Detail Package
Procurement of SPECT-CT
Project
SIHREN Parallel Financing
Project Description
Strengthening Indonesia's Healthcare Referral Network (SIHREN IsDB): a parallel financing IsDB for the referral hospital component.
Package Name
Procurement of SPECT-CT
Loan No.
IDN-1070
Activity Reference No.
KS.01.02/A.VI/6120/2024
Market Approach
International Open
Procurement Method
Request for Bids (RFB) - 1 Stage 2 Envelope (Rated Criteria)
Estimated Total Cost
€50,399,817.62
Currency
Euro
Stages
Contract Signed
Bid Submission Deadline
05 Feb 2025
Package Lot
| Name Of Lots | Units | Amount |
|---|---|---|
| Lot 1: Procurement of SPECT-CT | 21 | €44,515,548.80 |
| Lot 2: Procurement of SPECT-CT | 18 | €5,884,268.82 |
Documentation
Responses to Clarification of Bidding Document (Procurement of SPECT-CT)
| No. | Date of Received | Question | Responses | Part (RFB) | Cluster | Sub Cluster |
|---|---|---|---|---|---|---|
| 1 | 2024-11-05 | Line 127 : Perfusion Imaging Required Specifications: Preferred We request to kindly remove this item "Perfusion Imaging" Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/ diagnostic CT procedures in addition to SPECT/CT imaging, in other word if this system is intended to be run as a shared service between Nuclear Medicine and Radiology departments. CT Perfusion Imaging is generally performed in Radiology departments. This is usually not in the scope of Nuclear Medicine departments and to our knowledge Nuclear Medicine physicians in Indonesia are not certified in reading diagnostic CT cases. Should the system be intended primarily to provide Nuclear Medicine imaging services we would request to remove "Perfusion Imaging". |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to the bidder's suggestion understanding the User's direction of SPECT-CT services is under Nuclear Medicine department, the specification is amended and removed. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 2 | 2024-11-05 | Line 189 : b) Standard Sofware Modules/Functionality Requirement: Equipped with internal dosimetry software for evaluating patient absorbed dose, according to IAEA QUANUM nuclear medicine standards. We kindly request to remove this item. Among the technical and clinical reasons listed below, it also constitutes a potential exclusion criterion for all but one equipment vendor in the market. Reasons 1. Currently only one equipment vendor has an internal dosimetry solution. This item might exclude all other vendors from being able to offer competitively in this tender. 2. The QUANUM nuclear medicine standards are not referring to internal dosimetry software as an assessment tool. Commonly patients receiving radioligand therapies are assessed with a radiation detector or dose meter - external devices - before being released from the treatment facility. In contrast, internal dosimetry software is not used for that purpose. It is a specialized software that can calculate the absorbed dose for a tissue from the radioactive activity the patient receives measured with SPECT/CT. It is not used to assess if a patient leaving the treatment facility is a radiation risk to the public. 3. Internal dosimetry is used exclusively to assess the dose absorbed in tissue after radioligand therapies. In Indonesia the draft of the BPJS indicates a fixed dose for Lu177 radioligand-therapies. The dose is below levels of FDA approved therapies. The procedure guidelines for drugs of such low treatment doses do not require patient individual dosimetry as per the VISION clinical trial (EANM guideline). References: QUANUM 3.0: An updated tool for nuclear medicine audits. Chapter 4.9 Radionuclide therapy https://www-pub.iaea.org/MTCD/Publications/PDF/PUB1923_web.pdf Joint EANM/SNMMI procedure guideline for the use of 177Lu-labeled PSMA- targeted radioligand-therapy (177Lu-PSMA-RLT) https://pmc.ncbi.nlm.nih.gov/articles/PMC10317889/ |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. There are multiple third-party software's that can perform internal dosimetry measurements such as QDOSE and OLINDA/EXM |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 3 | 2024-11-05 | 1. Line 62 : System sensitivity, LEAP, cpm/µCi Requirement: ≥ 190 Proposal Specifications: System sensitivity, Low energy collimator, cpm/µCi at 10 cm Proposal Requirement: ≥ 160 We kindly request to amend the request to "Low energy collimator" instead of LEAP and change the sensitivity to ≥ 160 cpm/µCi at 10 cm. Reasons There are different low energy collimators available on SPECT/CT systems. Today the most used collimators for low energy are "Low Energy High Resolution" (LEHR) collimators (names can differ slightly across vendors). Because collimator holes are smaller and deeper on LEHR compared to LEAP collimators, the LEHR has better resolution than LEAP collimators because it accepts fewer scattered gamma rays. This makes the LEHR collimators a better general purpose gamma camera collimator as it produces higher quality images and better quantification for clinical use. LEHR collimators obtain higher resolution images than LEAP: smaller and elongated collimator holes results in more holes within the same collimator FOV, therefore giving better spatial resolution. We would therefore kindly request to specify "Low energy collimator" instead of LEAP and change the sensitivity to ≥ 160 cpm/µCi at 10 cm" to allow LEHR collimators to comply for a wider clinical utility for the SPECT/CT systems provided for a default configuration. References: Quantitative assessment of 99mTc-MIBI GSPECT performed with LEAP collimation compared to the standard LEHR method https://jnm.snmjournals.org/content/47/suppl_1/272P.1.short |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Different manufacturers uses different naming systems for their collimators, with different types of collimators having different levels of sensitivity and resolutions (both interrelated, higher on sensitivity means lower resolution, and vice versa) understanding the relationship of sensitivity and resolution (sensitivity affects resolution, and resolution is preferred over sensitivity). Bidders to state the sensitivity of the collimator types (low, medium and high energies), to ensure neutrality of the specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 4 | 2024-11-05 | Line 28 : Auto vessel mapping Requirement: Preferred We suggest to kindly remove "Auto vessel mapping" Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/diagnostic CT procedures in addition to SPECT imaging studies (i.e. if this system is intended to be a shared service between Nuclear Medicine and Radiology departments). Auto vessel mapping is generally performed in Radiology departments. This is usually not in the scope of Nuclear Medicine departments and to our knowledge Nuclear Medicine physicians in Indonesia are not certified in reading diagnostic CT cases. Should the system be intended primarily to provide Nuclear Medicine services we would request to remove "Auto vessel mapping". |
Many thanks for this feedback. As this specification is rated criteria, the bidder can choose to comply or not. MoH will retain the current specification. Auto mapping is a preferred specs, similar to other vessel scanning; to remain neutral for other models that may able to provide this additional feature. Back up CT are for images to be sent to the radiologist for reporting; added provisions of CT services within nuclear medicine SPECT CT, unless the CT is only for SPECT-CT requirements. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 5 | 2024-11-05 | Line 208 : Consumables needed Required Specifications: Bidder to specify itemized quantity for 100 typical patient procedures Proposal Technical Specifications: Consumables needed Proposal Required Specifications: Bidder to specify itemized quantity for 100 typical patient procedures. Radiopharmaceuticals are not to be provided. Please kindly clarify whether the request for consumables includes radiopharmaceuticals for patient injection/ scans. Reason We would propose to exclude the supply of radiopharmaceuticals and related consumables explicitly as it is at that moment difficult for vendors to understand what companies could supply radiopharmaceuticals to which hospital, what are the clinical needs (different radiopharmaceuticals needed), and the patient population at each hospital. All of that would require a very detailed analysis and discussion with each hospital to derive a supply plan. |
Many thanks for this feedback. As this specification (white cell), the bidder can describe the proposed specification. MoH will retain the current specification. The informational specification (white) for the bidder to provide consumables for the full functionality of the SPECT-CT system proposed. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 6 | 2024-11-05 | New : Imaging of radio-ligand therapies Requirement: Able to image Lu-177 and Y-90 Proposal Specifications: Imaging of radio-ligand therapies Proposal Requirement: Required; Able to image Lu-177 and Y-90 We kindly would like to clarify if imaging services of radio-ligand therapies, especially the isotopes Lu-177 and Y-90 would need to be provided. Lutetium-177 (Lu-177) isotope is a promising radionuclide for the treatment of neuroendocrine tumors and prostate cancer. It has a therapeutic beta-energy of 0.5 MeV and two main gamma-energies of 113 and 208 keV (6.1% and 10.3% yield) used for imaging to evaluate the radiotracer biodistribution. Using ME collimator and 20% energy window is enough to improve Lu-177 SPECT image to its fullest extent. If it is intended for Nuclear Medicine departments to be equipped to offer either clinical service for Lu-177 or Y-90 imaging, we would kindly propose to add this as an explicit requirement. Reference: Energy Window and Collimator Optimization in Lutetium-177 Single-photon Emission Computed Tomography Imaging using Monte Carlo Simulation https://pmc.ncbi.nlm.nih.gov/articles/PMC6958958/ |
