Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Mark T. Madsen
Radiology, University of Iowa
Jon A. Anderson
Radiology, University of Texas Southwest Texas Medical Center at Dallas
James R. Halama
Nuclear medicine, Loyola University Medical Center
Jeff Kleck
Attainia, Inc.
Douglas J. Simpkin
Radiology, St. Lukes Medical Center
John R. Votaw
Radiology, Emory University
Richard E. Wendt III
University of Texas MD Anderson Cancer Center
Lawrence E. Williams
Radiology, City of Hope Medical Center
Michael V. Yester
Radiology, University of Alabama at Birmingham Medical Center
Received 21 July 2005; revised 17 October 2005; accepted for publication 18 October 2005;
published 19 December 2005
The shielding of positron emission tomography PET and PET/CT computed tomography facili-
ties presents special challenges. The 0.511 MeV annihilation photons associated with positron
decay are much higher energy than other diagnostic radiations. As a result, barrier shielding may be
required in floors and ceilings as well as adjacent walls. Since the patient becomes the radioactive
source after the radiopharmaceutical has been administered, one has to consider the entire time that
the subject remains in the clinic. In this report we present methods for estimating the shielding
requirements for PET and PET/CT facilities. Information about the physical properties of the most
commonly used clinical PET radionuclides is summarized, although the report primarily refers to
fluorine-18. Typical PET imaging protocols are reviewed and exposure rates from patients are
estimated including self-attenuation by body tissues and physical decay of the radionuclide. Ex-
amples of barrier calculations are presented for controlled and noncontrolled areas. Shielding for
adjacent rooms with scintillation cameras is also discussed. Tables and graphs of estimated trans-
mission factors for lead, steel, and concrete at 0.511 MeV are also included. Meeting the regulatory
limits for uncontrolled areas can be an expensive proposition. Careful planning with the equipment
vendor, facility architect, and a qualified medical physicist is necessary to produce a cost effective
design while maintaining radiation safety standards 2006 American Association of Physicists in
Medicine. DOI: 10.1118/1.2135911
4 Med. Phys. 33 1, January 2006 0094-2405/2006/331/4/12/$23.00 2006 Am. Assoc. Phys. Med. 4
5 Madsen et al.: AAPM Task Group 108: PET and PET/CT Shielding 5
Positron
Decay maximum Photon Photons/
Nuclide Half-life mode energyMeV emissionkeV decay
11
C 20.4 min + 0.96 511 2.00
13
N 10.0 min + 1.19 511 2.00
15
O 2.0 min + 1.72 511 2.00
18
F 109.8 min +, EC 0.63 511 1.93
64
Cu 12.7 h , +, EC 0.65 511, 1346 0.38, 0.005
68
Ga 68.3 min +, EC 1.9 511 1.84
82
Rb 76 s +, EC 3.35 511, 776 1.90, 0.13
124
I 4.2 d +, EC 1.54, 2.17 511, 603, 1693 0.5,0.62,0.3
TABLE II. Effective dose equivalent dose rate constants for commonly used
PET radionuclides.
Transmission Factors
TABLE V. Fitting parameter for broad beam 511 keV transmission data.
Shielding
material cm1 cm1
tients antecubital vein over a period of 5 10 s. A built-in sources are positioned so that nearly all of the emitted pho-
ionization chamber, flow control valve, and calculator are tons are absorbed by the patient and the detectors of the PET
used to deliver the prescribed patient doses of either 740 or scanner. As a result, the additional dose from these transmis-
2220 MBq for 3D or 2D PET acquisitions, respectively. A sion sources to the surrounding area is negligible and can be
4 6 min single-position image acquisition begins 2 min fol- excluded from shielding calculations. The radiation from the
lowing the end of administration. This procedure is per- CT component of a PET/CT system does have to considered,
formed twice. During the first study the patients heart is at and that will be discussed below.
rest, while the second study begins after applying pharmaco-
logical stress. It is possible to complete both studies in RADIOACTIVITY ADMINISTRATION
30 min.7 Because of the short half-life of Rb-82, the dose
The amount of administered activity for F-18 FDG studies
levels from myocardial perfusion studies are at least a factor
depends to some extent on the mass of the patient, the length
of 2 less than that obtained from the studies performed with
of the uptake time, and the acquisition mode. Adults typi-
F-18 that are discussed in the next section.
