# Comparative Assessment of Agreement in Uniformity Analyses across Quality Control Software Platforms

## TL;DR

This study compares different software tools for quality control in nuclear medicine to ensure accurate gamma camera performance.

## Contribution

The study evaluates agreement between integrated and free QC software for gamma camera uniformity analysis.

## Key findings

- Integrated QC software showed reliable uniformity analysis aligned with NEMA standards.
- Free tools showed mean differences under 2% for differential uniformity.
- Variations in computed values may come from pixel values and data corrections.

## Abstract

Objective
 In nuclear medicine, quality control (QC) activities adhere to international standards, yet their complexity can pose challenges. Gamma camera manufacturers have introduced integrated QC software, offering instantaneous results. However, the agreement of these automated processes with established protocols remains uncertain. This study aims to clarify this uncertainty by comparatively analyzing uniformity from various software solutions for a dual-head gamma camera.

Methods
 The study utilized integrated QC analysis software and three free QC analysis tools (IAEA-NMQC Toolkit, NM Toolkit, and Fiji) for uniformity analyses. Following the National Electrical Manufacturers Association standards, NEMA Standards Publication NU 1-2018, the intrinsic uniformity test was performed on a GE Discovery NM/CT 670 Pro system. Ten uniformity QC images underwent analysis with both integrated QC software and alternative software. Data agreements were tested using the Blant–Altman regression-based analysis.

Results
 Significant differences were observed in integral and differential uniformities (
p
 < 0.001). The central field of view (useful field of view) integral uniformity mean differences for NMQC Toolkit, NM Toolkit, and Fiji were 2.46% (2.34%), 2.44% (2.31%), and 2.56% (2.64%), respectively. Conversely, x-differential and y-differential uniformity mean differences were consistently under 2%. Regression-based analysis confirmed good agreement between computed values.

Conclusion
 The integrated QC software of Discovery NM/CT 670 Pro provides reliable uniformity analysis, aligned with the NEMA standards. Variations in computed values may stem from differences in pixel values and applied data corrections.