Phantom Testing: Nuclear Medicine (Revised 10-23-2025)

Katie Albus

Modified on: Thu, 23 Oct, 2025 at 5:33 PM

Revision History

Introduction

The Nuclear Medicine Accreditation Physics Subcommittee has defined scoring criteria for planar (uniformity and resolution) and SPECT (uniformity, spatial resolution, and contrast). These criteria are based on results obtained from a variety of cameras that are operating satisfactorily.

Data must be collected, and images prepared, according to the phantom instructions. If sites do not follow the testing requirements as specified in these instructions, then sites may be required to resubmit images or may be subject to failing the submission. Note: Specialty scanners may not be capable of meeting the image acquisition parameters, and guidance is provided within these instructions. Contact the ACR for additional questions or clarifications.

Breast imaging units should follow the small FOV requirements; for spatial resolution the four-quadrant bar phantom should be placed on a 45-degree angle to visualize all quadrants.

Common reasons for image rejection:

Planar images acquired with incorrect parameters (e.g., matrix and counts)
Data form does not accurately reflect information for images submitted
Planar images submitted are not acquired as static planar images (Sites should not submit the daily QC results page)
Planar uniformity images with graphic overlays
Screenshot images with the upper threshold not equal to 100% and lower threshold not between 0-5%
Attenuation correction was not applied (required for cameras that rotate 360 degrees; for SPECT CT units, CT attenuation correction is acceptable)

As appropriate, planar and/or SPECT phantom images must be obtained and submitted for review using the phantom that has been approved by the ACR Committee on Nuclear Medicine Accreditation. Please see the article on Modalities with Low Volume or Emergency Use as needed.

NM QC should be carried out in accordance with the methods outlined in the 2024 NM Quality Control Manual.

The ACR-approved SPECT phantom is commonly used for quality control in nuclear medicine. For cameras that are used to perform planar and SPECT imaging studies, an ACR-approved phantom should be used for evaluating planar and tomographic image quality. The phantom is a cylinder with an internal height of 18.6 cm and internal diameter of 20.3 cm (flangeless phantom). The lower portion of the phantom contains 6 sets of acrylic rods arranged in a pie-shaped pattern with the following diameters: 4.8, 6.4, 7.9, 9.5, 11.1, and 12.7 mm. The upper section contains six solid spheres with the following diameters: 9.5, 12.7, 15.9, 19.1, 25.4, and 31.8 mm.

The ACR has also approved a Small SPECT phantom. The phantom is a cylinder with an internal length of 15 cm and an internal diameter of 13.9 cm (flangeless phantom). The lower portion of the phantom contains 6 sets of acrylic rods arranged in a pie-shaped pattern with the following diameters: 4.8, 6.4, 7.9, 9.5, 11.1, and 12.7 mm. The upper section contains six solid spheres with the following diameters: 6.4, 9.5, 12.7, 15.9, 19.1, and 25.4 mm.

The spatial resolution test can be completed using a four-quadrant bar phantom or an ACR approved SPECT phantom. If a four-quadrant bar phantom is submitted, the smallest bars must be between 2 and 3mm.

Currently the only ACR approved SPECT phantoms are the Data Spectrum Deluxe flanged or flangeless phantom and the Data Spectrum Small flangeless Jaszczak phantom (Small SPECT phantom). The Small SPECT phantom is only approved for use on certain cameras. Submission of accreditation data using any other phantom without ACR permission will disqualify the site.

Cameras that should use Small SPECT phantom: GE 530c, GE 570c, MyoSPECT, maiCam, C!, P3000, and ClearVision

Optional (can use either the Deluxe or Small ACR phantom): c.cam, CardioMD, D-SPECT, Digirad dedicated cardiac SPECT cameras (e.g., Cardius, 2XPO, 3XPO, X-ACT, 2020TC SPECT, SPECTpak), CorCam, and Ventri

The following are available directly from Data Spectrum of Durham, NC (order forms for the large and small phantoms are available in our Testing Overview: Nuclear Medicine and PET article):

Jaszczak Deluxe Flangeless ECT phantom and PET faceplate (can be used for both SPECT and PET acquisitions)
Jaszczak Deluxe Flanged or Flangeless ECT phantom (for SPECT only)
Small SPECT Phantom (for SPECT only)
Flangeless PET phantom (for PET only)
PET faceplate made to fit an existing flangeless or flanged Jaszczak Deluxe ECT phantom

One set of Site Scanning Data Forms (attached below), along with all pertinent worksheets, should be completed for each camera system that is undergoing accreditation.