Many thanks for this feedback. The bidder can choose to comply or not. MoH will retain the current specification. The radio-ligand therapies requirement depends on the clinical application to be implemented and this feature is supported by a Medium-energy collimator Bidder is provided the option to describe the proposed model i.e., imaging capabilities of radio-ligand therapies under specification "Others, if any" that is part of the "Advanced Image Acquisition" |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 7 | 2024-11-05 | Line 27 : Body perfusion Requirement: Preferred We kindly request to clarify if this statement on "Body perfusion" refers to SPECT or CT-only imaging studies. Proposal Technical Specifications: SPECT perfusion studies Proposal Requirement: Preferred Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/diagnostic CT procedures in addition to SPECT imaging studies (ie. if this system is intended to be a shared service between Nuclear Medicine and Radiology departments). CT perfusion imaging is generally performed in Radiology departments, such as CT Brain perfusion for acute stroke suspicion, in emergency events. This is usually not in the scope of Nuclear Medicine departments, and to our knowledge Nuclear Medicine physicians in Indonesia are not certified to read and report diagnostic CT cases, in particular contrast-enhanced CT Brain perfusion studies. If the system is intended to be primarily used to provide Nuclear Medicine imaging services, we request to modify the request to "SPECT perfusion studies" |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. The Body perfusion refers to the usage of SPECT-CT for body perfusion studies. The body perfusion studies involved imaging test that measures blood flow throughout the body by injecting a small amount of radioactive tracer into the bloodstream, then using a SPECT scanner to capture detailed 3D images of how the tracer distributes in different tissues. Amended specification "for SPEC-CT body perfusion studies" for bidder to clarify. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 8 | 2024-11-05 | Line 121 : Arrhythmia Correction Required Specifications: Preferred We request to kindly remove "Arrhythmia Correction" We kindly would also like to confirm that "Arrhythmia Correction" means "image quality correction in case of arrhythmia". Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/ diagnostic CT procedures in addition to SPECT/CT imaging, in other word if this system is intended to be run as a shared service between Nuclear Medicine and Radiology departments. Arrhythmia imaging for CT is generally performed in Radiology departments. This is usually not in the scope of Nuclear Medicine departments and to our knowledge Nuclear Medicine physicians in Indonesia are not certified in reading diagnostic CT cases, in particular cardiac CT. Should the system be intended primarily to provide Nuclear Medicine services we would request to remove "Arrhythmia Correction". |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to the bidder's suggestion understanding the User's direction of SPECT-CT services is under Nuclear Medicine department, the specification is amended and removed. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 9 | 2024-11-05 | Line 149 : Calcium scoring Required Specifications: Preferred We kindly request to remove "Calcium scoring" Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/ diagnostic CT procedures in addition to SPECT/CT imaging, in other word if this system is intended to be run as a shared service between Nuclear Medicine and Radiology departments. Calcium Scoring is generally performed in Radiology departments. This is usually not in the scope of Nuclear Medicine departments and to our knowledge Nuclear Medicine physicians in Indonesia are not certified in reading diagnostic CT cases, in particular cardiac CT. Should the system be intended primarily to provide Nuclear Medicine imaging services we would request to remove "Calcium Scoring". |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to the bidder's suggestion understanding the User's direction of SPECT-CT services is under Nuclear Medicine department, the specification is amended and removed. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 10 | 2024-11-05 | "3. New : Thyroid Imaging Requirement: Required; Able to image I-131. Proposal Specifications: Thyroid Imaging Proposal Requirement: Required; Able to image I-131 We kindly would like to clarify if Thyroid imaging and treatment services would need to be provided. Iodine-131 (I-131) is a non-invasive radionuclide imaging procedure used to visualize functionality of thyroid tissue, detect metastatic thyroid cancer, and assess the remaining thyroid tissue after thyroidectomy. If it is intended for Nuclear Medicine departments to be equipped to offer this clinical service, we would kindly propose to add this as an explicit requirement. Reference: Iodine-131 Uptake Study https://www.ncbi.nlm.nih.gov/books/NBK559283/" |
"Many thanks for this feedback. The bidder can choose to comply or not. MoH will retain the current specification. Bidder is provided the option to describe the model proposed additional features under ""Others"" section (White), e.g., to visualize the functionality of thyroid tissue, detect metastatic thyroid cancer, and assess the remaining thyroid tissue after thyroidectomy." |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 11 | 2024-11-05 | New : Clinical Application: Quantitative SPECT Imaging Requirement: Required If MOH sees radioligand therapies as a critical clinical service that is intended to be provided, we would kindly propose to add the following mandatory points: Proposal Technical Specifications: Quantitative SPECT Imaging Proposal REQUIREMENT: Required Reasons: Quantification of SPECT imaging allows physicians to assess activity quantitatively. It is clinically established to assess activity to tumors and organs after radioligand therapies. It is also a prerequisite for any dosimetry calculations. Quantitative SPECT imaging is established for diagnostic accuracy beyond the area of theranostics. Including this software solution on the SPECT/CT system would potentially improve the clinical impact of SPECT/CT examinations. References: EANM practice guideline for quantitive SPECT-CT This paper highlights the benefits of quantitative SPECT for different clinical areas including theranostics. https://pmc.ncbi.nlm.nih.gov/articles/PMC9931838/ |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to amend as a preferred specification; to further enhance patient assessment where the primary aim for quantitative SPECT-CT is to produce a tomographic image with voxel values representing activity concentration. The utilisation of these voxel values will be dependent on the clinical application. Amend specification "Quantitative SPECT-CT imaging" under Clinical Application. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 12 | 2024-11-05 | New : Clinical Application: CT metal artifact reduction Requirement: Required If MOH sees radioligand therapies as a critical clinical service that is intended to be provided we would kindly propose to add the following mandatory points: Proposal Technical Specifications: CT metal artifact reduction Proposal Requirement: Required Reasons: Many patients today have metal implants (pace makers, screws, prosthesis, dental fixtures, etc.). The presence of metal can critically impact the CT image by masking structures due to artifacts created by the X-ray beam of the CT. In SPECT/CT the quantitative results are potentially impacted if a region of interest is close to a metal implant and affected by artifacts in the CT attenuation. It is therefore a critical requirement to have metal artifact reduction implemented on the system if the monitoring of radioligand therapies are planned. Metal artifact correction are relevant to essentially all clinical areas investigated with SPECT/CT. Including this software would potentially improve the clinical impact across the spectrum of SPECT/CT examinations. References: Metal artifact reduction for improving quantitative SPECT/CT imaging This paper shows the benefits of metal artifact reduction in quantitative SPECT/CT studies. https://pubmed.ncbi.nlm.nih.gov/33460009/ Quantitative imaging of bone remodeling in patients with a unicompartmental joint unloading knee implant (ATLAS Knee System)—effect of metal artifacts on a SPECT-CT-based quantification https://link.springer.com/article/10.1186/s40658-021-00360-z |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to the bidder's suggestion as a preferred specification. Metal artifact reduction is an additional feature in patient diagnosis, image reconstruction, and more accurate quantification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 13 | 2024-11-05 | New : System Sensitivity, Medium Energy collimator, cpm/µCi at 10 cm Requirement: ≥ 140 Proposal Specifications: System sensitivity, Medium Energy collimator, cpm/µCi at 10 cm Proposal Requirement: ≥ 140 This related to our previous request: We kindly would like to clarify if imaging services of radio-ligand therapies, especially the isotopes Lu-177 and Y-90 would need to be provided. If it is intended for Nuclear Medicine departments to be equipped to offer either clinical service for Lu-177 or Y-90 imaging, we would kindly propose to add this as an explicit