The subresolution DaTSCAN phantom: a cost-effective, flexible alternative to traditional phantom technology

The Alderson striatal phantom is frequently used to assess (123)I-FP-CIT (Ioflupane) image quality and to test semi-quantification software. However, its design is associated with a number of limitations, in particular: unrealistic image appearances and inflexibility. A new physical phantom approach is proposed on the basis of subresolution phantom technology. The design incorporates thin slabs of attenuating material generated through additive manufacturing, and paper sheets with radioactive ink patterns printed on their surface, created with a conventional inkjet printer. The paper sheets and attenuating slabs are interleaved before scanning. Use of thin layers ensures that they cannot be individually resolved on reconstructed images. An investigation was carried out to demonstrate the performance of such a phantom in producing simplified (123)I-FP-CIT uptake patterns. Single photon emission computed tomography imaging was carried out on an assembled phantom designed to mimic a healthy patient. Striatal binding ratio results and linear striatal dimensions were calculated from the reconstructed data and compared with that of 22 clinical patients without evidence of Parkinsonian syndrome, determined from clinical follow-up. Striatal binding ratio results for the fully assembled phantom were: 3.1, 3.3, 2.9 and 2.6 for the right caudate, left caudate, right putamen and right caudate, respectively. All were within two SDs of results derived from a cohort of clinical patients. Medial–lateral and anterior–posterior dimensions of the simulated striata were also within the range of values seen in clinical data. This work provides the foundation for the generation of a range of more clinically realistic, physical phantoms.