Phantom Requirements by Module

Module 1 (Planar Imaging Only): Sites that perform only planar imaging on one or more Nuclear Medicine camera systems, and are only applying for accreditation in Module 1 - Planar Imaging on those systems must perform, evaluate, and submit for review images documenting the planar uniformity and spatial resolution for those systems.

All sites applying for Module 1 accreditation are required to submit Tc-99m or Co-57 intrinsic or system planar uniformity images and planar spatial resolution images.

Sites also seeking accreditation for Ga-67 or In-111 must submit Ga-67 or In-111 planar uniformity images and planar spatial resolution images. Sites that perform less than 25 exams using Ga-67 or In-111 in a year are not required to apply for those isotopes.

The Planar protocol should be followed for camera systems only seeking accreditation for Module 1. Images must be submitted for all detectors on systems with more than one detector.

The spatial resolution test can be completed using a four-quadrant bar phantom or the ACR SPECT phantom. If a four-quadrant bar phantom is submitted, the smallest bars must be between 2 and 3mm.

Planar Protocol for Systems Applying for Module 1 (Planar Imaging Only) Accreditation

Isotope One: Tc-99m/Co-57

Planar Field Uniformity - Each Detector

Planar Spatial Resolution - Each Detector

(Four-Quadrant Bar Phantom or SPECT phantom rods are acceptable)

Acquire an intrinsic or system uniformity image with the following parameters:

Tc-99m or Co-57
256 x 256 matrix (with zoom 1x).
For intrinsic uniformity, the point source must be set at a distance from the detector that is 3-5 times the longest dimension of the detector. For a 50 cm detector, this would be 150-250 cm from the detector.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 10 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 5 million counts.

Four Quadrant Bar Phantom:

Acquire an intrinsic or system spatial resolution pattern image with the following parameters:

Tc-99m or Co57
512 x 512 matrix (with zoom 1x). If the scanner is not capable of acquiring in a 512 x 512 matrix, use the largest matrix available on the system.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 5 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 3 million counts.

ACR SPECT Phantom Rods:

Fill the ACR phantom with an aqueous solution of Tc-99m, taking care to ensure that it is thoroughly mixed. Place the phantom with the flat bottom on the rods side sitting up and centered on the face of the low-energy collimator.

Acquire a static image with the following parameters:

256 x 256 matrix (with zoom 1x)
600,000 counts
The count rate should not exceed 50 kcps.

Isotope Two: Ga-67/In-111

Planar Field Uniformity - Each Detector

Planar Spatial Resolution - Each Detector

(Four-Quadrant Bar Phantom or SPECT phantom rods are acceptable)

Acquire an intrinsic or system uniformity image with the following parameters:

Ga-67 or In-111
256 x 256 matrix (with zoom 1x).
For intrinsic uniformity, the point source must be set at a distance from the detector that is 3-5 times the longest dimension of the detector. For a 50 cm detector, this would be 150-250 cm from the detector.
Intrinsic floods acquired using the Siemens point source holder will not be accepted.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 10 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 5 million counts.

Four Quadrant Bar Phantom:

Acquire an intrinsic or system spatial resolution pattern image with the following parameters;

Ga-67 or In-111
512 x 512 matrix (with zoom 1x). If the scanner is not capable of acquiring in a 512 x 512 matrix, use the largest matrix available on the system.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 5 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 3 million counts.

ACR SPECT Phantom Rods:

Fill the ACR phantom with an aqueous solution of Ga-67 or In-111, taking care to ensure that it is thoroughly mixed. Place the phantom with the flat bottom on the rods side sitting up and centered on the face of the medium-energy collimator.