cally receive 370 740 MBq of F-18 FDG, while pediatric
patients receive approximately 4 5 MBq/ kg.19 The amount
HOW F-18 FDG PET STUDIES ARE PERFORMED of radiotracer that can be administered differs with the ac-
F-18 FDG is a nonspecific tracer for glucose metabolism quisition mode and limits of the PET tomograph as previ-
that is taken up normally in the brain, heart, bone marrow, ously discussed.
bowel, kidneys, and activated muscles. It also concentrates in Because of the number of variables involved in determin-
many metabolically active tumors, making it a powerful di- ing the administered activity, it becomes necessary to gather
agnostic agent for a large number of cancers. To reduce up- information from the institution on the study mix, preference
take in skeletal muscles, the patients must be kept in a qui- for 2D and 3D acquisitions, radiotracer uptakes times, and
escent state before and after the administration of the F-18 match those with the specific recommendations made by the
FDG in either a bed or chair. This uptake time is 30 90 min PET tomograph vendor. For illustrations that follow in this
depending on the type of scan and the practices of the insti- report, it will be assumed that the F-18 FDG dose is
tution. A patient preparation room for this uptake phase is a 555 MBq 15 mCi with an uptake time of 60 min.
requirement for all PET facilities and must be included in the
radiation safety planning. It should be noted that a busy PET FACTORS AFFECTING DOSE RATES FROM
facility will often have more than one patient in the uptake RADIOACTIVE PATIENTS
area and this needs to be considered when performing shield- In this section the parameters associated with dose rate
ing calculations. After the uptake period, the patient should from positron-emitting sources are discussed; Table VI has a
void to clear the radioactivity that has accumulated in the summary of the terms that are used. The patient is the pri-
bladder; approximately 15%20% of administered activity is mary source of radiation that needs to be considered. In de-
excreted within the first 2 h.17,18 It is a good idea to have a termining the radiation dose from the patient to the surround-
bathroom reserved for PET patients within the immediate ing areas, the following points must be considered.
imaging area so that they do not alter the background counts
of other detection devices as they pass though the clinic.
Dose rate constant
After voiding, the patient is positioned on the tomograph for
the procedure. The patient is translated though the tomo- The appropriate dose rate constant for F-18 for shielding
graph in a step and shoot fashion. Images are acquired at 6 to purposes is 0.143 Sv m2 / MBq h, and the dose rate associ-
10 bed positions over a 15 60 min interval. The patient may ated with 37 MBq 1 mCi of F-18 is 5.3 Sv/ h at 1 m from
be released immediately following the procedure or may go an unshielded point source.
to a waiting area while the PET study is reviewed. If the
patients are kept in the clinic for any length of time after the Patient attenuation
study is completed, that area must also be included in the
Since the body absorbs some of the annihilation radiation,
radiation safety planning. Because of the high penetration of
the dose rate from the patient is reduced by a significant
annihilation radiation, all surrounding areas in the vicinity of
factor. A number of papers have been published where direct
the PET imaging clinic must be considered for shielding cal-
measurements have been made at different orientations from
culations. This includes areas above and below the PET
the patient.2027 These reported values were normalized for
clinic as well as adjacent areas on the same floor.
the amount of administered activity and measurement dis-
tance, and were also corrected for radioactive decay back to
TRANSMISSION SOURCES the administration time. Based on the mean of these cor-
Conventional PET systems use either Ge-68 or Cs-137 rected results, the Task Group recommends using a patient
radionuclide sources for acquiring the transmission studies dose rate of 0.092 Sv m2 / MBq h 3.4 Sv m2 / h / 37 MBq
that are required for attenuation compensation. These sources immediately after administration. This corresponds to an ef-
are located in shielded containers except for the time that fective body absorption factor of 0.36, which is in good
they are actively being used to acquire the transmission por- agreement with the total body absorption factor of 0.34 for
tion of the PET scan. During the transmission study, the 500 keV photons calculated by Snyder et al.28
Rt = Dt/D0 t RtU/dm2 . 3
For F-18, this corresponds to Rt factors of 0.91, 0.83, and B = 10.9 P dm2/T NW AoMBq tUh RtU.
