Quantitative simultaneous In-111/Tc-99m planar imaging in a long-bone infection phantom

Xuping Zhu, Mi Ae Park, Victor H. Gerbaudo, Stephen C. Moore

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


In-111-white-blood-cell and Tc-99m-sulfur-colloid dual-radionuclide imaging are frequently utilized in the evaluation of patients with suspected osteomyelitis. We have developed a quantitative planar imaging method in which Tc-99m and In-111 scans are acquired simultaneously in accurate spatial registration. Long, thin tubes containing only In-111 or Tc-99m were first imaged in a list mode within a water bath inclined with respect to the water surface; from these, 12 energy spectra corresponding to different Tc/In ratios were synthesized. Triple-energy-window (TEW) parameters for scatter and radionuclide crosstalk correction, including scatter windows and weights, were optimized using 100 noise realizations of each of the spectra (1200 total). A long-bone phantom containing a simulated infection site was then imaged in water with five In/Tc ratios; 100 noise realizations of two conjugate-view images were generated from each acquisition (500 total). Two regions of interest (ROIs) were defined, and the ratio of In/Tc count ratios in these two ROIs was evaluated with and without the TEW scatter correction and geometric mean attenuation compensation. The average bias improved from 17.2% to 5.3%, with comparable precision. TEW corrections with non-optimized but practical energy windows also improved the bias to 6.4%. Compared with subjective visual assessment, quantitation of In-111/Tc-99m ratios may improve diagnostic accuracy and could eventually permit grading of osteomyelitis.

Original languageEnglish (US)
Pages (from-to)7353-7365
Number of pages13
JournalPhysics in medicine and biology
Issue number24
StatePublished - Dec 21 2007
Externally publishedYes

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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