Charge-coupled devices (CCDs) coupled to scintillation crystals can be used for high resolution imaging with x-rays and gamma-rays. When the CCD images can be read out fast enough, the energy and interaction position of individual gamma quanta can be estimated by real-time image analysis of scintillation light flashes ('photon counting mode'). We tested a set-up in which an electron-multiplying CCD was coupled to a 1 mm thick columnar CsI crystal by means of a fibre-optic taper. We found that, compared to light integration, photon counting improves the intrinsic spatial resolution by a factor of about 3 to 6. Applying our set-up to Tc-99m and I-125 imaging, we were able to obtain intrinsic resolutions below 60 microm (full width at half maximum). Counting losses due to overlapping of light flashes are negligible for event rates typical for biomedical radio-nuclide imaging and do strongly depend on energy window settings. Energy resolution was estimated to be approximately 35 keV FWHM for a 1:1 taper. We conclude that CCD-based gamma cameras have great potential for applications such as in vivo imaging of gamma emitters.

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