0.76 for t = 30, 60, and 90 min, respectively. 4
T is the occupancy factor and P is the weekly dose limit in
Regulatory limits Sv. In the US, P = 20 Sv for uncontrolled areas, corre-
The federal code of regulations 10 CFR20 establishes the sponding to the 1 mSv/ year limit to the general public and
dose limits in controlled radiation areas and uncontrolled ar- P = 100 Sv for ALARA levels in controlled areas. Thus, for
eas open to the general public. Under these regulations, the uncontrolled areas
facility must be shielded so that the effective dose equivalent B = 218 dm2/T NW AoMBq tUh RtU
in uncontrolled areas does not exceed 1 mSv/ year or 20 Sv
5
in any 1 h. The 1 mSv/ year limit implies a weekly dose
limit of 20 Sv, and this limit becomes the determining fac-
=5.89 dm2/T NW AomCi tUh RtU.
tor for shielding calculations in uncontrolled areas. The oc-
cupational dose limit in controlled areas is 50 mSv/ year. 6
Most shielding calculations use a target level of 5 mSv/ year And, for controlled areas at ALARA levels
in controlled areas to be consistent with ALARA recommen-
dations. B = 1090 d2/T NW AoMBq tUh RtU 7
the patient chair in an uptake room? Assume patients are B = 10.9 P dm2/T NW AoMBq 0.85
administered 555 MBq of F-18 FDG, there are 40 patients
per week, and the uptake time is 1 h. FUtIh RtI. 10
218 MBq h/m24 m2/40 555 MBq 1 h 0.83 = 0.189. Thus, the transmission factor for uncontrolled areas is
Using Table IV values, 1.2 cm of lead or 15 cm of concrete B = 256 dm2/T NW AoMBq FU tIh RtI.
shielding is required. 11
TABLE VII. Sample calculation for a dedicated PET Facility Fig. 4. This calculation is based on the following assumptions: 40 patients per week, 555 MBq
administration, 1 h uptake, and 30 min imaging time. Transmission data are measured with sources built into the camera that do not significantly increase the
exposure of personnel.
the patient into the room and position them for the scan, the sponding transmission factors are also included in Table VII.
effective reduction is realistically about 15%. The example The required lead shielding for the uptake and scanner rooms
below does not include this reduction. is given in Table VIII.
Example 3
TABLE VIII. Lead shielding requirements for example PET facility Fig. 4.
Figure 4 shows an example of a PET facility layout that
will image 40 patients per week with an average adminis- Uptake room Tomographroom
tered activity of 555 MBq. The uptake time is 1 h and the Walls Shielding mm Pb Shielding mmPb
imaging time is 30 min for each study. Table VII gives in-
N 0 0
formation on the distances from potential sources in the up-
E 5 3
take room and PET tomograph room to points of interest, S 5 0
along with the target weekly dose values and occupancy fac- W 2 12.1
tors. The calculations for the weekly doses and the corre-
desirable to reduce the control room exposure well below diagnostic CT scanner, although the area scanned per patient
5 mSv/ year. If the operator console cannot be located more will be higher. Typical techniques used for the CT portion of
than 2.32 m from the scanner, additional shielding should be the study would be 135 kVp, 80 mAs, and 125 150 cm
installed to reduce the dose to below ALARA levels. This axial scan length. Currently, many PET/CT facilities are per-
shielding could be placed in a walled partition between the forming nondiagnostic CT scans without contrast agents,
technologist and scanner similar to that designed for a CT which accounts for the lower technique values given above.
scanner or alternatively, movable lead shields could be used. The trend in the future may shift toward performing higher
quality diagnostic CT studies, resulting in higher doses re-
ADJACENT ROOMS ON THE SAME LEVEL IN quiring more shielding. It is important to determine whether
CONTROLLED AREAS the CT scanner will be used a portion of the time solely for
Badged individuals working in rooms adjacent to PET diagnostic CT studies. This additional workload must be in-
uptake and scanning rooms should also be considered. Many cluded in the shielding calculations for the CT component.
