[Intl_DxMedPhys] [EXTERNAL] Re: QC on Dedicated Cardiac PET/CT (IAC, TJC)

[Januseski, Daniel]

I don't see how you could not have a hot lab or similar type space to process isotope to support a RB-82 cardiac system.  In addition to what was mentiopned about the daily QC of the generator measurement system, there will also be generated radioactive waste from leftover eluate in the system; this will likely have long lived Sr contaminates that will need to be held somewhere for disposal.  Also the PET-CT systems typically have either an internal or external chekc source for it's own daily QC/calibration, as well as a Ni source for other QC on the generator, all of which require leak testing periodically and weekly surveys based on RAM license conditions.  So don't forget the survey meter and well counter.

Nothing I have seen indicates any QC process not involving F-18 for testing, ACR or otherwise.  We are standing up our 2nd PET-CT caridac system and actually using a single-day delivery of a generator which shortcuts some of the regular QC, but there is still the waste storage issue and QC of the camera.  Woulde definitely run this by the state regulators before taking a wrecking ball to any hot labs.

Dan Januseski
Voorhees, NJ


________________________________
From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+djanuseski=virtua.org at lists.osu.edu> on behalf of Scott Fuller via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu>
Sent: Thursday, January 22, 2026 22:49
To: Michael Masiar <mmasiar at gmail.com>
Cc: DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu>
Subject: [EXTERNAL] Re: [Intl_DxMedPhys] QC on Dedicated Cardiac PET/CT (IAC, TJC)


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Yes, this is a Bracco system and it operates exactly as Michael has explained…the clinical dose assay occurs as the rubidium is injected into the patient. Sounds like I need to ask a few more questions about the daily QC process to advise if
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Yes, this is a Bracco system and it operates exactly as Michael has explained…the clinical dose assay occurs as the rubidium is injected into the patient. Sounds like I need to ask a few more questions about the daily QC process to advise if
Yes, this is a Bracco system and it operates exactly as Michael has explained…the clinical dose assay occurs as the rubidium is injected into the patient.  Sounds like I need to ask a few more questions about the daily QC process to advise if the facility will want to keep its current dose calibrator (they are transitioning from SPECT to the PET/CT system).  To make room for the scanner, however, the hope is to be able to get rid of the hot lab.  I’ll ask a few more questions of everyone involved.

That still leaves me with the question of any sites who might be completing QC at a facility that does not routinely receive/handle F-18?  If anyone has that experience I would be appreciative of understanding what TJC/IAC expects.  Otherwise, my current advice to the facility is that they will need to set up an agreement to receive F-18 from a pharmacy (with whom they don’t currently have an agreement) to receive QC doses and perform ACR prescribed QC.

Thanks for the responses.

Scott

On Jan 22, 2026, at 7:00 PM, Michael Masiar via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu> wrote:

The Rubidium generator I've seen (Bracco), has a built in scintillation detector that measures the dose as it leaves the generator. The patient gets hooked up to the generator device and it automatically gives the prescribed dose. You don't assay the dose in a dose calibrator prior to injection to the patient.

The system has a daily QC and calibration procedure though... The daily QC involves putting a dose into a vial and measuring with your dose calibrator...

So you don't assay the patient doses in a dose calibrator, but you do a QC procedure every morning that does go in the dose calibrator. I'm not sure how this could be done without one.

Michael Masiar MS DABR
Certified Medical Physicist
Therapy Physics, Inc.
2501 Cherry Ave., Suite 270
Signal Hill, CA 90755
email: mmasiar at gmail.com<mailto:mmasiar at gmail.com>
cell: 310-625-9906
office: 562-317-0650



On Thu, Jan 22, 2026 at 5:50 PM William Sensakovic via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>> wrote:
Thinking of 10cfr35.63

William F. Sensakovic, PhD, MRSC(MRSE), FAAPM
Chair and Assoc. Prof., Mayo Clinic (Arizona)
Founder, Telerad Physics Teaching, LLC
________________________________
From: William Sensakovic <wfsensak at outlook.com<mailto:wfsensak at outlook.com>>
Sent: Thursday, January 22, 2026 5:20:21 PM
To: DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>>
Subject: Re: [Intl_DxMedPhys] QC on Dedicated Cardiac PET/CT (IAC, TJC)

I did not think that would be allowed. If they are drawing from a generator themselves (instead of getting unit doses from the radiopharmacy) I thought they are required to assay dose before injection. I thought you can avoid dose assay only if you use a unit dose.
Am I mistaken?

William F. Sensakovic, PhD, MRSC(MRSE), FAAPM
Chair and Assoc. Prof., Mayo Clinic (Arizona)
Founder, Telerad Physics Teaching, LLC
________________________________
From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+wfsensak=outlook.com at lists.osu.edu<mailto:outlook.com at lists.osu.edu>> on behalf of Scott Fuller via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>>
Sent: Wednesday, January 21, 2026 1:52:36 PM
To: DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>>
Subject: [Intl_DxMedPhys] QC on Dedicated Cardiac PET/CT (IAC, TJC)

I’m working with a facility that intends to install a Rubidium dedicated PET/CT system.  They would like to do so without installing any sort of a hot lab or dose measuring equipment as there is no intention of using anything other than Rb-82 (seems ok from a clinical perspective and all vendors involved have supported this).

My question is, does anyone have experience providing QC support for a setup such as this?  A dedication Rubidium unit that is not able to order, prepare, or store longer lived isotopes such as F-18?  I’m unsure how one would go about supporting an image quality assessment and program without, at minimum, scanning a filled phantom.

For accreditation purposes, the facility is under the umbrella of IAC and Joint Commission.  It looks like IAC provides some flexibility and will want the facility to follow manufacturer requirements.  Joint Commission provides me with a bit more confusion as to how the facility would meet the expectations.

Thanks, in advance, for any prior experiences or insights shared.

Scott



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