Artifacts and image quality are two sides of the same coin. The ring artifact is scanner-based and caused mainly by either a miscalibrated element or a defective element of a detector row. We describe a rare cause of the ring artifact that appeared on a transaxial CT image because of a loose electronic contact. To our knowledge, this particular cause of the ring artifact has not been described in literature. Adi agnostic outcome from PET/CT imaging is the product of images that combine quality, reliability, and reproducibility. Hence, quality control testing of PET/CT equipment, both at acceptance and periodically, is mandatory to achieve the best results (1). Artifacts on CT images, though independent of PET image acquisition, can still degrade the quality of PET images during processing and interpretation (2). Non-scanner-based CT artifacts are caused mainly by improper selection of acquisition parameters and by metallic implants, patient motion, and improper patient preparation (2,3). Scanner-based artifacts may appear because of a sudden breakdown of the system.
CASE REPORTWe encountered the ring artifact on a transaxial CT image while performing routine PET/CT on a 64-slice timeof-flight Gemini TF 64 scanner (Philips) (Fig. 1A, arrows). The artifact persisted on the CT scan of the uniformity phantom (Fig. 1B, arrows) and remained even after cleaning of the Mylar (DuPont Teijin Films) window with warm water. The service engineer performed the bad-detector test to rule out the possibility that the artifact was caused by defective detector modules. Modules 21 and 26 did not pass the test. Two possibilities for the defect were suspected, either an electronic issue within the detector module or a loose connection between the module and the motherboard. Because the first cause would have required replacing the detector module, we tried to rule out the second cause-a loose connection. Both modules were reset in the motherboard, and the bad-detector test was repeated. This time the test did not reveal a problem with any of the modules, including 21 and 26. We then performed CT scanning of the uniformity phantom and found that the ring artifact had disappeared (Fig. 1D). We repeated the scan to confirm disappearance of the artifact. Before starting clinical imaging, we performed an air calibration test. We resumed clinical imaging after obtaining a satisfactory result from this test, and the ring artifact was not present on the clinical images (Fig. 1C).
DISCUSSIONThe CT artifacts described in literature are categorized as physics-based, patient-based, or scanner-based (3). Scanner