clinics set their ALARA limits at 5 mSv/ year, and this level It should be noted that the lead shielding required in the
can be exceeded for workers in rooms adjacent to the uptake walls for the CT system alone ignoring the PET component
area if the distance from the radioactive patients is less than will have only a modest shielding effect for the 511 keV
4 m and their work keeps them relatively stationary though- annihilation radiation. For example, 1.6 mm of lead will pro-
out the day. Careful planning of the workflow around the vide a transmission factor of only 0.81 for the annihilation
PET facility can minimize this occurrence, and if necessary, radiation. Because the HVL for the CT x rays is so much
additional lead shielding can be employed. smaller than that for 511 keV photons, a room that is
shielded to meet the general public levels for PET
DESIGN CONSIDERATIONS 1 mSv/ year is unlikely to need additional shielding for the
CT component. However, there are situations where minimal
Using the assumptions given above for a busy PET center shielding of the PET radiation component is required to meet
average administered activity 555 MBq, uptake time the 5 mSv/ year in controlled areas. This would occur in
60 min, and 40 patients per week, the distance required to many clinics when the distance from the source to the area of
maintain a weekly dose equivalent below 20 Sv for a busy concern is greater than 3 m. In such circumstances, the CT
PET facility is 9.3 m. Since it is unlikely that rooms will be shielding will be the primary concern.
either large or isolated enough to accommodate this distance,
some additional shielding will be required. New facilities can
efficiently use concrete to achieve required shielding factors. SHIELDING OF THE PET TOMOGRAPH FROM
In existing facilities, lead is often the best resort. Portable AMBIENT RADIATION
lead shields can be used effectively to shield patients in up- The PET tomograph itself, especially when operated in
take rooms where they are required to remain stationary. 3D mode, can be highly sensitive to ambient radiation, such
Lead shields 2.5 and 5.0 cm thick are commercially avail- as that from an adjacent patient uptake room. One PET ven-
able, providing dose reduction factors of 40 and 1900, re- dor specifies that the ambient radiation level must be
spectively. Using shields in the tomograph room may be 0.1 mR/ h for correct operation. However, it is unlikely
more problematic because the patient is translated though the that a source from a patient in an adjacent room would affect
gantry and thus moves with respect to the shield. In addition the scanner as much as the activity in the patient being im-
the shields can restrict access to the patient. aged that is outside the tomograph field of view. It may be
Planning for new PET facilities should carefully consider possible to minimize the effect with the orientation of the
the constraints associated with the regulatory limits. Uncon- PET tomograph, and it is worthwhile to discuss this issue
trolled areas with high occupancy should be located as far with the vendor in the planning stages of the installation. The
from the PET uptake and imaging rooms as possible. Also, vendor may also be able to provide a contour map describing
the placement of the door must be carefully considered to the safe distances that unshielded sources may be located.
avoid the expense with installing a door with substantial lead
shielding. If uncontrolled areas are located above and below
the PET uptake and tomograph rooms, the spacing between PET FACILITIES LOCATED IN NUCLEAR MEDICINE
floors may need to be greater than normal. If that is not DEPARTMENTS
feasible, the floors need to be able support the weight asso- If a PET scanner is installed within a nuclear medicine
ciated with additional shielding. Floors often but not al- clinic where gamma cameras, uptake probes, or other scin-
ways have 10 cm of concrete, which will provide a dose tillating counters are located in adjoining areas, consider-
reduction factor of 2.5. ation for the effect of the annihilation radiation must be
made. Reasonable efforts should be made to place the PET
PET/CT INSTALLATIONS scanner, patient waiting and uptake rooms, radiotracer stor-
The shielding considerations for the CT portion of the age, and dose administration areas as far away from sensitive
PET/CT systems are substantially the same as they would be counting equipment as possible. Consolidating these instru-
for any CT installation.33 The number of patients examined ments to a remote corner of the facility is the most preferable
in a PET/CT system will generally be less than that of a solution in terms of shielding.
The devices most affected by the presence of radioactive background count rate is 592 000 CPM. How much shielding
PET patients are thyroid uptake probes and scintillation well is required to reduce the 511 keV background rate to 1000
counters. These devices should be located away from the CPM?