requirement. |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Different manufacturers uses different naming systems for their collimators, with different types of collimators having different levels of sensitivity and resolutions (both interrelated, higher on sensitivity means lower resolution, and vice versa) understanding the relationship of sensitivity and resolution (sensitivity affects resolution, and resolution is preferred over sensitivity). Bidders to state the sensitivity of the collimator types (low, medium and high energies), to ensure neutrality of the specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 14 | 2024-11-05 | Line 150 : Coronary artery quantification Required Specifications: Preferred We kindly request to remove "Coronary artery quantification" Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/ diagnostic CT procedures in addition to SPECT/CT imaging, in other word if this system is intended to be run as a shared service between Nuclear Medicine and Radiology departments. Coronary artery quantification is generally performed in Radiology departments. This is usually not in the scope of Nuclear Medicine departments and to our knowledge Nuclear Medicine physicians in Indonesia are not certified in reading diagnostic CT cases, in particular cardiac CT. Should the system be intended primarily to provide Nuclear Medicine imaging services we would request to remove "Coronary artery quantification". |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to the bidder's suggestion understanding the User's direction of SPECT-CT services is under Nuclear Medicine department, the specification is amended and removed. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 15 | 2024-11-05 | Line 223 : Estimated Operation Time, minutes Required Specifications: Preferred; At least 60 minutes Proposal Technical Specifications: Estimated Operation Time, minutes Proposal Required Specifications: Preferred; At least 10 minutes We kindly propose to modify to "At least 10 minutes" instead of 60 minutes. Reasons It is not advisable to operate multiple patient scans dependent on the UPS. A SPECT/CT scan on modern SPECT/CTs would be able to be fully completed within 30 min. For safety reasons an established practice is to bring the patient directly out when the power outage occurs which would require only about 5 min. Choosing a solution supplying power for 10 min not only aligns with environmental objectives, it also offers enhanced practicality due to their compact size, making them a more efficient within the operating environment, ultimately benefitting clinical users and patients. Furthermore, as nuclear medicine procedures are generally non-invasive, only a short power supply is typically needed for patient removal, safe shutdown and proper image saving, in the event of a total hospital power loss |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. | Supply Requirements | Evaluation Process | Technical Evaluation |
| 16 | 2024-11-05 | Line 120 : Axial Cardiac Required Specifications: Preferred We kindly request to remove "Axial Cardiac" Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/diagnostic CT procedures in addition to SPECT/CT imaging, in other word if this system is intended to be run as a shared service between Nuclear Medicine and Radiology departments. Axial cardiac imaging is generally performed in Radiology departments. This is usually not in the scope of Nuclear Medicine departments and to our knowledge Nuclear Medicine physicians in Indonesia are not certified in reading diagnostic CT cases, in particular cardiac CT. Should the system be intended primarily to provide Nuclear Medicine services, we request to remove "Axial Cardiac". |
"Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to the bidder's suggestion understanding the User's direction of SPECT-CT services is under Nuclear Medicine department, the specification is amended and removed. " |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 17 | 2024-11-05 | Line 151 : Ventricular output Required Specifications: Preferred We kindly request to remove "Ventricular output" Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/ diagnostic CT procedures in addition to SPECT/CT imaging, in other word if this system is intended to be run as a shared service between Nuclear Medicine and Radiology departments. Ventricular output is generally performed in Radiology departments. This is usually not in the scope of Nuclear Medicine departments and to our knowledge Nuclear Medicine physicians in Indonesia are not trained in reading diagnostic CT cases, in particular cardiac CT. Should the system be intended primarily to provide Nuclear Medicine imaging services we would request to remove "Ventricular Output". |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to the bidder's suggestion understanding the User's direction of SPECT-CT services is under Nuclear Medicine department, the specification is amended and removed. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 18 | 2024-11-05 | Related to the Specific Procurement Notice (SPN) that was released: RFB number: KS.01.02/A.VI/6120/2024 Contract title: Procurement of SPECT-CT Lot 1: Procurement of SPECT-CT ( 21 Units ) Lot 2: Procurement of SPECT-CT ( 18 Units ) We have the attached input/questions for submission to the Procurement Committee. We urge MOH, ISDB and the World Bank to please consider the critical input from us and to make the necessary adjustments/revisions to the technical specifications. We acknowledge and appreciate that the Procurement Committee, MOH and ISDB are highly committed and working very diligently for the project – in recognition of that and in order to ensure a successful RFB process that attracts the submission of high-quality bids from the market, we kindly request the Procurement Committee, MOH and ISDB to kindly: please release answers, feedback and technical specification revisions no later than 7 calendar days after receipt of the questions/input and/or at the latest 10 calendar days before bid submission deadline, as the information shared with the market are very pertinent, impactful and in many cases, mandatory (e.g. technical specifications sheet) for individual bidder’s bid preparation please give early announcement for new/extended submission deadline that is issued at least 10 days before the actual new/extended deadline itself please stagger submission deadlines of all and individual on-going ISDB-related RFBs wider apart, minimally 1 calendar week from each other We believe early notice will be helpful for all stakeholders involved and reduce health stresses from short notice updates/changes. Our requests are in connection to ensure good, fair, transparent and healthy participation of the entire market for an eventual successful tender process for the ultimate benefit of the people of Indonesia. Thank you. Best regards, |
Thank you for your feedback. MOH (Purchaser) will respond to bidders' clarifications at least 5 (five) days before the deadline of bid submission to ensure sufficient time for the prospective bidder to prepare and submit its bid. If any changes are communicated close to the bid submission date, an extension of time will be included in the amendment. Please also be advised that late requests for clarification will not be reviewed and responded to. All guidance and documents have been published on the IHSS public website: https://ihss.kemkes.go.id/ Any amendments (if any) and responses to questions will be published there as well |
Bidding Procedure | Procurement Regulations | Procurement Methodology |
| 19 | 2024-11-05 | Line 153 : Noncardiac artery analysis Required Specifications: Preferred We kindly request to remove "Noncardiac artery analysis". Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/ diagnostic CT procedures in addition to SPECT/CT imaging, in other word if this system is intended to be run as a shared service between Nuclear Medicine and Radiology departments. Noncardiac artery analysis is generally performed in Radiology departments. This is usually not in the scope of Nuclear Medicine departments and to our knowledge Nuclear Medicine physicians in Indonesia are not trained in reading diagnostic CT cases, in particular vascular CT. Should the system be intended primarily to provide Nuclear Medicine imaging services we would request to remove "Noncardiac artery analysis". |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to the bidder's suggestion understanding the User's direction of SPECT-CT services is under Nuclear Medicine department, the specification is amended and removed. