Counts from PET sources will in SPECT usually be seen as a diffuse background rather than as foci. The thick septa of high-energy collimators may result in structure in the image, and a high-energy collimator is recommended only if PET activity is greater than 10 MBq.