Acquire a static image with the following parameters:

256 x 256 matrix (with zoom 1x)
600,000 counts
The count rate should not exceed 50 kcps.

Planar Images for Submission

Submit only gray scale images.
Use linear mapping of the display with the lower threshold set at 0 (or ≤ 5% of the maximum upper level) and the upper threshold set to 100% or the maximum count.
Planar images must be submitted for all detectors on systems with more than one detector.
All images should be appropriately labeled with camera head number for systems with more than one detector and isotope. Make sure the Site Scanning Data Forms are filled out completely and match the acquired data.
Images with graphic overlays will not be accepted.
DICOM images are preferred.

Module 2 and/or 3 (SPECT with Planar): Facilities applying for accreditation in the SPECT Module or the Nuclear Cardiology Module must perform, evaluate, and submit for review images documenting the planar uniformity and spatial resolution of each detector, and the SPECT image quality of the system.

All sites applying for Module 2 and/or 3 accreditation are required to submit Tc-99m or Co-57 intrinsic or system planar uniformity images and planar spatial resolution images, except for camera models listed below that cannot acquire planar imaging.

The following cameras are exempt from planar image submission and should proceed to the SPECT Imaging section below: Dedicated cardiac SPECT cameras (e.g., D-SPECT, Digirad, Cardius, 2XPO, 3XPO, X-ACT, 2020TC SPECT, SPECTpak), Veriton, Starguide, GE 530c, GE 570c, MyoSPECT, Clearvision, and GVI.

Sites also seeking accreditation for Ga-67 or In-111 must submit Ga-67 or In-111 planar uniformity images and planar spatial resolution images. Ga-67 or In-111 SPECT phantom images are not required. Facilities that perform less than 25 exams using Ga-67 or In-111 in a year are not required to apply for those isotopes.

The planar and SPECT protocol should be followed for camera systems seeking accreditation for Module 2 and/or Module 3. The spatial resolution test can be completed using a four-quadrant bar phantom or the ACR SPECT phantom. If a four-quadrant bar phantom is submitted, the smallest bars must be between 2 and 3 mm.

Planar and SPECT Protocol for Systems Applying for Module 2 and/or 3 (SPECT and/or Nuclear Cardiology) Accreditation

Isotope One: Tc-99m/Co-57

Planar Field Uniformity - Each Detector

Planar Spatial Resolution - Each Detector

(Four Quadrant Bar Phantom or SPECT phantom rods are acceptable)

Acquire an intrinsic or system uniformity image with the following parameters:

Tc-99m or Co-57
256 x 256 matrix (with zoom 1x)
For intrinsic uniformity, the point source must be set at a distance from the detector that is 3-5 times the longest dimension of the detector. For a 50 cm detector, this would be 150-250 cm from the detector.
Intrinsic floods acquired using the Siemens point source holder will not be accepted.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 10 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 5 million counts.

Four Quadrant Bar Phantom:

Acquire an intrinsic or system spatial resolution pattern image with the following parameters;

Ga-67 or In-111
512 x 512 matrix (with zoom 1x). If the scanner is not capable of acquiring in a 512 x 512 matrix, use the largest matrix available on the system.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 5 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 3 million counts.

ACR SPECT Phantom Rods:

Fill the ACR phantom with an aqueous solution of Ga-67 or In-111, taking care to ensure that it is thoroughly mixed. Place the phantom with the flat bottom on the rods side sitting up and centered on the face of the medium-energy collimator.

Acquire a static image with the following parameters:

256 x 256 matrix (with zoom 1x)
600,000 counts
The count rate should not exceed 50 kcps.

Isotope Two: Ga-67/In-111

Planar Field Uniformity - Each Detector

Planar Spatial Resolution - Each Detector

(Four Quadrant Bar Phantom or SPECT phantom rods are acceptable)

Acquire an intrinsic or system uniformity image with the following parameters:

Ga-67 or In-111
256 x 256 matrix (with zoom 1x).
For intrinsic uniformity, the point source must be set at a distance from the detector that is 3-5 times the longest dimension of the detector. For a 50 cm detector, this would be 150-250 cm from the detector.
Intrinsic floods acquired using the Siemens point source holder will not be accepted.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 10 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 5 million counts.

