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

[Steiner, Joseph [BSD]]

To add to what others have said, the facility should also consider the benefits of offering F-18 imaging, e.g.,

  *
Sarcoid and/or viability imaging
  *
Fluripiridaz MPI (and some sites are imaging much faster than "recommended" making it much more similar in duration to Rb-82)

Thanks,
Joe

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From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+joseph.steiner=bsd.uchicago.edu at lists.osu.edu> on behalf of Ward, James via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu>
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To: Erin Niven <macphys92 at yahoo.com>; Michael Masiar <mmasiar at gmail.com>; Scott Fuller <scott at imphysics.com>
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Subject: [EXTERNAL] Re: [Intl_DxMedPhys] QC on Dedicated Cardiac PET/CT (IAC, TJC)

I’d say you need a dose calibrator to do your Rb82 generator QC, specifically Sr82/85 breakthrough. If you’re US based, it’s needed to comply with 10cfr35. 204. I agree with needing F18 for QC. Since it’s only for QC, though, you could try to
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I’d say you need a dose calibrator to do your Rb82 generator QC, specifically Sr82/85 breakthrough. If you’re US based, it’s needed to comply with 10cfr35. 204. I agree with needing F18 for QC. Since it’s only for QC, though, you could try to

I’d say you need a dose calibrator to do your Rb82 generator QC, specifically Sr82/85 breakthrough. If you’re US based, it’s needed to comply with 10cfr35.204.



I agree with needing F18 for QC. Since it’s only for QC, though, you could try to put the “hot lab” in the corner or something with a lead bunker. You could also potentially store QC sources in there. I’d go with one of the thicker cabinets since it’s in the room, though.





James





From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+james.ward1=nm.org at lists.osu.edu> On Behalf Of Erin Niven via Intl_dxmedphys_wd_osu_list
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To: Michael Masiar <mmasiar at gmail.com>; Scott Fuller <scott at imphysics.com>
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Subject: Re: [Intl_DxMedPhys] QC on Dedicated Cardiac PET/CT (IAC, TJC)



I would think you would need at least a mini hot lab, with at least a shielded well counter, contamination monitor, spills kit, and waste container? As for QC, I would expect the need to receive and use F-18 for acceptance testing if undergoing

I would think you would need at least a mini hot lab, with at least a shielded well counter, contamination monitor, spills kit, and waste container?



As for QC, I would expect the need to receive and use F-18 for acceptance testing if undergoing accreditation.  And has the PET/CT vendor said you never need F-18?







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On Friday, January 23, 2026 at 12:20:28 a.m. NST, 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>> wrote:





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<mailto: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

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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

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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>>
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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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