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 20 | 2024-11-05 | New : System sensitivity, High Energy collimator, cpm/µCi at 10 cm Requirement: Preferred; ≥ 130 Proposal Specifications: System sensitivity, High Energy collimator, cpm/µCi at 10 cm Proposal Requirement: Preferred; ≥ 130 This related to our previous request: We kindly would like to clarify if Thyroid imaging and treatment services would need to be provided. If it is intended for Nuclear Medicine departments to be equipped with SPECT/CT to offer this clinical service, we would kindly propose to add the requirement for a high energy collimator as an explicit requirement and to specify a higher sensitivity of ≥ 130 cpm/µCi at 10 cm to ensure high-quality imaging |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Different manufacturers uses different naming systems for their collimators, with different types of collimators having different levels of sensitivity and resolutions (both interrelated, higher on sensitivity means lower resolution, and vice versa) understanding the relationship of sensitivity and resolution (sensitivity affects resolution, and resolution is preferred over sensitivity). Bidders to state the sensitivity of the collimator types (low, medium and high energies), to ensure neutrality of the specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 21 | 2024-11-05 | New : System Sensitivity, Medium Energy collimator, cpm/µCi at 10 cm Requirement: Preferred; ≥ 240 Proposal Specifications: System sensitivity, Medium Energy collimator, cpm/µCi at 10 cm Proposal Requirement: Preferred; ≥ 240 We kindly would like to clarify if imaging services of radio-ligand therapies, especially the isotopes Lu-177 and Y-90 would need to be provided. If it is intended for Nuclear Medicine departments to be equipped to offer either clinical service for Lu-177 or Y-90 imaging, we would kindly propose to add this as an explicit requirement and to specify a higher sensitivity of ≥ 240 cpm/µCi at 10 cm to ensure high-quality imaging. |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Different manufacturers uses different naming systems for their collimators, with different types of collimators having different levels of sensitivity and resolutions (both interrelated, higher on sensitivity means lower resolution, and vice versa) understanding the relationship of sensitivity and resolution (sensitivity affects resolution, and resolution is preferred over sensitivity). Bidders to state the sensitivity of the collimator types (low, medium and high energies), to ensure neutrality of the specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 22 | 2024-11-05 | Line 191 : Radiation Protective Equipment Requirement: Bidder to supply the following: 1. Lead Apron (2 pcs per unit) 2. Thyroid Shield (2 pcs per unit) 3. Pb Glasses (2 pcs per unit) 4. Syringe Shield 1, 3, 5 cc (2 sets per unit) We would kindly ask to clarify the thickness of lead or equivalent structural barriers for lead apron, thyroid shield and Pb Glasses to be provided. Proposal Technical Specifications: Radiation Protective Equipment Proposal Required Specifications: Bidder to supply the following: 1. Lead Apron (2 pcs per unit) of xx mm thickness 2. Thyroid Shield (2 pcs per unit) of xx mm thickness 3. Pb Glasses (2 pcs per unit) of xx mm thickness 4. Syringe Shield 1, 3, 5 cc (2 sets per unit) of xx mm thickness |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. The required protective equipment are for the purpose of shielding from ionizing radiation, ensuring the safety of both patients and healthcare providers, i.e. materials and thickness of the supplied radiation protective equipment must be effective in blocking the highest levels of radiation emitted by the proposed devices and adhering to the regulatory requirements (BAPETEN). |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 23 | 2024-11-05 | 2. Line 63 : System sensitivity, LEAP, cpm/µCi Requirement: Preferred; ≥ 250 Proposal Specifications: System sensitivity, Low energy collimator, cpm/µCi at 10 cm Proposal Requirement: Preferred ≥ 200 We kindly request to amend the request to "Low energy collimator" instead of LEAP and change the sensitivity to ≥ 200 cpm/µCi at 10 cm. Reasons There are different low energy collimators available on SPECT/CT systems. Today the most used collimators for low energy are "Low Energy High Resolution" (LEHR) collimators (names can differ slightly across vendors). Because collimator holes are smaller and deeper on LEHR compared to LEAP collimators, the LEHR has better resolution than LEAP collimators because it accepts fewer scattered gamma rays. This makes the LEHR collimators a better general purpose gamma camera collimator as it produces higher quality images and better quantification for clinical use. LEHR collimators obtain higher resolution images than LEAP: smaller and elongated collimator holes results in more holes within the same collimator FOV, therefore giving better spatial resolution. We would therefore kindly request to specify "Low energy collimator" instead of LEAP and change the sensitivity to ≥ 200 cpm/µCi at 10 cm" to allow LEHR collimators to comply for a wider clinical utility for the SPECT/CT systems provided for a default configuration and to specify a higher sensitivity of ≥ 200 cpm/µCi at 10 cm to ensure high-quality imaging. References: Quantitative assessment of 99mTc-MIBI GSPECT performed with LEAP collimation compared to the standard LEHR method https://jnm.snmjournals.org/content/47/suppl_1/272P.1.short |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Different manufacturers uses different naming systems for their collimators, with different types of collimators having different levels of sensitivity and resolutions (both interrelated, higher on sensitivity means lower resolution, and vice versa) understanding the relationship of sensitivity and resolution (sensitivity affects resolution, and resolution is preferred over sensitivity). Bidders to state the sensitivity of the collimator types (low, medium and high energies), to ensure neutrality of the specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 24 | 2024-11-05 | "New : System sensitivity, High Energy collimator, cpm/µCi at 10 cm Requirement: ≥ 90 Proposal Specifications: System sensitivity, High Energy collimator, cpm/µCi at 10 cm Proposal Requirement: ≥ 90 This related to our previous request: We kindly would like to clarify if Thyroid imaging and treatment services would need to be provided. If it is intended for Nuclear Medicine departments to be equipped with SPECT/CT to offer this clinical service, we would kindly propose to add the requirement for a high energy collimator as an explicit requirement." |
"Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Different manufacturers uses different naming systems for their collimators, with different types of collimators having different levels of sensitivity and resolutions (both interrelated, higher on sensitivity means lower resolution, and vice versa) understanding the relationship of sensitivity and resolution (sensitivity affects resolution, and resolution is preferred over sensitivity). Bidders to state the sensitivity of the collimator types (low, medium and high energies), to ensure neutrality of the specification." |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 25 | 2024-11-05 | Line 132 : Reconstruction Matrices Requirement: Adjustable:128 x 128, 256 x 256, 512 x 512 Proposal Technical Specifications: Reconstruction Matrices Proposal Requirement: 512 x 512 We propose to kindly amend the requirement to "512 x 512" instead of "adjustable 128 x 128, 256 x 256, 512 x 512". Reasons This will harmonize this requirement with the recently published tender for CT systems and specify the highest matrix required. Higher matrix size (e.g., 512x512) means more pixels are used to represent the image. This allows the system to capture more detailed anatomical structures, making small lesions or fine details more visible. For CT there is no benefit of going to smaller reconstruction matrixes. With current computers used there is no clinical or workflow relevant time difference in reconstruction times for the indicated matrixes. Lower matrix sizes might not be available on newer generation of systems and would therefore exclude those from the submission |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. The CT system is capable of adjusting image reconstructions between a 128x128 and a 512x512 matrix.; i.e., a CT system capable of processing at a higher matrix size (e.g.: 512x512) should be capable of processing lower resolution (e.g.: 128x128, 256x256). This provides matrix sizes flexibility; ensuring the system is adaptable to various clinical needs and streamlines workflows. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 26 | 2024-11-05 | Line 114 : Prospective ECG Gating Required Specifications: Preferred Proposal Technical Specifications: Retrospective Gating Proposal Requirement: Preferred We request to kindly modify this item to "Retrospective Gating" or at least to "Prospective or Retrospective Gating". Retrospective Gating is a newer technology compared to prospective gating. Retrospective gating allows potentially for a larger selection of heart beat ranges: For patients with irregular heart beats this can potentially result in more counts being collected and with that image quality and scan time can be improved compared to prospective gating. Usually only one gating technology can be applied. Currently the tender would favor the older technology. Reference 1. Nakajima. K., et al. (2022)."Application of list-mode based retrospective gating in patients with and without arrhythmia for myocardial perfusion SPECT".Journal of Nuclear Medicine, Vol. 63, Issue supplement 2. Although prospective electrocardiographic (ECG) gating with a predetermined beat length window has been commonly used for myocardial perfusion imaging, unpredicted irregular beat length due to multiple premature beats or atrial fibrillation, may deteriorate tomographic consistency due to suboptimal curation of beats. Retrospective list-mode based gating could successfully use 98% of the beats, while losing only 2% of outlier beats. |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to the bidder's suggestion to amend to "Prospective or Retrospective ECG Gating". Prospective ECG gating provides image acquisition triggered in real-time based on specific points of the ECG signal (e.g., R-wave or another point in the cardiac cycle) i.e. images only at predefined points during the cardiac cycle (e.g., end-diastole or end- systole), however requires lower radiation compared to Retrospective ECG Gating. Retrospective ECG gating provides a system continuously collecting data throughout the entire cardiac cycle; post scan data is sorted and gated retrospectively based on the ECG signal. The images are then reconstructed by selecting data from specific phases of the cardiac cycle (e.g., end-diastole or end-systole), however more recent technology. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 27 | 2024-11-05 | Line 118 : Artificial Intelligence Image Reconstruction Required Specifications: Preferred Proposal Technical Specifications: Artificial Intelligence Image Reconstruction or Post-processing Proposal Required Specifications: Preferred We kindly request to change from "reconstruction" to "reconstruction or post processing." Reasons Artificial Intelligence is deployed today at different parts of the imaging processing chain with generally the intention to improve image quality. We would kindly like to suggest to open this criteria up for alternative deployments of AI with similar benefits. Key points for application of AI for reconstruction and post-processing Stage of Application: - Reconstruction DL methods are applied during image formation from raw data. - Post-processing DL methods are applied after the image has already been formed. Impact on Image Quality: - DL in reconstruction directly affects the image quality from the start, offering a foundational improvement, especially in low-dose imaging. - Post-processing DL methods refine and optimize images by removing specific artifacts or enhancing particular features without altering the original raw data. References 1. Wang, G., et al. (2020). "Deep Learning for Tomographic Image Reconstruction." Nature Machine Intelligence, 2, 737-748. This paper discusses the application of deep learning in tomographic reconstruction, including CT, and provides a comprehensive overview of the techniques and benefits over traditional methods. 2. McCann, M. T., Jin, K. H., Unser, M. (2017). "Convolutional Neural Networks for Inverse Problems in Imaging: A Review." IEEE Signal Processing Magazine, 34(6), 85-95. Provides insights into how convolutional neural networks (CNNs) are applied for various image post-processing tasks, including denoising, artifact correction, and super-resolution. |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Use of AI in image reconstruction and/or post processing helps reduce radiation dose by reducing scan time required to produce a quality SPECT imaging. Note: AI generates a complete image from raw data captured by the SPECT, while Post- processing by AI proposed refines the image generated by the SPECT. Amended specification to "Artificial Intelligence Image Reconstruction or Post- Processing" |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 28 | 2024-11-05 | Line 102 : Optional Minimum Slice Width, mm Required: Preferred; ≤ 0.5 mm We kindly request to remove this line item. Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/ diagnostic CT procedures in addition to SPECT/ Nuclear Medicine, in other word if this system is intended to be run as a shared service between Nuclear Medicine and Radiology departments. Thin Slice Width of 0.5 mm are generally not required for CTs used in SPECT systems/ Nuclear Medicine but only for diagnostic CT procedures. Should the system be intended primarily to provide Nuclear Medicine services we would request to remove the requirement for slice width ≤ 0.5mm. |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to bidder's suggestion to remove to maintain a more neutral specs. Note: The preferred smaller slices supports and improves spatial resolution. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 29 | 2024-11-05 | Line 51 : Dead time, µsec Required: Preferred; ≤ 1 Proposal Technical Specifications: Dead time, µsec or Maximum Count Rate for Count Rate Performance in Air, kcps Proposal Requirement: Preferred; Dead time ≤ 1 µsec; Maximum Count Rate ≥ 300 kcps We request to kindly change this to include the Maximum Count Rate of the Intrinsic Count Rate Performance as the equivalent measurement to dead time. The detector dead time translates to a limitation on the maximum count rate by measuring the minimum resolving time between two distinct events. This is expressed as the Intrinsic Count Rate Performance in air as per NEMA definition. The maximum count rate is therefore an equivalent measure to detector dead time. |
Many thanks for this feedback. As this specification is rated criteria, the bidder can choose to comply or not. MoH will retain the current specification. Dead time is the period after a photon is detected during which the detector is unable to register another photon event whilst processing the previous photon; due to the time required to record and reset the detector for the next event. Maximum count rate is the highest rate at which photons can be detected by the system's detector without introducing significant errors or loss of data due to dead time. This rate represents the threshold beyond which the system can no longer reliably register all incoming photon events. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 30 | 2024-11-05 | New : Tin filter Requires Specifications: Preferred Proposal Technical Specifications: Tin filter Proposal Required Specifications: Preferred; We would kindly request "Tin filter" as an additional criteria. Reasons Tin filter has been proven as an effective feature to reduce dose to patients in CT scans. With this feature potentially being available on SPECT/CT systems, patients in Indonesia undergoing SPECT/CT Imaging can benefit from significant CT dose reduction if SPECT/CT systems with this feature are being installed |
No additional specification. Tin filter is capable of selectively filtering out lower-energy gamma photons that can cause scatter or noise in the image; enhances the system's ability to provide accurate and precise imaging for various clinical applications., cardiac imaging (like myocardial perfusion imaging) and oncological imaging. Further research suggested not all brands utilise tin filters. No additional specification to remain as a neutral tech specs. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 31 | 2024-11-05 | Line 104 :Rotation times (360°), sec Required Specifications: Preferred; ≤ 0.5 sec We kindly request to remove the line item for "Rotation times ≤ 0.5 sec" Reasons We would like to clarify if the SPECT/CT system is intended to perform radiology procedures/ diagnostic CT procedures in addition to SPECT/ Nuclear Medicine, in other word if this system is intended to be run as a shared service between Nuclear Medicine and Radiology departments. High rotation times below 0.5 sec are generally not required for CTs used in SPECT systems/ Nuclear Medicine but only for more demanding diagnostic CT procedures like Cardiac scanning. Should the system be intended primarily to provide Nuclear Medicine services we would request to remove the requirement for rotation times ≤ 0.5 sec. |
Many thanks for this feedback. As this specification is rated criteria, the bidder can choose to comply or not. MoH will retain the current specification. Rotation time affects the image resolution. A faster rotation time results in better image resolution (less blurring of images). |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 32 | 2024-11-05 | Line 103 : Sliding Collimation (Overbeaming Reduction) Requires Specifications: Preferred Proposal Technical Specifications: Sliding Collimation (Overbeaming Reduction) or equivalent Proposal Required Specifications: Preferred; We would kindly request to modify this to add "or equivalent". Reason There are other CT dose reduction techniques than sliding collimation deployed at different SPECT/CT systems. "Equivalent" would allow other bidders to get points for features that reduce dose. |
Line 103 : Sliding Collimation (Overbeaming Reduction). Supposed to be Line 119. Many thanks for this feedback. As this specification is rated criteria, the bidder can choose to comply or not. MoH will retain the current specification. Sliding collimation is a specialized collimator design where the individual lead slats within the collimator can move slightly, allowing for dynamic adjustments to the field of view during data acquisition, allow better image quality when scanning irregularly shaped structures. It also reduce scatter of radiation during scanning, reduces overall radiation dose to be absorbed by the patient. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 33 | 2024-11-08 | 18. The below clinical applications will provide advanced clinical capabilities to hospitals and more benefits to patients, easy access for physicians to have the comprehensive nuclear medicine facility. Kindly include the below clinical applications in the tender specification as optional (Orange) with additional points. Information of percentage mismatch lung perfusion and ventilation - 1 point Liver shunt analysis for SIRT treatment – 1 point myocardial automatic recognition cardiac structures or equivalent – 1 point Organ automatic contouring – 1 point AI based image processing – 1 point |
Many thanks for this feedback. The bidder can choose to comply or not. MoH will retain the current specification. Bidder is provided the option to describe the model proposed additional features under "Others" section (White) at Row31. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 34 | 2024-11-08 | 7. Line No. 104 Clarification on kW output >= 30 kW 24KW generator would be sufficient to operate CT tube for better clinical performance and lower maintenance to hospital. Propose to amendment : kW output >= 24 kW |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. | Supply Requirements | Evaluation Process | Technical Evaluation |
