UNLABELLED: Because γ cameras are generally susceptible to environmental conditions and system vulnerabilities, they require routine evaluation of uniformity performance. The metrics for such evaluations are commonly pixel value-based. Although these metrics are typically successful at identifying regional nonuniformities, they often do not adequately reflect subtle periodic structures; therefore, additional visual inspections are required. The goal of this project was to develop, test, and validate a new uniformity analysis metric capable of accurately identifying structures and patterns present in nuclear medicine flood-field uniformity images. METHODS: A new uniformity assessment metric, termed the structured noise index (SNI), was based on the 2-dimensional noise power spectrum (NPS). The contribution of quantum noise was subtracted from the NPS of a flood-field uniformity image, resulting in an NPS representing image artifacts. A visual response filter function was then applied to both the original NPS and the artifact NPS. A single quantitative score was calculated on the basis of the magnitude of the artifact. To verify the validity of the SNI, an observer study was performed with 5 expert nuclear medicine physicists. The correlation between the SNI and the visual score was assessed with Spearman rank correlation analysis. The SNI was also compared with pixel value-based assessment metrics modeled on the National Electrical Manufacturers Association standard for integral uniformity in both the useful field of view (UFOV) and the central field of view (CFOV). RESULTS: The SNI outperformed the pixel value-based metrics in terms of its correlation with the visual score (ρ values for the SNI, integral UFOV, and integral CFOV were 0.86, 0.59, and 0.58, respectively). The SNI had 100% sensitivity for identifying both structured and nonstructured nonuniformities; for the integral UFOV and CFOV metrics, the sensitivities were only 62% and 54%, respectively. The overall positive predictive value of the SNI was 87%; for the integral UFOV and CFOV metrics, the positive predictive values were only 67% and 50%, respectively. CONCLUSION: The SNI accurately identified both structured and nonstructured flood-field nonuniformities and correlated closely with expert visual assessment. Compared with traditional pixel value-based analysis, the SNI showed superior performance in terms of its correlation with visual perception. The SNI method is effective for detecting and quantifying visually apparent nonuniformities and may reduce the need for more subjective visual analyses.