PET tomograph and uptake rooms and should also be re- The transmission factor is 1000/ 592 000= 0.0017. Using
moved from proximity to restrooms used by the PET pa- Fig. 1, a barrier of 3.9 cm of lead is required.
tients. The lead required in the above example is substantial, and
Patients injected with positron-emitting radionuclides will is much greater than needed to protect personnel in the area.
increase the background count rate of devices in their vicin- Limiting the required thickness to cover just the critical area
ity. Inevitably, radioactive PET patients will be traversing of the wall will reduce the cost significantly. It may be pos-
though the hallways of the imaging area. The significance of sible to purchase a rolling radiotherapy shield of similar
changes in the background count rate must be assessed for thickness to provide the necessary barrier.
each device in relation to the type of exam being performed
e.g., a quantitative uptake study that could easily be cor-
rupted by inaccurate measurements of the background or SUMMARY AND CONCLUSIONS
calibration standard counts and the length of time of in-
creased exposure. Technologists should be instructed to The shielding requirements for a PET facility are different
move the radioactive PET patients past nuclear medicine in- from those of most other diagnostic imaging facilities. This
strumentation at a reasonable pace and should not let them is due to the high energy of the annihilation radiation and the
remain in the vicinity of detection systems for an extended fact that the patient is a constant source of radiation through-
length of time. Likewise, the positron radiotracers must be out the procedure. Meeting the regulatory limits for uncon-
contained in properly designed shielding as they are being trolled areas can be an expensive proposition. Careful plan-
transported though the department in the vicinity of imaging ning with the equipment vendor, facility architect, and a
or detection systems. qualified medical physicist is necessary to produce a cost-
For scintillation cameras in close proximity to PET imag- effective design while maintaining radiation safety standards.
ing areas, the following considerations should be kept in 1
J. C. Courtney et al., Photon shielding for a positron emission tomogra-
mind. Although the sensitivity of the NaITl crystal to phy suite, Health Phys. 81, S2428 2001.
511 keV photons is low, low- and medium-energy collima- 2
M. P. Frick et al., Considerations in setting up a positron emission to-
tors do not absorb a high fraction of 511 keV photons. Thus, mography center, Semin Nucl. Med. 22, 182188 1992.
3
the background counts from annihilation photons can be sig- K. J. Kearfott et al., Radiation protection design for a clinical positron
emission tomography imaging suite, Health Phys. 63, 581589 1992.
nificant, but the distribution of counts is fairly uniform 4
B. M. Methe, Shielding design for a PET imaging suite: a case study,
across the camera field of view. Gamma camera studies with Health Phys. 84, S8388 2003.
5
the detector directed toward the floor or ceiling are not likely M. D. Harpen, Positronium: Review of symmetry, conserved quantities
and decay for the radiological physicist, Med. Phys. 31, 5761 2004.
to be significantly affected by positron emitters in the adja- 6
P. Alagona, Jr., D. T. Hart, and E. A. Eikman, Regional distribution of
cent rooms. However, substantial increases in the back- 2-deoxy-218F-fluoro-D-glucose for metabolic imaging using positron
ground rate will be recorded if the camera is pointed directly emission tomography, Int. J. Card. Imaging 10, 137143 1994.
7
at a positron-emitting source such as a radioactive patient. As H. R. Schelbert et al., PET myocardial perfusion and glucose metabo-
lism imaging: Part 2-Guidelines for interpretation and reporting PET
a result, SPECT cameras should not be placed adjacent to a myocardial glucose metabolism and perfusion imaging: Part 1-Guidelines
PET scanning or uptake room unless the detectors can be for data acquisition and patient preparation, J. Nucl. Cardiol. 10, 557
oriented so they will not point at a 511 keV source during 571 2003.
8
the SPECT acquisition. ANS, ANSI/ANS-6.1.1-1991: Neutron and Gamma-Ray Fluence-To-Dose
Factors American Nuclear Society, LaGrange Park, IL, 1991.
If scintillation cameras are located in adjoining rooms of 9
ANS, ANSI/ANS-6.1.1-1977: Neutron and Gamma-Ray Fluence-To-Dose
the PET scanner and patient waiting areas, shielding may Factors American Nuclear Society, LaGrange Park, IL, 1977.
10
become necessary to reduce the background count rate. Ac- B. R. Archer, J. I. Thornby, and S. C. Bushong, Diagnostic X-ray shield-
tual background measurements with a known activity of a ing design based on an empirical model of photon attenuation, Health
Phys. 44, 507517 1983.
positron-emitting source are recommended. The background 11
NCRP, NCRP Report 49: Structural Shielding Design and Evaluation for
should be measured at the energy window used for the scin- Medical Use of X Rays and Gamma Rays of Energies up to 10 MeV
tillation camera exams and with the camera rotated to the National Council on Radiation Protection, Bethesda, MD, 1976.