| 35 | 2024-11-08 | 4. Line No. 104 Clarification on kW output >= 30 kW 30 kW is vendor specific specification. 24KW generator would be sufficient to operate CT tube for better clinical performance and lower maintenance to hospital. Propose to amendment : kW output >= 24 kW |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. | Supply Requirements | Evaluation Process | Technical Evaluation |
| 36 | 2024-11-08 | Line No. 45 Clarification on Ring Aperture (opening), cm ; Preferred; ≥ 80 cm It’s preferred to have optimum aperture size to have better CT performance. Larger aperture will make CT scanners with higher tube capacity, technically increasing the Source to image distance (SID) for CT imaging, eventually more radiation dose to patients to achieve better images. Hence we request to change the specification less than 80cm to have more effective system to deliver lower dose and better image quality. |
Many thanks for this feedback. As this specification is Rated Criteria, the bidder can choose to comply or not. MoH will retain the current specification. The specification permits SPEC-CT models to comply; maintain good performance of the specification. Models with larger size of ring aperture for potential enhancements is encouraged. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 37 | 2024-11-08 | 9.Line No. 208 Clarification and elaboration on consumables needed. Propose amendment: Please share the full list of consumables with required quantity for 100 patient studies. |
Many thanks for this feedback. As this specification (white cell), the bidder can describe the proposed specification. MoH will retain the current specification. The informational specification (white) for the bidder to provide consumables for the full functionality of the SPECT-CT system proposed. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 38 | 2024-11-08 | 5.Line No. 83 Clarification on Heat Storage, MHU ; at least 3.5 MHU. Higher MHU requires higher operation cost and maintenance to hospitals over the years. Propose to amendment : at least 2MHU. |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. Higher heat storage is essential for a SPEC-CT system to operate efficiently, helping to prevent overheating and service interruption. The heat storage capacity, measured in MHU will be associated with the proposed CT scan model. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 39 | 2024-11-08 | 11. Line No. 236 Clarification and elaboration on system upgradeable in the future. System software update will provide necessary software update on regular basis to keep up the system up to date. The hardware upgrade and software upgrades are open specification which involves larger hardware upgrade including operation cost impact to the hospital. Propose amendment : Software updates at no cost |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 40 | 2024-11-08 | 3. Line No. 65 Collimator types: Bidder to specify: Low energy, medium energy, high energy, pin hole, fan beam and etc., Line No. 62, it’s understood that LEAP/LEGP collimators are expected to include in the configuration. We request for a change in collimator type of Line no. 62 as LEHR or LEHRS instead of LEAP and additionally please make MEGP and HEGP as mandatory to perform comprehensive clinical nuclear medicine studies for all patients including radio isotope therapy. Propose to amendment : LEHR or LEHRS, MEGP and HEGP (Please make it as Green) |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Different manufacturers uses different naming systems for their collimators, with different types of collimators having different levels of sensitivity and resolutions (both interrelated, higher on sensitivity means lower resolution, and vice versa) understanding the relationship of sensitivity and resolution (sensitivity affects resolution, and resolution is preferred over sensitivity). Bidders to state the sensitivity of the collimator types (low, medium and high energies), to ensure neutrality of the specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 41 | 2024-11-08 | 12. Line No. 287 Clarification and elaboration on acceptance testing & commissioning. Bidder must perform acceptance testing & commissioning in accordance to IAEA or NEMA standards following BAPETEN requirements. In current practice BAPETEN requirements for acceptance and commissioning is aligned with international standards. Kindly amend the specs to perform acceptance and commissioning test accordance to Bapeten. Propose amendment: Bidder must perform acceptance testing & commissioning in accordance with BAPETEN requirements. |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply and describe. MoH will retain the current specification. The acceptance testing and commissioning is in accordance BAPETEN standards, adhering to standards such as IAEA and NEMA standards. Bidder to conduct acceptance testing and commissioning in accordance with BAPETEN requirements shall comply to this specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 42 | 2024-11-08 | 15. Line No. 199 Planar Sensitivity Phantom Planar sensitivity is calculated using Petri Dish not phantoms. Propose amendment: Petri Dish set for Planar sensitivity calculation. |
Many thanks for this feedback. As this specification is Rated Criteria, the bidder can choose to comply or not. MoH will retain the current specification. Planar sensitivity phantoms are designed to measure the planar sensitivity of gamma cameras. The method includes a planar sensitivity phantom, e.g., Petri dish or similar flat container, filled with a quantity of radioactive solution (e.g., Tc-99m); positioning the phantom at a standardized distance from the gamma camera detector (e.g., 10 cm); acquiring an image of the phantom, count rate, and calculated to provide a measured camera's efficiency in detecting gamma rays from the source. This calibrates the gamma camera and ensuring its performance is within acceptable limits for accurate diagnostic imaging. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 43 | 2024-11-08 | 10. Line No. 223 Clarification on estimated operation time for UPS preferred at least 60 minutes. We request the committee to change the specification as at least 10 minutes which is good enough to store the patients’ studies and complete the ongoing PET studies without data loss. 60 minutes back up will need more space for the installation of the battery and increase maintenance cost Propose amendment : estimated operation time for UPS preferred at least 10 minutes back up. |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 44 | 2024-11-08 | 17. Line No. 189 b) Standard Sofware Modules/Functionality: Equipped with internal dosimetry software for evaluating patient absorbed dose, according to IAEA QUANUM nuclear medicine standards. The IAEA QUANUM nuclear medicine standards are meant for the entire nuclear medicine facility standard operating procedure, standard workflow, QC/QA and radioactive waste disposal and radionuclide therapy protocol. The internal dosimetry software will be part of Radionuclide therapy assessment and SOP. Since IAEA QUANUM standards are not meant only for Internal dosimetry, we request to remove the wording “according to IAEA QUANUM nuclear medicine standards”. Propose amendment: b) Standard Sofware Modules/Functionality: Equipped with internal dosimetry software for evaluating patient absorbed dose |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to bidder's suggestion to further clarify the specification and maintain the neutrality the specification. Amended specification to "Equipped with internal dosimetry software for evaluating patient absorbed dose" |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 45 | 2024-11-08 | 16. Line No. 201 Orthogonal hole test Pattern (OHTP) Phantom Please specific to phantom model or commercial name of the phantom. As of now, no 3rd party vendors offer this phantom in the market. Most of the phantoms included in the tender specification for routine quality control and acceptance. Hence this phantom can be removed from the specification. |
Many thanks for this feedback. As this specification is Rated Criteria, the bidder can choose to comply or not. MoH will retain the current specification. The Orthogonal Hole Test Pattern (OHTP) Phantom is an additional specialized tool used in nuclear medicine to evaluate the performance of gamma cameras; designed to assess the spatial resolution, linearity, object shape, and contrast of gamma cameras, i.e., a comprehensive evaluation in a single image. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 46 | 2024-11-08 | 6. Line No. 98 Clarification on Maximum mA ; at least 400mA. The higher the mA, the higher the dose will be to patient. The state-of-the-art CT scanners are designed with low dose CT reconstruction algorithm which will reduce the dose by 50% to give low radiation burden to patients and superior image quality. More well as, most of the SPECTCT scanners are operated as non-contrast CT scanner with maximum 100mA for SPECTCT studies. Propose to amendment : Maximum mA ; at least 200mA. |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to bidder to reduce maximum mA range to "at least 200mA", to include lower slices of CT system. Note: Radiation dose is dependent on clinical needs. Amend the requirement to " ≥ 200mA". |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 47 | 2024-11-08 | Propose to amendment : Preferred; ≤ 80 cm 2. Line No. 62 and No.63 Clarification on system sensitivity, LEAP, cpm/uCi. LEAP (Low Energy All Purpose) is same term as ELEGP (Low Energy General Purpose). Both collimators are used for low energy isotopes like Tc99m or Thallium 201 based clinical applications. Propose to amendment : Line No. 62: System sensitivity, LEHR or LEHRS, cpm/uCi: ≥ 190 Line No. 63: System sensitivity, LEHR or LEHRS, cpm/uCi: ≥ 205 |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Different manufacturers uses different naming systems for their collimators, with different types of collimators having different levels of sensitivity and resolutions (both interrelated, higher on sensitivity means lower resolution, and vice versa) understanding the relationship of sensitivity and resolution (sensitivity affects resolution, and resolution is preferred over sensitivity). Bidders to state the sensitivity of the collimator types (low, medium and high energies), to ensure neutrality of the specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 48 | 2024-11-08 | 4. Line No. 81 Clarification on CT specification type >= 32 slices, or equivalent. In SPECTCT, CT scan provides attenuation map and anatomical correlation of SPECT images to increase the clinical confidence. The SPECT.CT should be diagnostic CT with capabilities to perform all SPECT.CT applications and stand-alone CT scans as back up CT scanner. Based on the required size of detector on Line No. 99 >= 10 mm. The 10mm detector can provide minimum 16slice diagnostic CT which fuses well with SPECT images to increase clinical confidence. Propose to amendment : CT specification type >= 16 slices, or equivalent |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. The higher slice count of CT scan in SPEC-CT is an added advantage i.e., reduce scanning times and provide improved images resolution. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 49 | 2024-11-08 | 14. Line No. 197 Intrinsic spatial resolution phantoms It’s same as Quadrant Bar Phantom mentioned in Line No. 196 - Hence we request to remove Line 197. Intrinsic spatial resolution phantoms |
Many thanks for this feedback. As this specification is Rated Criteria, the bidder can choose to comply or not. MoH will retain the current specification. The quadrant bar phantom and intrinsic spatial resolution phantoms are both used in nuclear medicine imaging to assess the performance of gamma cameras, but they serve slightly different purposes: Quadrant Bar Phantom Used to evaluate the spatial resolution of the entire imaging system, including the collimator. Intrinsic Spatial Resolution Phantom Used to measure the intrinsic spatial resolution of the gamma camera detector itself, without the influence of the collimator. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 50 | 2024-11-08 | 8. Line No. 193 – Line No. 204 Clarification and elaboration on additional accessories preferred. If the goals is enabling the centre to be ready to operate the SPECT.CT, there are other mandatory accessories based on BAPETEN regulation that still not mentioned in the specification. Please find Annexure document as attachment for the full list of accessories required for operation license. è Propose amendment: Add all mandatory accessories based on BAPETEN regulation and make it as green. |
Many thanks for this feedback. As this specification is Rated Criteria, the bidder can choose to comply or not. MoH will retain the current specification. | Supply Requirements | Evaluation Process | Technical Evaluation |
| 51 | 2024-11-08 | 13. Line No. 291 Clarification on extension of warranty duration. Kindly confirm the warranty for accessories also should be as same as main equipment or standard 1 year manufacturer warranty |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply and describe. The warranty should cover the main equipment and all accessories. |
Contract | Contract Management | Warranty |
| 52 | 2024-11-20 | 8. Could the Gantry Aperture requirement be changed to preferred; ≥ 70 cm ? | Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 53 | 2024-11-20 | 3. Please Change the quantity Requirement experience to 4 Units in the last year ? | Many thanks for this feedback. The MoH will retain the current requirements outlined in the bidding document. Bidders are kindly requested to comply and provide the necessary items as per the specified requirements. | Supply Requirements | Evaluation Process | Specific Experience |
| 54 | 2024-11-20 | 4. Could the requirement for manufacturing experience and technical capacity be removed ? | Many thanks for this feedback. The MoH will retain the current requirements outlined in the bidding document. Bidders are kindly requested to comply and provide the necessary items as per the specified requirements. | Supply Requirements | Evaluation Process | Specific Experience |
| 55 | 2024-11-20 | 5. Could the requirement for cybersecurity experience and accreditation (ISO 27001 or equivalent) be removed ? | Thank you for the question. Bidder must clearly demonstrates the bidder's experience in managing cyber security, practice and track record, including relevant Cyber security accreditation such as ISO 27000 (ISO 27001) or equivalent, and commits to ensure these cybersecurity requirements for all devices part of the bid. The bidder is also requested to provide relevant equipment cybersecurity mitigation measures via their MDS2 Form in the bid. | Bidding Procedure | Evaluation Process | Qualification Requirements |
| 56 | 2024-11-20 | 1.The Time for the bid submission is to short, please Extend for two months or above | Thank you for your request. Unfortunately, we cannot consider extending the bid submission deadline without a valid reason. Please provide further details or justification for the extension |
Bidding Procedure | Procurement Regulations | Procurement Methodology |
| 57 | 2024-11-20 | We would like to confirm whether payment is paid after all units are finished installation? or paid separately for each unit when they are finished installation |
Please refer to SCC16.1 of the Bidding Document | Contract | Contract Management | Payment Term |
| 58 | 2024-11-20 | 9. Could the Thickness requirement (Preferred; ≥ 15.9 mm) be removed ? | Many thanks for this feedback. As this specification is Rated Criteria, the bidder can choose to comply or not. MoH will retain the current specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 59 | 2024-11-20 | 6. Could the requirement for compliance with IEC 60601 - Safety of Medical Electrical Equipment be removed ? |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 60 | 2024-11-20 | 7. Could the requirement for compliance with IEC Standards for Energy Efficiency be removed ? |
Many thanks for this feedback. As this specification (white cell), the bidder can describe the proposed specification. MoH will retain the current specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 61 | 2024-11-20 | Could the Detector Field of View requirement (Preferred; ≥ 70 cm) be removed ? | Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 62 | 2024-11-20 | 2. Please delete Technical Part Qualification criteria Point H, about AATO Requirements for JV. | Many thanks for this feedback. The MoH will retain the current requirements outlined in the bidding document. Bidders are kindly requested to comply and provide the necessary items as per the specified requirements. | Supply Requirements | Evaluation Process | Qualification Requirements |
| 63 | 2024-11-20 | We would like to know the detail terms in letter of credit and is irrevocable confirmed letter of credit opened by the time of all units are shipped ? |
Please refer to IsDB Disbursement Handbook published in IsDB external website https: //www.isdb.org/publications/disbursement-handbook-2019 |
Contract | Contract Management | Payment Term |
| 64 | 2024-11-21 | Line NA Radioactive calibration sources #2/ accessories We would kindly like to clarify that it is intended for the hospitals to supply the I-131 radioactive sources for calibration purposes, and this is not the responsibility of the bidder. Reasons: If I-131 are planned for the purpose of patient scans, this source would need to be supplied by an outside supplier. It would make sense to use the same supplier and supply contract to supply the I-131 m for calibration of equipment as the purchase volumes for calibrations are minimal compared to the volumes needed for clinical scans. |
Thank you for your question. Iodine-131 is used during exposure tests for treatment rooms and gamma camera rooms. Notes: MoH is not request the bidder to supply the I-131 source for calibration. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 65 | 2024-11-21 | please give early announcement for new/extended submission deadline that is issued at least 10 days before the actual new/extended deadline itself | Thank you for your feedback. MOH (Purchaser) will respond to bidders' clarifications at least 5 (five) days before the deadline of bid submission to ensure sufficient time for the prospective bidder to prepare and submit its bid. If any changes are communicated close to the bid submission date, an extension of time will be included in the amendment. Please also be advised that late requests for clarification will not be reviewed and responded to. All guidance and documents have been published on the IHSS public website: https://ihss.kemkes.go.id/naskah/announcement Any amendments (if any) and responses to questions will be published there as well |
Bidding Procedure | Procurement Regulations | Procurement Methodology |