Four Quadrant Bar Phantom:

Acquire an intrinsic or system spatial resolution pattern image with the following parameters;

Ga-67 or In-111
512 x 512 matrix (with zoom 1x). If the scanner is not capable of acquiring in a 512 x 512 matrix, use the largest matrix available on the system.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 5 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 3 million counts.

ACR SPECT Phantom Rods:

Fill the ACR phantom with an aqueous solution of Ga-67 or In-111, taking care to ensure that it is thoroughly mixed. Place the phantom with the flat bottom on the rods side sitting up and centered on the face of the medium-energy collimator.

Acquire a static image with the following parameters:

256 x 256 matrix (with zoom 1x)
600,000 counts
The count rate should not exceed 50 kcps.

Planar Images for Submission

Submit only gray scale images.
Use linear mapping of the display with the lower threshold set at 0 (or ≤ 5% of the maximum upper level) and the upper threshold set to 100% or the maximum count.
Planar images must be submitted for all detectors on systems with more than one detector.
All images should be appropriately labeled with camera head number for systems with more than one detector and isotope. Make sure the Site Scanning Data Forms are filled out completely and match the acquired data.
Images with graphic overlays will not be accepted.
DICOM images are preferred.

SPECT Imaging Protocol

Spheres must be placed in order of decreasing size and aligned with the rods in decreasing size.
The recommended activity for the ACR SPECT phantom is 10-20 mCi of Tc-99m. The recommended activity for the Small SPECT phantom is 5-15 mCi of Tc-99m.
QC Information: Center-of-rotation and flood uniformity calibrations are regularly performed on SPECT systems. Fill in the appropriate data fields based on the most recent calibrations.
The ACR phantom used for the SPECT tests must be described on the Site Scanning Data Forms.
For more information, please see the ACR’s SPECT Phantom Video.

Positioning of ACR Phantom for Tomography:

Place the phantom on the patient support (bed, chair, etc.) so that it is positioned lengthwise, corresponding to the primary patient axis. The phantom’s long axis must be parallel to the rotational (z)-axis of the detector system with the phantom level. Phantoms with flanges may require extra support for leveling. The phantom should be positioned in the center of the field of view of the detector(s).

Note: For cameras that are only capable of rotating through 180 degrees and have the detectors in a fixed relative angle of 90 degrees, special caution must be exercised in the orientation of the spheres and rods. You may use your cardiac acquisition protocol. Ensure that the phantom configuration is consistent (largest sphere adjacent to largest rods, second-largest sphere adjacent to second-largest rods, etc.). Position the phantom on the imaging table such that the largest sphere will be in approximately the 10 o'clock position in the reconstructed image. When set up properly, the largest sphere will be in the upper left of the phantom when viewed from the foot of the table. If you are imaging from 0 to 180 degrees, the largest sphere should be at the 12 o'clock position. See the images below for guidance.

Collimator:

Use the highest resolution low-energy parallel hole collimator that is routinely used for clinical studies.

Acquisition:

Select the appropriate isotope and acquire a SPECT study with the window setting, orbit shape, and detector motion (step-and-shoot or continuous motion for rotating SPECT cameras) that is used clinically.
Total counts - For SPECT acquisitions the sum of the counts from all images (for all heads on multiple detector systems) should be approximately 32 million counts for the Deluxe Phantom and 20 million counts for the Small SPECT phantom. A sample calculation to determine the number of seconds per image to use when acquiring the SPECT data is provided below. Alternatively, use the table below to determine the number of counts in the first image for cameras that may be set to acquire the first image for a set number of counts and the rest of the images for the same time.
Count rate should not exceed 50 kcps.
Use a 128 x 128 matrix regardless of which phantom is used. Acquire 120 (or 128) views over 360 degrees for rotating SPECT cameras. Some cardiac SPECT systems cannot acquire a single set of projections over 360 degrees. For these systems, the phantom should be acquired with the maximum number of rotational steps for the standard rotational arc. This is generally 60 or 64 steps over 180 degrees. Cameras that do not rotate should use the angular sampling that is used clinically.
A circular or non-circular orbit can be used. If a circular orbit is used, then the radius of rotation should be as close as possible to 20 cm. For either acquisition type, the center of the phantom must be close to the axis-of-rotation so that the distance from the face of the collimator(s) to the phantom does not change significantly during rotation. The Small phantom should be placed at the optimal clinical imaging position for cameras that do not rotate around the patient.
For an acquisition matrix of 128 x 128, pixel size should be near 2.7 to 3.3 mm. Some systems will require an acquisition zoom factor (up to a maximum of 1.6) to achieve the appropriate pixel size.
If the camera cannot acquire a 128 x 128 matrix, use the matrix closest to 128 x 128.

Sample Calculation for SPECT Acquisition

Calculation of the time per view to acquire approximately 32M counts in the SPECT study: If the system you are using shows the count rate prior to starting the SPECT acquisition, use the procedure given below. If the count rate is not shown, just prior to starting the SPECT study, acquire a planar acquisition for 10 seconds (be sure the imaging table is not between the detector you are using and the phantom) and divide the acquired counts by 10 to get the rate in counts per second.

Example:

R = count rate in counts per second for one of the detectors

N = number of views (120 or 128, whichever is available or whichever you want to use if both are available)

T = time for the first view

Assume R = 28,000 counts per second. Assume N = 120 views.

Round time up to the next whole number if the fraction of a second is greater than 0.5. Round time down to the next whole number if the fraction of a second is less than 0.5.

If the system has two detectors, the total acquisition time will be approximately one-half of the time for a single detector system. If the system has three detectors, the total acquisition time will be approximately one-third of the time for a single detector system.

Table for the number of counts to acquire when acquiring the first image by counts and the rest by time

Total number of Projections - Rotation Arc (in degrees)	Number of Counts in First Image
Total number of Projections - Rotation Arc (in degrees)	Deluxe Phantom- 32 M counts	Small Phantom - 20 M counts
120-360	267,000	167,000
128-360	250,000	156,000
60-180	534,000	334,000
64-180	500,000	312,000

Reconstruction:

Reconstruction with filtered back projection is recommended using the Butterworth filter that is available on most commercial systems. For the Butterworth filter, suggested parameters are a cutoff of 0.55 and a slope of 6, which is optimal for many systems (for some vendors the cutoff will be close to 0.35); however, parameter values can be adjusted to optimize contrast of spheres and sharpness of smallest visible rods in the transaxial slices. Lower cutoff numbers will result in a smoother image with less noise and less detail. Sites may use the clinical reconstruction method and filter they are currently using with parameters optimized for the ACR phantom. Note that using iterative reconstruction methods may result in the appearance of edge artifacts in the reconstructed images that could result in a lower uniformity score. Review your images carefully for this type of artifact prior to submission.
Attenuation correction is required for cameras that rotate 360 degrees. For most cameras, the effective linear attenuation coefficient for Tc-99m is 0.11 to 0.12/cm. Use the uniform part of the phantom to define the boundary for attenuation correction. Please note that on most systems, the attenuation correction is applied as a separate step in the reconstruction programs or a separate program outside of the reconstruction. The operator is usually required to set the boundaries and to apply attenuation correction. Sites submitting data from cameras that can acquire only 180 degrees of data (i.e., cardiac only cameras) are not required to apply attenuation correction to the data.
For SPECT CT units, CT attenuation correction is acceptable.
The filter and parameters as well as the slice thickness and attenuation coefficient must be documented on the Site Scanning Data Form.
Display the first image of the raw SPECT data. Record the total counts in the image on the Site Scanning Data Form.
Display all transaxial reconstructed images with a slice thickness 0.6-0.9 cm by summing 2 or 3 slices. For most large FOV cameras, summing 2 slices will generate the appropriate thickness.

