Phantom Laboratory Catphan 503, CTP503 User Manual

T h e P h a n t o m L a b o r a t o r y
C a t p h a n ® 503 M a n u a l
Copyright © 2017
WARRANTY THE PHANTOM LABORATORY INCORPORATED (“Seller”) warrants that this product shall remain in good working order and free of all material defects for a period of one (1) year following the date of purchase. If, prior to the expiration of the one (1) year warranty period, the product becomes defective, Buyer shall return the product to the Seller at: By Truck By Mail
The Phantom Laboratory, Incorporated The Phantom Laboratory, Incorporated 2727 State Route 29 PO Box 511 Greenwich, NY12834 Salem, NY 12865-0511
Seller shall, at Seller’s sole option, repair or replace the defective product. The Warranty does not cover damage to the product resulting from accident or misuse.
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IF THE PRODUCT IS NOT IN GOOD WORKING ORDER AS WARRANTED, THE SOLE AND EXCLUSIVE REMEDY SHALL BE REPAIR OR REPLACEMENT, AT SELLER’S OPTION. IN NO EVENT SHALL SELLER BE LIABLE FOR ANY DAMAGES IN EXCESS OF THE PURCHASE PRICE OF THE PRODUCT. THIS LIMITATION APPLIES TO DAMAGES OF ANY KIND, INCLUDING, BUT NOT LIMITED TO, DIRECT OR INDIRECT DAMAGES, LOST PROFITS, OR OTHER SPECIAL, INCIDENTAL, OR CONSEQUENTIAL DAMAGES, WHETHER FOR BREACH OF CONTRACT, TORT OR OTHERWISE, OR WHETHER ARISING OUT OF THE USE OF OR INABILITY TO USE THE PRODUCT. ALL OTHER EXPRESS OR IMPLIED WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTY OF MERCHANT ABILITY AND FITNESS FOR PARTICULAR PURPOSE, ARE HEREBY DISCLAIMED.
WARNING
This product has an FH3-4 mm/min ame rating and is considered to be ammable. It is advised not to expose this product to open ame or high temperature (over 125° Celsius
or 250° Fahrenheit) heating elements.
CTP503
1/12/17
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T h e P h a n t o m L a b o r a t o r y
Catphan® Manual
Contents
Warranty 1 Introduction 4 Initial phantom positioning 5 Illustration of Catphan® 503 model 6
Phantom position verication 7
Incremental phantom module positioning 8 Drawings in the manual 8 CTP404 module 9 Patient alignment system check 10 Scan slice geometry (slice width) 11 Scan incrementation 12 Circular symmetry 13
Spatial linearity of pixel size verication 13
Spherical acrylic contrast targets 13
CT or Hounseld Numbers by David Goodenough, Ph.D. 14
Sensitometry (CT number linearity) 15 CTP528 High resolution module with 21 line pair per cm gauge and point source 17 Bead point source for point spread function and MTF 17 Use of automated scanner MTF programs 18
Bead point source (slice sensitivity prole) 19
21 Line pair per centimeter high resolution gauge 20 CTP486 Image uniformity module 21 Installation and removal of test modules 23 Optional phantom annuli 24 Dose Phantoms 25 Sample quality assurance program 26 Automated computer analysis program 27 Bibliography 28
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Introduction
The Catphan® 503 phantom conguration has been selected by Elekta. This manual
is intended to supplement the Elekta Procedures and Manuals by offering additional details regarding the use of the Catphan® phantom. The Phantom Laboratory and physicist, David J. Goodenough, Ph.D., are continually developing and researching new
tests and modications for the Catphan® phantoms. The test objects that make up the current Catphan® models embody more than a quarter century of scientic evaluation and eld experience. This manual outlines the applications of each module contained in
the Catphan® 503 phantom.
We do not make specic recommendations on the content of your quality assurance
program, because each medical imaging facility has its own unique set of requirements. A sample program is provided to give you ideas for possible program content. We suggest
a review of local governing regulations, manufacturers’ specications and the needs of
your radiologists and physicists before developing your CT quality assurance program.