12
most compromising angle encountered when performing a German Deutsches Institut fr Normung, 6844-3. Nuklearmedizinische
Betriebe; Strahlenschutzberechnungen Installations for nuclear medicine;
routine exam. The following example should help provide radiation protection calculations 19892009.
insight into how much shielding may be required. 13
D. J. Simpkin, Shielding requirements for constant-potential diagnostic
x-ray beams determined by a Monte Carlo calculation, Health Phys. 56,
151164 1989.
14
F. H. Fahey et al., Positron emission tomography instrumentation design
Example 7 considerations for PET scanners, Radiol. Clin. North Am. 39, 919929
2001.
15
The PET uptake room is located next to a room with an H. Everaert et al., Optimal dose of 18F-FDG required for whole-body
PET using an LSO PET camera, Eur. J. Nucl. Med. Mol. Imaging 30,
existing single-head gamma camera used principally for Tc- 16151619 2003.
99m imaging. When the collimated detector head points di- 16
G. Muehllehner, J. S. Karp, and S. Surti, Design considerations for PET
rectly towards a patient in the uptake room, the measured scanners, Q. J. Nucl. Med. 46, 1623 2002.
17
S. C. Jones et al., The radiation dosimetry of 2 F-18fluoro-2-deoxy-D- from patients undergoing PET: Implications for technologists and waiting
glucose in man, J. Nucl. Med. 23, 613617 1982. areas, Eur. J. Nucl. Med. 27, 583589 2000.
18 26
D. Swanson, H. Chilton, and J. Thrall, Pharmaceuticals in Medical Im- S. White et al., Occupational exposure in nuclear medicine and PET,
aging Macmillan Publishing Company, New York, 1990. Clin Positron Imaging 3, 127129 2000.
19 27
E. A. Wegner et al., The impact of PET scanning on management of B. W. Zeff and M. V. Yester, Patient self-attenuation and technologist
paediatric oncology patients, Eur. J. Nucl. Med. Mol. Imaging 32, 2330 dose in positron emission tomography, Med. Phys. 32, 861865 2005.
28
2005. W. Snyder et al., MIRD Pamplet 5: Estimates of absrobed fractions for
20
A. Bixler, G. Springer, and R. Lovas, Practical aspects of radiation monenergetic photon sources uniformly distributed in various organs of a
safety for using fluorine-18, J. Nucl. Med. Technol. 27, 1416 1999. heterogeneous phantom, J. Nucl. Med., Suppl. 10 Supplement 3, 4445
21
T. F. Brown and N. J. Yasillo, Radiation safety considerations for PET 1969.
29
V. A. McCormick and J. A. Miklos, Radiation dose to positron emission
centers, J. Nucl. Med. Technol. 25, 98102 1997; quiz, 104105.
22 tomography technologists during quantitative versus qualitative studies,
C. Chiesa et al., Radiation dose to technicians per nuclear medicine
J. Nucl. Med. 34, 769772 1993.
procedure: comparison between technetium-99m, gallium-67, and iodine- 30
N. L. McElroy, Worker dose analysis based on real time dosimetry,
131 radiotracers and fluorine-18 fluorodeoxyglucose, Eur. J. Nucl. Med.
Health Phys. 74, 608609 1998.
24, 13801389 1997. 31
C. D. Greaves and W. B. Tindale, Dose rate measurements from radiop-
23
B. Cronin, P. K. Marsden, and M. J. ODoherty, Are restrictions to harmaceuticals: Implications for nuclear medicine staff and for children
behaviour of patients required following fluorine-18 fluorodeoxyglucose with radioactive parents, Nucl. Med. Commun. 20, 179187 1999.
positron emission tomographic studies? Eur. J. Nucl. Med. 26, 121128 32
M. Griff, T. Berthold, and A. Buck, Radiation exposure to sonographers
1999. from fluorine-18-FDG PET patients, J. Nucl. Med. Technol. 28, 186
24
T. M. Lundberg, P. J. Gray, and M. L. Bartlett, Measuring and minimiz- 187 2000.
33
ing the radiation dose to nuclear medicine technologists, J. Nucl. Med. P. Lin and T. Beck, AAPM Report No. 39: Specification and Acceptance
Technol. 30, 2530 2002. Testing of Computed Tomography Scanners AAPM, New York, 1993,
25
N. A. Benatar, B. F. Cronin, and M. J. ODoherty, Radiation dose rates p. 95.