SPECT Images for Submission

Submit the complete set of transaxial slices (0.6 to 0.9 cm thick). Do not submit more than 28 slices on a single page. Image size should be adjusted with the display zoom so that each image occupies about 80% of the image frame.
DICOM reconstructed axial slices reframed to the correct slice thickness may be uploaded in lieu of screen captures.
Submit a composite image of 3-6 cm thick through the rod section; 2-3 cm thick for the small phantom.
Submit only gray scale images.
Use linear mapping of the display with the lower threshold set at 0 (or ≤ 5% of the maximum upper level) and the upper threshold set to 100 % or the maximum count.
All images should be appropriately labeled. Slice number(s) or position location should be included on secondary capture images that are submitted. Make sure Site Scanning Data Forms are filled out completely and match the data submitted.
For multi-detector cameras, separate SPECT data sets for each detector should not be submitted.
Only the transaxial images should be submitted. Do not submit sagittal or coronal images. Do not submit secondary capture images that display the three orthogonal planes (transaxial, sagittal and coronal) on one page.

Evaluation of the Images Submitted

Uniformity, noise, and the presence of artifacts are evaluated qualitatively by inspection of planar images and reconstructed tomographic sections. Planar spatial resolution is judged by identifying the smallest bars in a resolution phantom that can be visualized on cameras used for planar imaging only. For tomographic systems, the smallest “cold” rods in the ACR-approved phantom are used. Collimator type (e.g., general purpose, high resolution) is considered in scoring the spatial resolution. The reconstructed transaxial slices containing the "cold" spheres are used to visually evaluate image contrast based on identifying the smallest “cold” sphere seen at high contrast. As with the evaluation of spatial resolution, collimator type is considered when the score for contrast is determined.

Clarified language in the Planar module 1, Planar module 2, and SPECT Imaging Protocol sections

Revision History for this Article
Date	Section	Description of Revision(s)
12-12-19	All	Article created; FAQs incorporated; No criteria changes
9-23-2020		Added link to Phantom Image Atlas
11-30-2020		Added link to NM Equipment Evaluation Summary Form
2-4-2021		Added Clearvision GVI to list of cameras that are unable to acquire planar images
5-6-2022	All	Clarification of instructions (no new requirements)
6-22-2022	Planar and SPECT Protocol for Systems Applying for SPECT Accreditation	Phantom rods and Bars are acceptable for Planar Spatial Resolution - each detector ACR Phantom (Recommended)
8-29-2022	Module 2 and/or 3 (SPECT with Planar)	Removed exception for Digirad dedicated cardiac cameras
11-9-2022		Grammatical edit
11-18-22	Introduction	Attached Phantom Order and Site Scanning Data forms
12-6-22	Introduction	Moved Phantom Order Forms to Testing Overview: NM/PET article
4-20-2023		Edited 2020TC SPECT and added SPECTpak
6-21-2023	Introduction	Added notice at the beginning regarding a change effective January 1, 2024.
	SPECT acquisition	Added bullet instruction for cameras that cannot acquire a 128 x 128 matrix
	SPECT Images for Submission	Clarified 3rd bullet for composite images
1-4-2024	Introduction	Added clarification for breast imaging units
		Added 7th bullet for common reasons for image rejection
	Planar Only Module and Planar Imaging Protocol	Changed longest to smallest
	Reconstruction	Added bullet for SPECT CT units
		Updated attachments
1-5-2024	Planar Only Module and Planar Imaging Protocol	Updated longest and smallest language
5-1-2024	Introduction	Removed notice of January 1, 2024 effective changes
	Module 1 (Panar Imaging Only)	Added instructions for ACR SPECT phantom use and language on emergency use
	Planar Only Protocol	Added instructions for ACR rod phantom use
9-4-2024	Introduction	Added link to the Modalities with Low Volume or Emergency Use article
	Planar Only Protocol	Changed longest dimension to smallest dimension for large rectangular field cameras under both field uniformity and spatial resolution
	Planar and SPECT Protocol for Systems Applying for SPECT Accreditation	Changed longest dimension to smallest dimension for large rectangular field cameras for the planar field uniformity and planar spatial resolution
11-15-2024		Added link to the ACR NM Quality Control Manual
1-14-2025		Clarified Jaszczak Deluxe Flanged or Flangeless ECT phantom (for SPECT only)
2-11-2025		Updated broken link
7-9-2025		Updated phantom TID attachment
		Removed TI-201
10-23-2025		Removed NM/PET Phantom Image Atlas reference
		Clarified language in Module 1, Module 2 and/or 3, and SPECT Imaging Protocol sections