If you would like a pdf version of this manual they can be downloaded from the Catphan® page of our website. www.phantomlab.com
If you have any additional questions please contact The Phantom Laboratory at: Phone: 800-525-1190 or 518-692-1190 Fax: 518-692-3329 email: sales@phantomlab.com Additional product information is available at: www.phantomlab.com
Initial phantom positioning
The Catphan® phantom is positioned in the CT scanner by mounting it on the case.
Place the phantom case on the gantry end of the patient table with the box hinges away from the gantry. It is best to place the box directly on the table and not on the table pads.
Open the box, rotating the lid back 180°. If you are using an annulus, additional weight
will need to be placed in the box to counterweigh the phantom. The patient straps can be used for additional stability.
Remove the phantom from the box and hang the Catphan® from the gantry end of the box. Make sure the box is stable with the weight of the phantom and is adequately counterweighed to prevent tipping.
Use the level and adjust the black thumb screws to level the Catphan®. Once the
phantom is level, slide the phantom along the end of the box to align the section center dots on the top of the phantom with the x axis alignment light. Raise or lower the patient table so the laterial height dot on the side of the phantom aligns with the y axis alignment light.
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Use the z axis table drive to position the phantom for scanning.
Depending on the type of scanner being tested and the selected protocols there are different ways to align the phantom along the z axis.
Cone beam CT: the most common approach is to center the scanner between the second and third alignment dots and do a single scan that will provide slices of all test modules. However because of beam divergence there will be variations between images taken of a module that is in the center of the beam verses images taken on the edge of the beam.
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Because of beam divergence a physicist may develop specic alignment protocols.
Single slice axial CT: the phantom can be centered on the CTP404 module and then after verifying the alignment, the table can be indexed to the center of the other modules.
Spiral CT: the scanner can be aligned with the rst module and then the phantom can
be scanned in one sequence.
Review the scans of the CTP404 module to check the image for proper alignment as
illustrated in the Phantom position verication section.
Illustration of Catphan® 503 model
Note: The brass mount nuts hold the mount to the phantom housing. Only the black
adjusting thumb screws should be used to level the phantom.
Phantom position verication
By evaluating a scan image of the CTP404 module the phantom’s position and alignment
can be veried. The section contains 4 wire ramps which rise at 23° angles from the base
to the top of the module. The schematic sketches below indicate how the ramp images change if the scan center is above or below the z axis center of the test module. The use of the scanner’s grid image function may assist in evaluation of phantom position.
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If misalignment is indicated by the scan image, the phantom should be repositioned to obtain proper alignment and then rescanned. If the images of the repositioned phantom duplicate the original misalignment indications, the scanner’s alignment lights may
require adjustment (contact your local service engineer).
Once correct alignment has been established, you can proceed with the tests.
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Incremental phantom module positioning
The Catphan® 503 phantom is designed so all test sections can be located by precisely indexing the table from the center of module CTP404 to the center of the other test modules. The indexing distances from the center of the CTP404 module are listed below.
Catphan® 503 test module locations:
Module Distance from the center of CTP404 CTP528, 21 line pair high resolution 30mm CTP486, Solid image uniformity module 110mm
Drawings in the manual
The drawings in this manual show a schematic view of the modules as they would be
seen in a typical head rst CT scan where the right side of the phantom is shown on the
left side of the image.
Most of the schematic drawings show the 15cm diameter module without the 20cm diameter housing. Please note that the modules are pressed into the housing and sometimes there is a small air gap that creates a black crescent line between the test module and the housing. This is shown on the above illustration running from the 10:00 to 12:30 positions. Since this is a radial air gap it will not affect the internal image
measurements if the phantom is centered in the scan eld.
CTP404 Module with slice width, sensitometry and pixel size
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Patient alignment system check
The laser, optical, and mechanical patient alignment system can be checked for accuracy. Align the white dots on the phantom housing with the alignment lights as discussed in Initial phantom positioning. The scanned image should show good alignment as discussed in Phantom position verication.
For measuring the z axis alignment accuracy, measure from the center of the ramp image to the part of the ramp which aligns with the center of the phantom and sensitometry samples. Multiply the distance A by 0.42 to determine the z axis alignment light accuracy. To evaluate x and y accuracy, measure from the center of the phantom to the
center of the scan eld by use of the grid function or knowledge of the central pixel
location.
