Procedure Guideline for SPECT/CT Imaging 1.0 (original) (raw)
Related papers
The Open Medical Imaging Journal, 2008
Hybrid imaging is becoming a popular technology in nuclear medicine. We have evaluated the added value of an integrated SPECT/low-dose multislice CT over conventional planar/SPECT nuclear imaging. Phantom and clinical studies were performed on the Infinia™ Hawkeye™ 4 slice (HWK-4) with an upgraded software package (Xeleris 2.05v) from GE Heatlthcare to assess 1) the benefit of CT for contrast-resolution, attenuation correction, and anatomic localisation; 2) the impact of hybrid imaging in 456 consecutive patients in a clinical setting. SPECT/CT data were compared to conventional planar/SPECT data and correlated to clinical, biochemical, morphological imaging, angiography, and pathology findings. SPECT/CT was well tolerated by the patients with minimal CT irradiation dose (< 2mSv). HWK-4 provided useful attenuation correction for its routine use in MPI and accurate anatomic localisation of physiological and pathological foci in 99m Tc-RBC, 99m Tc-HMPAO-WBC, 131/123 I-MIBG, Octreoscan ® , and 67 Ga studies. Low-dose multislice CT also helped detect gross morphological abnormalities. Hybrid imaging had a significant impact in ProstaScint ® and parathyroid imaging for image-guided intervention. In bone imaging and differentiated thyroid cancers, SPECT/CT was able to clarify equivocal findings from planar whole-body scan. SPECT/CT was also found useful to precisely localize sentinel lymph nodes. Research protocols are being evaluated for half-time acquisition with resolution recovery and quantification of tracer distribution. SPECT/low-dose multislice CT has been successfully implemented in routine clinical practice. CT provided added value for effective attenuation correction and accurate anatomic localisation of disease with an impact on patient management. Keywords: Hybrid imaging, SPECT/CT, low-dose multislice CT, clinical impact. § Part of this work was presented as selected poster at the Lawson Research Day (London, Canada, March 2007).
SPECT-CT in routine clinical practice
Nuclear Medicine Communications, 2012
Objective To assess the patient radiation dose during routine clinical single-photon emission computed tomography-computed tomography (SPECT-CT) and measure the increase as compared with SPECT alone. Materials and methods Data pertaining to 357 consecutive patients who had undergone radioisotope imaging along with SPECT-CT of a selected volume were retrospectively evaluated. Dose of the injected radiopharmaceutical (MBq) was noted, and the effective dose (mSv) was calculated as per International Commission on Radiological Protection (ICRP) guidelines. The volume-weighted computed tomography dose index (CTDIvol) and dose length product of the CT were also assessed using standard phantoms. The effective dose (mSv) due to CT was calculated as the product of dose length product and a conversion factor depending on the region of investigation, using ICRP guidelines. The dose due to CT was compared among different investigations. The increase in effective dose was calculated as CT dose expressed as a percentage of radiopharmaceutical dose. Results The per-patient CT effective dose for different studies varied between 0.06 and 11.9 mSv. The mean CT effective dose was lowest for 99m Tc-ethylene cysteine dimer brain SPECT-CT (0.9±0.7) and highest for 99m Tc-methylene diphosphonate bone SPECT-CT (4.2±2.8). The increase in radiation dose (SPECT-CT vs. SPECT) varied widely (2.3-666.4% for 99m Tc-tracers and 0.02-96.2% for 131 I-tracers). However, the effective dose of CT in SPECT-CT was less than the values reported for conventional CT examinations of the same regions. Conclusion Addition of CT to nuclear medicine imaging in the form of SPECT-CT increases the radiation dose to the patient, with the effective dose due to CT exceeding the effective dose of RP in many instances. Hence, appropriate utilization and optimization of the protocols of SPECT-CT is needed to maximize benefit to patients. Nucl Med Commun 33:926-932
A review on the clinical uses of SPECT/CT
European Journal of Nuclear Medicine and Molecular Imaging, 2010
In the era when positron emission tomography (PET) seems to constitute the most advanced application of nuclear medicine imaging, still the conventional procedure of single photon emission computed tomography (SPECT) is far from being obsolete, especially if combined with computed tomography (CT). In fact, this dual modality imaging technique (SPECT/CT) lends itself to a wide variety of useful diagnostic applications whose clinical impact is in most instances already well established, while the evidence is growing for newer applications. The increasing availability of new hybrid SPECT/CT devices with advanced technology offers the opportunity to shorten acquisition time and to provide accurate attenuation correction and fusion imaging. In this review we analyse and discuss the capabilities of SPECT/CT for improving sensitivity and specificity in the imaging of both oncological and non-oncological diseases. The main advantages of SPECT/CT are represented by better attenuation correction, increased specificity, and accurate depiction of the localization of disease and of possible involvement of adjacent tissues. Endocrine and neuroendocrine tumours are accurately localized and characterized by SPECT/CT, as also are solitary pulmonary nodules and lung cancers, brain tumours, lymphoma, prostate cancer, malignant and benign bone lesions, and infection. Furthermore, hybrid SPECT/ CT imaging is especially suited to support the increasing applications of minimally invasive surgery, as well as to precisely define the diagnostic and prognostic profile of cardiovascular patients. Finally, the applications of SPECT/ CT to other clinical disorders or malignant tumours is currently under extensive investigation, with encouraging results in terms of diagnostic accuracy. Keywords SPECT/CT. Hybrid imaging. Attenuation correction. Diagnostic specificity. Localization and extent of disease. Malignant and benign disorders The increasing clinical demand for more specific diagnostic systems and improved algorithms aimed at optimizing patients'
European Journal of Nuclear Medicine and Molecular Imaging, 2019
Purpose Single-photon emission computed tomography (SPECT) combined with computed tomography (CT) was introduced as a hybrid SPECT/CT imaging modality two decades ago. The main advantage of SPECT/CT is the increased specificity achieved through a more precise localization and characterization of functional findings. The improved diagnostic accuracy is also associated with greater diagnostic confidence and better inter-specialty communication. Methods This review presents a critical assessment of the relevant literature published so far on the role of SPECT/CT in a variety of clinical conditions. It also includes an update on the established evidence demonstrating both the advantages and limitations of this modality. Conclusions For the majority of applications, SPECT/CT should be a routine imaging technique, fully integrated into the clinical decision-making process, including oncology, endocrinology, orthopaedics, paediatrics, and cardiology. Large-scale prospective studies are lacking, however, on the use of SPECT/CT in certain clinical domains such as neurology and lung disorders. The review also presents data on the complementary role of SPECT/CT with other imaging modalities and a comparative analysis, where available.