Previous: Nuclear Cardiology Module: NM

Next: Clinical Image Testing: PET

NM Phantom TID.pdf
(184 KB)

Revision History

Introduction

The Nuclear Medicine Accreditation Physics Subcommittee has defined scoring criteria for planar (uniformity and resolution) and SPECT (uniformity, spatial resolution, and contrast). These criteria are based on results obtained from a variety of cameras that are operating satisfactorily.

Breast imaging units should follow the small FOV requirements; for spatial resolution the four-quadrant bar phantom should be placed on a 45-degree angle to visualize all quadrants.

Common reasons for image rejection:

Planar images acquired with incorrect parameters (e.g., matrix and counts)

Data form does not accurately reflect information for images submitted

Planar images submitted are not acquired as static planar images (Sites should not submit the daily QC results page)

Planar uniformity images with graphic overlays

Screenshot images with the upper threshold not equal to 100% and lower threshold not between 0-5%

Attenuation correction was not applied (required for cameras that rotate 360 degrees; for SPECT CT units, CT attenuation correction is acceptable)

As appropriate, planar and/or SPECT phantom images must be obtained and submitted for review using the phantom that has been approved by the ACR Committee on Nuclear Medicine Accreditation. Please see the article on Modalities with Low Volume or Emergency Use as needed.

NM QC should be carried out in accordance with the methods outlined in the 2024 NM Quality Control Manual.

The spatial resolution test can be completed using a four-quadrant bar phantom or an ACR approved SPECT phantom. If a four-quadrant bar phantom is submitted, the smallest bars must be between 2 and 3mm.

Cameras that should use Small SPECT phantom: GE 530c, GE 570c, MyoSPECT, maiCam, C!, P3000, and ClearVision

Optional (can use either the Deluxe or Small ACR phantom): c.cam, CardioMD, D-SPECT, Digirad dedicated cardiac SPECT cameras (e.g., Cardius, 2XPO, 3XPO, X-ACT, 2020TC SPECT, SPECTpak), CorCam, and Ventri

The following are available directly from Data Spectrum of Durham, NC (order forms for the large and small phantoms are available in our Testing Overview: Nuclear Medicine and PET article):

Jaszczak Deluxe Flangeless ECT phantom and PET faceplate (can be used for both SPECT and PET acquisitions)

Jaszczak Deluxe Flanged or Flangeless ECT phantom (for SPECT only)

Small SPECT Phantom (for SPECT only)

Flangeless PET phantom (for PET only)

PET faceplate made to fit an existing flangeless or flanged Jaszczak Deluxe ECT phantom

One set of Site Scanning Data Forms (attached below), along with all pertinent worksheets, should be completed for each camera system that is undergoing accreditation.

Phantom Requirements by Module

All sites applying for Module 1 accreditation are required to submit Tc-99m or Co-57 intrinsic or system planar uniformity images and planar spatial resolution images.

Sites also seeking accreditation for Ga-67 or In-111 must submit Ga-67 or In-111 planar uniformity images and planar spatial resolution images. Sites that perform less than 25 exams using Ga-67 or In-111 in a year are not required to apply for those isotopes.

The Planar protocol should be followed for camera systems only seeking accreditation for Module 1. Images must be submitted for all detectors on systems with more than one detector.