The accuracy of the localizer, pilot or scout view can be checked. To check this function perform a localization scan of the phantom. Align an axial scan at the crossing point of the wire ramps. Scan this axial cut and check the misalignment as discussed above.
Scan slice geometry (slice width)
Section 1 has two pair of 23° wire ramps: one pair is oriented parallel to the x axis;
the other pair to the y axis. These wire ramps are used to estimate slice width measurements and misalignment errors as previously discussed.
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The 23° wire ramp angle is chosen to improve measurement precision through the
trigonometric enlargement of 2.38 in the x-y image plane.
To evaluate the slice width (Zmm), measure the Full Width at Half Maximum (FWHM) length of any of the four wire ramps and multiply the length by 0.42:
(Zmm) = FWHM * 0.42
To nd the FWHM of the wire from the scan image, you need to determine the CT
number values for the peak of the wire and for the background.
To calculate the CT number value for the maximum of the wire, close down the CT “window” opening to 1 or the minimum setting. Move the CT scanner “level” to the
point where the ramp image just totally disappears. The CT number of the level at this
position is your peak or maximum value.
To calculate the value for the background, use the region of interest function to identify
the “mean” CT number value of the area adjacent to the ramp.
Using the above CT values, determine the half maximum:
First calculate the net peak... (CT # peak - background = net peak CT #)
Calculate the 50% net peak... (net peak CT # ÷ 2 = 50% net peak CT #)
Calculate the half maximum CT number... (50% net peak CT # + background CT # = half maximum CT #)
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Now that you have determined the half maximum CT number, you can measure the full width at half maximum of the ramp. Set the CT scanner level at the half maximum CT value and set your window width at 1. Measure the length of the wire image to determine the FWHM. Multiply the FWHM by 0.42 to determine the slice width.
Schematic illustration of two sequential 5mm scans superimposed. L1 is
the center point on the 23° ramp in the rst scan image and L2 is the center point on the 23° ramp on the second image.
Scan incrementation
Use the wire ramps to test for proper scanner incrementation between slices, and for table movement.
Scan section 1 using a given slice width, (e.g. 5mm). Increment the table one slice width (e.g. 5mm) and make a second scan. Establish the x and y coordinates for the center of
each ramp image. Calculate the distance between these points and multiply by the 23°
ramp angle correction factor of 0.42.
0.42(L1 - L2) = scan incrementation
This test can also be used to test table increment accuracy. Scan the section and increment the table 30mm in and out of the gantry and scan again. The ramp centers should be the same on both images.
0.42(L1 - L2) = 0
Circular symmetry of display system
The circular phantom sections are used to test for circular symmetry of the CT image, including calibration of the CT display system. If an elliptical image is produced, the x-y
balance of the image display system should be adjusted.
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Measuring spatial linearity in x and y axes.
Spatial linearity of pixel size verication
This section has four holes (one with a Teon pin). These 3mm diameter holes are
positioned 50mm on center apart. By measuring from center to center the spatial
linearity of the CT scanner can be veried. Another use is to count the number of pixels
between the hole centers, and by knowing the distance (50mm) and number of pixels, the
pixel size can be veried.
The Teon pin is used for identication and orientation only. The ability to change the Teon pin position enables organizations with more than one Catphan® phantom to identify their phantoms by images of the rst section.
Spherical acrylic contrast targets
The section has ve acrylic spheres located in a 30mm diameter circular pattern. These
spheres are used to evaluate the scanner’s ability to image volume averaged spheres. The sphere diameters are 2, 4, 6, 8, and 10mm.
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CT or Hounseld Numbers
by David Goodenough, Ph.D.