| 66 | 2024-11-21 | please stagger submission deadlines of all and individual on-going ISDB-related RFBs wider apart, minimally 1 calendar week from each other | Thank you for your feedback. MOH (Purchaser) will respond to bidders' clarifications at least 5 (five) days before the deadline of bid submission to ensure sufficient time for the prospective bidder to prepare and submit its bid. If any changes are communicated close to the bid submission date, an extension of time will be included in the amendment. Please also be advised that late requests for clarification will not be reviewed and responded to. All guidance and documents have been published on the IHSS public website: https://ihss.kemkes.go.id/naskah/announcement Any amendments (if any) and responses to questions will be published there as well |
Bidding Procedure | Procurement Regulations | Procurement Methodology |
| 67 | 2024-11-21 | Line NA Installation Activities tab within technical specifications excel sheet Requirement: Power distribution board at Radiology/Nuclear Medicine Department with adequate power capacity. Network outlets, electrical outlets, light switches, air conditioning piping outlets, medical gas tubing and inlet pre-installation, as per Bidder pre-installation drawings. Specific technical details and/or requirements to be provided by the Bidder. We would like to kindly clarify – that the power distribution board with adequate power capacity will need to be available within the nuclear medicine department (and not radiology department) as the SPECT-CT will not be allowed for normal CT radiology examination, and this will have significant impact on room planning/installation requirements. |
The power distribution will be available at the building which the equipment should be installed. | Supply Requirements | Evaluation Process | Technical Evaluation |
| 68 | 2024-11-21 | Line 293 Manufacturer Recommended Annual Preventive Maintenance (including Calibration) Interval Requirement: Bidder to specify, by number of times a year, minimum 4 times per year We would like to clarify that calibration of the SPECT/CT systems in general is the responsibility of the hospital operating the system (specifically: conducted by the on- site physicist) - not the responsibility of the bidder. We would like to clarify that the wording “including calibration” refers to the calibration interval, not that each preventive maintenance should include a mandatory calibration of the system. |
Many thanks for this feedback. As this specification is mandatory criteria, the bidder can choose to comply or not. MoH will retain the current specification. Notes: Manufacturer Recommended Annual Preventive Maintenance (including Calibration) Interval: Bidder to specify, by number of times a year, minimum 4 times per year |
Supply Requirements | Contract Management | Contract |
| 69 | 2024-11-21 | 2. Line No. 83 Clarification on Heat Storage, MHU ; at least 3.5 MHU. 3.5 MHU is vendor specific specification. Higher MHU requires higher operation cost and maintenance to hospitals over the years. Propose to amendment : at least 2MHU. |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. Higher heat storage is essential for a SPEC-CT system to operate efficiently, helping to prevent overheating and service interruption. The heat storage capacity, measured in MHU will be associated with the proposed CT scan model. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 70 | 2024-11-21 | We have the attached input/questions for submission to the Procurement Committee. We urge MOH, ISDB and the World Bank to please consider the critical input from us and to make the necessary adjustments/revisions to the technical specifications. We acknowledge and appreciate that the Procurement Committee, MOH and ISDB are highly committed and working very diligently for the project – in recognition of that and in order to ensure a successful RFB process that attracts the submission of high-quality bids from the market, we kindly request the Procurement Committee, MOH and ISDB to kindly: please release answers, feedback and technical specification revisions no later than 7 calendar days after receipt of the questions/input and/or at the latest 10 calendar days before bid submission deadline, as the information shared with the market are very pertinent, impactful and in many cases, mandatory (e.g. technical specifications sheet) for individual bidder’s bid preparation |
Thank you for your feedback. MOH (Purchaser) will respond to bidders' clarifications at least 5 (five) days before the deadline of bid submission to ensure sufficient time for the prospective bidder to prepare and submit its bid. If any changes are communicated close to the bid submission date, an extension of time will be included in the amendment. Please also be advised that late requests for clarification will not be reviewed and responded to. All guidance and documents have been published on the IHSS public website: https://ihss.kemkes.go.id/naskah/announcement Any amendments (if any) and responses to questions will be published there as well |
Bidding Procedure | Procurement Regulations | Procurement Methodology |
| 71 | 2024-11-21 | 1. Line No. 81 Clarification on CT specification type >= 32 slices, or equivalent. 32 slices for 10 mm detector as per required is vendor specific specification. In SPECTCT, CT scan provides attenuation map and anatomical correlation of SPECT images to increase the clinical confidence. The SPECT.CT should be diagnostic CT with capabilities to perform all SPECT.CT applications and stand-alone CT scans as back up CT scanner. Based on the required size of detector on Line No. 99 >= 10 mm. The 10mm detector can provide minimum 16slice diagnostic CT which fuses well with SPECT images to increase clinical confidence. Propose to amendment : CT specification type >= 16 slices, or equivalent |
Many thanks for this feedback. As this specification is mandatory, the bidder can choose to comply or not. MoH will retain the current specification. The higher slice count of CT scan in SPEC-CT is an added advantage i.e., reduce scanning times and provide improved images resolution. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 72 | 2024-11-21 | Line NA Radioactive calibration sources #1/ accessories We would kindly like to clarify that it is intended for the hospitals to supply the Tc- 99m radioactive sources for calibration purposes, and this is not the responsibility of the bidder. Reasons: Tc-99m is eluded (harvested) from Mo99 generators that are usually kept in the hotlab of the hospitals. It would therefore be easiest for the hospital itself to supply the Tc-99m activity for preparation of the calibration sources for calibration of the SPECT/CT systems. If the Tc99-m – for the purpose of patient scans – is planned to be supplied by an outside supplier, it would make sense to use the same supplier and supply contract to supply the Tc-99m for calibration of equipment as the purchase volumes for calibrations are minimal compared to the volumes needed for clinical scans. |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Tc-99m is a radioactive source used for SPECT-CT calibration purposes for acceptance testing. Specification amended to mandatory. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 73 | 2024-11-21 | 3. Line No. 98 Clarification on Maximum mA ; at least 400mA. 400mA is vendor specific specification. The higher the mA, the higher the dose will be to patient. The state-of-the-art CT scanners are designed with low dose CT reconstruction algorithm which will reduce the dose by 50% to give low radiation burden to patients and superior image quality. More well as, most of the SPECTCT scanners are operated as non-contrast CT scanner with maximum 100mA for SPECTCT studies. Propose to amendment : Maximum mA ; at least 200mA |
Many thanks for this feedback. MoH has considered this input and will update the specification and included in a forthcoming amendment to the specifications. Agreeable to bidder to reduce maximum mA range to "at least 200mA", to include lower slices of CT system. Note: Radiation dose is dependent on clinical needs. |
Supply Requirements | Evaluation Process | Technical Evaluation |
| 74 | 2024-11-21 | Line 293 Manufacturer Recommended Annual Preventive Maintenance (including Calibration) Interval Requirement: Bidder to specify, by number of times a year, minimum 4 times per year Proposal Technical Specifications: Manufacturer Recommended Annual Preventive Maintenance Interval Proposal Required Specifications: Bidder to specify, by number of times a year, minimum 2 times per year We would kindly request to specify the minimum times per year of maintenance to “minimum 2 times per year” instead of “minimum 4 times per year”. Reasons Annual preventive maintenance is expected to be the same as other imaging equipment like MRI or CT as the SPECT components are considered more stable than the CT components. Specifying a minimum of two times per year would bring this requirement in line with other WB tenders for CT and would not compromise the reliability of the equipment – if they are in line with the manufacturer's recommended intervals. |
Many thanks for this feedback. As this specification is mandatory criteria, the bidder can choose to comply or not. MoH will retain the current specification. Notes: Manufacturer Recommended Annual Preventive Maintenance (including Calibration) Interval: Bidder to specify, by number of times a year, minimum 4 times per year |
Supply Requirements | Evaluation Process | Technical Evaluation |
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Procurement Bureau
Ministry of Health of The Republic of Indonesia
Prof. Dr. Sujudi Building, 14th Floor.
Jl. H.R. Rasuna Said Blok X-5 Kav. 4-9
Jakarta 12950, Indonesia
Ministry of Health of The Republic of Indonesia
Prof. Dr. Sujudi Building, 14th Floor.
Jl. H.R. Rasuna Said Blok X-5 Kav. 4-9
Jakarta 12950, Indonesia
+62 82240166289 (Weekdays, office hours)