The spatial resolution test can be completed using a four-quadrant bar phantom or the ACR SPECT phantom. If a four-quadrant bar phantom is submitted, the smallest bars must be between 2 and 3mm.

Isotope One: Tc-99m/Co-57

Planar Field Uniformity - Each Detector

Planar Spatial Resolution - Each Detector

(Four-Quadrant Bar Phantom or SPECT phantom rods are acceptable)

Acquire an intrinsic or system uniformity image with the following parameters:

Tc-99m or Co-57

256 x 256 matrix (with zoom 1x).

For intrinsic uniformity, the point source must be set at a distance from the detector that is 3-5 times the longest dimension of the detector. For a 50 cm detector, this would be 150-250 cm from the detector.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 10 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 5 million counts.

Acquire an intrinsic or system spatial resolution pattern image with the following parameters:

Tc-99m or Co57

512 x 512 matrix (with zoom 1x). If the scanner is not capable of acquiring in a 512 x 512 matrix, use the largest matrix available on the system.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 5 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 3 million counts.

Fill the ACR phantom with an aqueous solution of Tc-99m, taking care to ensure that it is thoroughly mixed. Place the phantom with the flat bottom on the rods side sitting up and centered on the face of the low-energy collimator.

Acquire a static image with the following parameters:

256 x 256 matrix (with zoom 1x)

600,000 counts

The count rate should not exceed 50 kcps.

Isotope Two: Ga-67/In-111

Planar Field Uniformity - Each Detector

Planar Spatial Resolution - Each Detector

(Four-Quadrant Bar Phantom or SPECT phantom rods are acceptable)

Acquire an intrinsic or system uniformity image with the following parameters:

Ga-67 or In-111

256 x 256 matrix (with zoom 1x).

For intrinsic uniformity, the point source must be set at a distance from the detector that is 3-5 times the longest dimension of the detector. For a 50 cm detector, this would be 150-250 cm from the detector.

Intrinsic floods acquired using the Siemens point source holder will not be accepted.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 10 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 5 million counts.

Acquire an intrinsic or system spatial resolution pattern image with the following parameters;

Ga-67 or In-111

512 x 512 matrix (with zoom 1x). If the scanner is not capable of acquiring in a 512 x 512 matrix, use the largest matrix available on the system.

Large rectangular field cameras (smallest dimension ≥ 32 cm), acquire 5 million counts.

All circular detectors and small rectangular field cameras (smallest dimension < 32 cm), acquire 3 million counts.

Fill the ACR phantom with an aqueous solution of Ga-67 or In-111, taking care to ensure that it is thoroughly mixed. Place the phantom with the flat bottom on the rods side sitting up and centered on the face of the medium-energy collimator.

Acquire a static image with the following parameters:

256 x 256 matrix (with zoom 1x)

600,000 counts

The count rate should not exceed 50 kcps.

Planar Images for Submission

Submit only gray scale images.

Use linear mapping of the display with the lower threshold set at 0 (or ≤ 5% of the maximum upper level) and the upper threshold set to 100% or the maximum count.

Planar images must be submitted for all detectors on systems with more than one detector.

All images should be appropriately labeled with camera head number for systems with more than one detector and isotope. Make sure the Site Scanning Data Forms are filled out completely and match the acquired data.

Images with graphic overlays will not be accepted.

DICOM images are preferred.

All sites applying for Module 2 and/or 3 accreditation are required to submit Tc-99m or Co-57 intrinsic or system planar uniformity images and planar spatial resolution images, except for camera models listed below that cannot acquire planar imaging.

The following cameras are exempt from planar image submission and should proceed to the SPECT Imaging section below: Dedicated cardiac SPECT cameras (e.g., D-SPECT, Digirad, Cardius, 2XPO, 3XPO, X-ACT, 2020TC SPECT, SPECTpak), Veriton, Starguide, GE 530c, GE 570c, MyoSPECT, Clearvision, and GVI.

Planar and SPECT Protocol for Systems Applying for Module 2 and/or 3 (SPECT and/or Nuclear Cardiology) Accreditation

Isotope One: Tc-99m/Co-57