Users of CT systems are often surprised when the CT number of a given tissue or substance is different from what they expect from previous experience. These differences do not usually indicate problems of a given CT scanner, but more likely arise from the fact that CT numbers are not universal. They vary depending on the particular energy,
ltration, object size and calibration schemes used in a given scanner. One of the
problems is that we are all taught that the CT number is given by the equation:
CT# = k(µ - µw)/µw,
where k is the weighting constant (1000 is for Hounseld Scale), µ is the linear attenuation coefcient of the substance of interest, and µw is the linear attenuation coefcient of water. Close review of the physics reveals that although the above equation is true to rst order, it is not totally correct for a practical CT scanner. In
practice, µ and µw are functions of energy, typical x-ray spectra are not monoenergetic but polychromatic, and a given spectrum emitted by the tube is “hardened” as it is
transmitted (passes) through lter(s) and the object, nally reaching the detector. More
accurately, µ=µ(E), a function of energy. Therefore:
CT#(E) = k(µ(E) - µw(E))/µw(E)
Because the spectrum is polychromatic we can at best assign some “effective energy” Ê to the beam (typically some 50% to 60% of the peak kV or kVp). Additionally, the CT detector will have some energy dependence, and the scatter contribution (dependent on
beam width and scanned object size, shape, and composition) may further complicate
matters. Although the CT scanner has a built in calibration scheme that tries to correct for beam hardening and other factors, this is based on models and calibration phantoms
that are usually round and uniformly lled with water, and will not generally match the
body “habitus” (size, shape, etc.).
The situation is really so complicated that it is remarkable that tissue CT numbers are in
some rst order ways “portable”!
In light of the above we can examine a parameter of CT performance, the “linearity
scale”, as required by the FDA for CT manufacturer’s performance specications.
The linearity scale is the best t relationship between the CT numbers and the
corresponding µ values at the effective energy Ê of the x-ray beam.
The effective energy Ê is determined by minimizing the residuals in a best-t straight
line relationship between CT numbers and the corresponding µ values.
In review, we will encounter considerable inter and intra scanner CT number variability.
CT numbers can easily vary by 10 or more based on kVp, slice thickness, and object size,
shape, and composition. There is some possibility of the use of iterative techniques and/ or dual energy approaches that might lessen these effects, but certainly CT numbers are not strictly portable and vary according to the factors listed above.
More complete scientic references are contained in the bibliography. In particular,
references 2, 13, 14, and 20 are recommended for those with greater interest in the topic.
Sensitometry (CT number linearity)
The CTP404 module has sensitometry targets made from Teon®, Delrin®, acrylic,
Polystyrene and low density polyethylene (LDPE), polymethylpentene (PMP) and air.
The Catphan® 600 is also equipped with a small vial which can be lled with water and inserted into the top hole of the CTP404 module. The CTP401 module has Teon,
acrylic and low density polyethylene (LDPE) and air targets. These targets range from approximately +1000 H to -1000 H.
The monitoring of sensitometry target values over time can provide valuable information, indicating changes in scanner performance.
Nominal material formulation and specic gravity
Material Formula Z
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Specic Gravity2 HU range
eff
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Air .78N, .21O, .01Ar 8.00 0.00 -1046 : -986 PMP [C6H12(CH2)] 5.44 0.83 -220 : -172 LDPE [C2H4] 5.44 0.92 -121 : -87 Water [H2O] 7.42 1.00 -7 : 7 Polystyrene [C8H8] 5.70 1.03 -65 : -29 Acrylic [C5H8O2] 6.47 1.18 92 : 137 Delrin® Proprietary 6.95 1.42 344 : 387
Teon® [CF2] 8.43 2.16 941 : 1060
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Electron density and relative electron density Material Electron Density Electron Density Relative Electron
(1023e/g) (1023e/cm3) Density4 Air 3.002 0.004 0.001
PMP 5 3.435 2.851 0.853 LDPE 6 3.435 3.160 0.945 Water 3.343 3.343 1.000 Polystyrene 3.238 3.335 0.998 Acrylic 3.248 3.833 1.147 Delrin® 3.209 4.557 1.363 Teon® 2.890 6.243 1.868
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Z
, the efective atomic number, is calculated using a power law approximation.
eff
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For standard material sensitometry inserts The Phantom Laboratory purchases a multiple year supply of
material from a single batch. Samples of the purchased material are then measured to determine the
actual specic gravity. The specic gravity of air is taken to be .0013 at standard temperature and pressure. For custom cast materials the specic gravity of each cast batch is noted and supplied
with the phantom.
