Experiences of using the Philips CardioMD Camera University Hospital Birmingham Foundation NHS Trust

Why choose a dedicated Cardiac camera?  Three cameras were routinely used before the CardioMD was installed: Dual Head (ADAC Vertex) used for MPI Single Head Large FOV (Toshiba) Single Head Small FOV (Siemens)  Plan was to replace the small FOV camera with a dedicated Cardiac Camera because:  MPI requests were growing  A dedicated cardiac camera has a smaller footprint than a modern SPECT-CT system  Money was available from the PCT for a dedicated Cardiac Camera (£190k)!

Why Choose the CardioMD?  Three dedicated Cardiac cameras were considered: Philips CardioMD (AC available) Siemens C-cam (AC available in future) Pulse IS2 (AC available in future)  Specifications similar between systems.  The Philips CardioMD was chosen primarily due to the availability of AC. The department had performed AC on MPI scans since  The CardioMD was also the cheapest!

Changes to Service in Department  Change in workflow for each camera  Dual Head (ADAC Vertex) Free for work other than MPI  Single Head Large FOV (Toshiba) Used for studies performed on the old small FOV camera replaced with CardioMD  CardioMD (Philips) Used for MPI and MUGA studies  The CardioMD has doubled the MPI scanning capacity and a full 5 day service can now be provided. (~550  ~1100patients/Yr)

Setting up a Study  Easy and quick to set- up an acquisition on the system.  However, since the introduction of the DICOM work list, there have been a few problems. Repetition of patient files. Handling of attenuation correction data

Positioning the Patient  Patients have difficulty both in getting on and off the bed.  Staff complain about bed not moving up or down.  Positioning has to be precise as the bed translates by a small amount.  Easy to set-up once patient is in position  However, range limits on very small or very large patients.

Image Reconstruction/Processing  Fast reconstruction/ processing software.  Motion correction software is quick and effective.  Software could be more intuitive. Some technologists report that they have to read manual/protocol on some occasions!

Routine QC ( 57 Co Daily Flood)

Routine QC ( 99m Tc Intrinsic Flood)  30M counts acquired using ~30MBq 99m Tc (~15min/head)  Integral uniformity results calculated and plotted

Weekly Intrinsic Uniformity Results

Routine QC (COR)  Easy to set-up.  X range values considered to be satisfactory.  Y range values considered to be good.

Summary  Pros Camera easy to use and reliable (since installation of UPS) System is relatively easy to maintain (e.g. PM tube retune) Quick and easy to use acquisition and reconstruction software Good motion correction software  Cons Most significant problem with the system is regarding ergonomics of the bed. Several problems with acquiring data following introduction of the DICOM work list. Set-up would be easier if an ‘OK’ button was present on the handset. Manual collimator exchange can be awkward