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These are maximum and minimum measured values from a sample of 94 scans using different scanners and protocols. HU can vary dramatically between scanners and imaging protocols and numbers outside of this range are not unusual.
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Relative Electron Density is the electron density of the material in e/cm divided by the electron density of water (H2O) in e/cm3.
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Polymethylpentene
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Low Density Polyethylene
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An excel le with the linear attenuation coefcient µ [units cm-1] for the sensitometry
materials can be downloaded from our web site.
Contrast Scale (CS) is formally dened as
CS = µm (E) - µw (E) CTm (E) – CTw (E)
where m is reference medium, and w is water, and E is the effective energy of the CT beam.
Alternatively, CS = µ1 (E) - µ2 (E) CT1 (E) – CT2 (E)
where 1,2 are two materials with low z effective, similar to water (eg. acrylic & air).
Linear attenuation coefcient µ [units cm-1]
CTP528 High resolution module with 21 line pair per cm gauge and point source
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This section has a 1 through 21 line pair per centimeter high resolution test gauge and two impulse sources (beads) which are cast into a uniform material. The beads are positioned along the y axis 20mm above or below the phantom’s center and 2.5 and 10mm past the center of the gauge in the z direction. On older CTP528 modules the bead is aligned in the z axis with the gauge.
Bead Point Source for point spread function and MTF
Use the impulse source to estimate the point source response function of the CT system. Print out a digitized image of the area surrounding the impulse source. Use the numerical data to determine the two-dimensional array of the CT values arising from the impulse source.
The FWHM of the point spread function is determined from the best-t curve of the point
spread function numerical data.
The average of several different arrays of impulse response functions is calculated to obtain the average point spread function of the system. These numerical values are
used in conjunction with the Fourier Transform Program to provide an estimate of the
two-dimensional spatial frequency response characteristics of the CT system (MTF). Illustration is on the next page.
The tungsten carbide bead has a diameter of 0.011” or 0.28mm. Because the bead is subpixel sized it is not usually necessary to compensate for it. However, some MTF programs are designed to compensate for its size.
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The above illustration shows how by summing the columns (y axis) of numbers in the point spread function (PSF) the line spread function (LSF) for the x axis is obtained.
The MTF curve results from the Fourier transform of the LSF data. Generally it is easiest to use automated software for this operation. Some CT scanners are supplied with software which can calculate the MTF from the Catphan® bead images. Independent software is listed in the Current automated programs available section of the manual.
Use of automated scanner MTF programs
Many manufacturers include automated MTF software in the standard scanner software packages. Because the bead is cast into an epoxy background which has a different density than water, the software must accept an input for the background. The point size
of .28mm must also be selected. While a sphere does produce a different density prole than a cross section of a wire or cylinder, the actual difference is not usually signicant in
current CT scanners.
Bead point source for slice sensitivity prole
The bead in this module can be used to calculate the slice sensitivity prole (SSP).
The above image illustrates how the bead will produce an ovoid object in a 3 dimensional reconstruction. The length of the object at the Full Width at Half Maximum signal
indicates the SSP. This measurement can be easily obtained on some systems, by making a sagittal or coronal reconstruction through the bead. The bead image in these reconstructions will appear as a small line. By setting the FWHM (use the same technique described in the Scan slice geometry section) measuring the z axis length of the bead image to obtain the SSP.
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If the scanner does not have the ability to measure z axis lengths in the sagittal or coronal planes, a SSP can be made by incrementing or spiraling the slice through the bead and reconstructing images in positive and negative table directions from the bead (using the smallest available increments) and plotting the peak CT number of the bead image in each slice. The FWHM measurement can then be made from the plotted CT values of the bead as a function of z axis table position.
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21 Line pair per centimeter high resolution gauge
The 21 line pair/cm gauge has resolution tests for visual evaluation of high resolution ranging from 1 through 21 line pair/cm. The gauge accuracy is ± 0.5 line pair at the 21 line pair test and even better at lower line pair tests.
The gauge is cut from 2mm thick aluminum sheets and cast into epoxy. Depending on the choice of slice thickness, the contrast levels will vary due to volume averaging.
CTP486 Image uniformity module
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The image uniformity module is cast from a uniform material. The material’s CT number is designed to be within 2% (20H) of water’s density at standard scanning protocols. The typically recorded CT numbers range from 5H to 18H. This module is used for measurements of spatial uniformity, mean CT number and noise value.
The precision of a CT system is evaluated by the measurement of the mean value and the corresponding standard deviations in CT numbers within a region of interest (ROI).
These measurements are taken from different locations within the scan eld.
The mean CT number and standard deviation of a large number of points, (say 1000 for example) in a given ROI of the scan, is determined for central and peripheral locations within the scan image for each type of scanning protocol. Inspect the data for changes from previous scans and for correlation between neighboring slices.
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Measure spatial uniformity by scanning the uniformity section. Observe the trends
above and below the central mean value of a CT number prole for one or several rows or
columns of pixels as shown above.
Select a prole which runs from one side of the uniformity module to the opposite side. Due to scanner boundary effects, typical proles start 2cm from the edge of the test
module.
Integral uniformity may be measured by determining the minimum and maximum CT
values along the prole and by using the following equation :
Integral Non-Uniformity = CTmax - CTmin CTmax + CTmin
The phenomenon of “cupping” or “capping” of the CT number may indicate the need for recalibration.
Installation and removal of test modules
For most applications there is no need to remove modules from the Catphan®. However, modules can be removed by carefully following these steps.
Note the positon of the mounting plate in relationship to the housing before removing it.
Remove the four brass nuts that secure the mounting plate to the phantom housing.
Set the phantom with the studs facing down on 2 to 4 blocks to keep the studs off the surface.
Use a blunt object, such as a wooden rod, to press the modules out of the housing.
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To insert modules hold the phantom housing on its side with the interior alignment key at the top. Align the module notches with the housing key as the modules are inserted one at a time into the housing. The illustrations on page 5 will indicate the correct locations of the modules.
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Optional phantom annuli
Warning Before mounting a Catphan® phantom with an annulus onto the Catphan® case, the case must be secured to the table by use of the patient restraint straps or additional weight. If the case is not secured to the table when the phantom is mounted, the case, phantom and annulus could fall off the edge of the table.
The following optional annuli are designed to be used with the standard 20cm Catphan® housing.
CTP299 21.5cm diameter, Teon annulus simulates the high absorption of bone.
CTP539 30cm diameter annulus, cast from the image uniformity material. CTP540 35cm diameter annulus, cast from the image uniformity material. CTP579 25-35cm OD oval annulus, cast from the image uniformity material. CTP599 45-55cm ODoval annulus, cast from the image uniformity material. CTP326 32cm diameter annulus, machined from acrylic.
The annuli are designed to slide over the 20cm Catphan® housing as illustrated below. Because the housing material and the uniformity annuli lack lubricity, the annuli may not slide easily. However, by adding some lubricant the resistance can be reduced.
Dose Phantoms
The CTP553 and CTP554 dose phantoms are designed to the Food and Drug
Administration’s Center for Devices and Radiological Health specication, listed in
1020.33.
The dose phantoms may be mounted on the Catphan® case following the same procedures and precautions used in Initial phantom positioning. The holes will accept a 1/2” or 13mm diameter dose probe.
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Warning
Make sure the Catphan® case is secure. Additional counterweight may be required before mounting 32cm dose module onto case.
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Sample quality assurance program The following shows a sample QA program. Review the local governing requirements, and the needs of your physicians and physicists when developing a QA program for your institution. This program should only be utilized as a sample.
All tests should be conducted at initial acceptance and after major repair such as tube
replacement. Perform the weekly tests after each preventative maintenance.
Suggested frequency of tests:
Daily Weekly Monthly*
Positional verication
Circular symmetry
Scan slice geometry
Impulse response function
Resolution
Low contrast
Contrast Sensitivity
Uniformity and noise characteristics
*or following preventative maintenance
Automated computer analysis program
To assist our customers The Phantom Laboratory has worked with Image Owl, Inc. to develop a web-based automated service. The Image Owl Catphan® QA service offers detailed CT performance testing and reports with the versatility of Internet access. This service can be used with Catphan® 500, 503, 504, 600, and 700 models.
Along with automated image processing and reporting Image Owl offers additional avanced tools and services, including longitudinal history, with a subscription to the service.
Test reports include: Spatial resolution (modulation transfer function) Noise and image uniformity Slice width and pixel size Sensitometry (CT# linearity, input - output relationship) Contrast detectability (C-D model)
Please contact Image Owl for information on the services avialable. www.imageowl.com info@imageowl.com
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Commercial automated software
There are now several commercial companies which offer stand alone software, or incorporate the ability to analyze Catphan® images as a part of their software package.
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Bibliography
1. AAPM Report No. 39
Specication and Acceptance Testing of Computed Tomography Scanners
Report of Task Group 2 Diagnostic X-Ray Imaging Committee. Published for the American Association of Physicists in Medicine by the American Institute of Physics. May 1993
2. M. J. Berger, J. H. Hubbell, S. M. Seltzer, J. Chang, J. S. Coursey, R. Sukumar, and D. S. Zucker, Feb. 2009, XCOM: Photon Cross Sections Database, NIST Standard Reference Database 8 (XGAM), http://www.nist.gov/physlab/data/xcom/index.cfm (July 7, 2010).
3. Brooks and DiChiro Principles of Computer Assisted Tomography (CAT) in Radiographic and Radioisotopic Imaging Phys Med Biol 1976:21:689-732
4. Cohen and DiBanca The Use of Contrast-Detail-Dose Evaluation of Image Quality in a Computed Tomographic Scanner Comput. Assist. Tomogr. 3, 189-195 1979
5. Goodenough Assessment of Image Quality of Diagnostic Imaging Systems In: Gray GA (ed). Medical images: formation, perception and measurements. Proceedings of the 7th L.H.Gray Conference, New York: John Wiley & Sons, 1976:263-77
6. Goodenough Automated Quality Assurance for CT Scanners (Chapter): Radiology ICR 749, Editors Silver, Abecasis and Veiga-Pires. Excerpta Medica Press, Amsterdam 1987
7. Goodenough Psychophysical Perception of Computed Tomography Images In: Newton and Potts (eds). Radiology of the skull and brain: technical aspects of computed tomography. Vol 5, St. Louis: CV Mosby, 1981:3993-4021
8. Goodenough and Atkins Theoretical and Practical Aspects of Automated Quality Assurance Approaches, Particularly for CT Proceedings of the ICR 89, Excerpta Medica Press, Amsterdam 1990
9. Goodenough and Weaver Factors Related to Low Contrast Resolution in CT Scanners Computerized Radiology Vol. 8 No, 5. 279-308 1984
10. Goodenough, Weaver, and Davis Development of a Phantom for Evaluation and Assurance of Image Quality in CT Scanning The Proceedings of the Application of Optical Instrumentation in Medicine V meeting sponsored by The Society of Photo-Optical Instrumentation Engineers and The Society
of Photographic Scientists and Engineers, September 16-19, 1976, Washington DC; and,
Optical Engineering, January 1977
11. Goodenough, Weaver, and Davis Potential Artifacts Associated with the Scanning Pattern of the EMI Scanner Radiology 117:615-620, December 1975
12. Goodenough, Weaver, and Davis Physical Measurement of the EMI Imaging System In: Ter-Pogossian, Phelps, Brownell, Cos Jr., Davis and Evens (eds). Reconstruction tomography in diagnostic radiology and nuclear medicine. Baltimore: University Park Press, 1977: 225-243
13. John M. Boone and J. Anthony Seibert, 1997, An accurate method for computer­generating tungsten anode x-ray spectra from 30 to 140 kV, Medical Physics, v. 24, No. 11, p. 1661-1670.
14. R. J. Kriz and Keith J.Strauss, 1985, An investigation of computed tomography (CT) linearity, Medical Imaging and Instrumentation, v. 555, p. 195-204.
15. McCullough Photon Attenuation in Computed Tomography Medical Physics, 2:307-320, Nov/Dec 1975
16. McCullough, Baker, Hattery, Sheedy, Stephens and Payne Performance Evaluation and Quality Assurance of Computed Tomography (CT) Equipment with Illustrative Data for ACTA, Delta , and EMI Scanners Radiology 120: 173-188, July 1976
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