SPECT/CT hybrid imaging; with which CT?
Contrast Media & Molecular Imaging, 2010
Aim: The aim of this study is to show the practical use of, and to discuss the rationale for, high-end computed tomography (CT) integrated with intrinsic low-resolution single-photon emission tomography (SPECT). Materials and methods: All examinations performed on three new SPECT/CT systems with diagnostic CT capabilities were recorded retrospectively. The use of CT was classified as low-dose, using the CT with restraint as to the tube current and radiation dose, or diagnostic, with an optimum use of the CT, using CT protocols as used in ordinary radiological practice. The number of low-dose CT was compared with the number of diagnostic CT examinations. The report is based on 436 patient examinations from three hospitals in Norway with recently installed SPECT/CT systems, the time of use varying from 6 months to 2 years. The examinations performed were myocardial perfusion (45%), various tumors (thyroid, parathyroid, neuroendocrine 37%), malignant skeletal disease (12%), brain perfusion (4%), sentinel nodes in breast cancer (1%) and gastrointestinal bleeding (1%). Results: Of the 436 patients, 431 had a low-dose CT for attenuation correction, anatomic localisation and, also for diagnosis, whereas five patients had a diagnostic CT. In these series, as was found in recent literature, the diagnostic potential of the CT was seldom used to its capacity and always in predetermined diagnostic situations. Conclusion: There is a low degree of utilization of the diagnostic capabilities of the CT in the SPECT/CT context, for a number of reasons. This raises questions about the cost-benefit of investing in high-end CT for SPECT/CT applications.
Role of SPECT CT in Diagnostic Imaging
Proceedings of Exploring New Frontiers in Medicine and Health, 2006
To investigate the dosimetric accuracy of the sliding window gated IMRT compared with the static treatment, using varying dose rates. Materials and methods: This study measured changes in output and diode array response with changing dose rate, verified the precision of the motion table, and measured changes in dose distribution accuracy with film and diodes at two depths with changing dose rate. During 4DCT (4 Dimensional Computed Tomography), the patient's respiratory signals and target motion were recorded and imported to the XY4D simulation table of SUN NUCLEAR Corporation to simulate the patient's respiration and tumour motion. A single field of each sliding window IMRT plan with 30º wedge and one for lung cancer were used in this study. Three irradiating conditions, static and moving target with and without gating, were applied to both plans. Results: The standard deviations of output, with the dose rates changing from 300-600 MU/min, were 0.065 cGy and 0.169 cGy for the ionisation chamber and diode, respectively. The verification of the motion table shows very good precision with 9.98 ± 0.02 cm (true value = 10.0 cm). The measurements by MapCheck show the gamma index of the planned absolute dose distribution in static and moving targets with gating, resulting in more than 96% passing for all dose rates. The absolute dose distribution measured by film for the static target was agreeable with the value of moving target with gating. Conclusion: The sliding window gated IMRT technique is able to deliver an accurate dose to a moving target with the dose rate of 300-600 MU/min that is suitable for clinical treatment.
Pictorial review of SPECT/CT imaging applications in clinical nuclear medicine
American journal of nuclear medicine and molecular imaging, 2012
Integrated SPECT/CT scanners are gaining popularity as hybrid molecular imaging devices which can acquire SPECT and CT in a single exam. CT can be a low dose non-contrast enhanced scan for attenuation correction and anatomical localization, or a contrast enhanced diagnostic quality scan for additional anatomical characterization. We present a pictorial review highlighting the usefulness of this emerging technology. We present SPECT/CT images of 13 patients where additional information was provided by the co-registered low dose non-contrast enhanced CT scan. They belong to 12 male and 1 female patients with age ranging from 28 to 76 yrs, who were referred to the Nuclear Medicine Department for various indications. We describe these cases under in the following categories: bone scintigraphy (2), leukocyte scintigraphy (2), nuclear oncology (5), nuclear cardiology (1), and general nuclear medicine (3). Additional information provided by the co-registered low dose CT improves the diagno...
Hybrid Imaging – SPECT/CT: Making a Difference
With the technological advancements in the medical imaging field, the past decade has witnessed a dramatic evolution of multimodality imaging systems. Scientists, technologists and researchers have been able to bring systems in clinical practice, in which two or more standalone diagnostic imaging modalities have been combined. Some of those multimodality imaging systems are: PET/CT, SPECT/CT, PET/MRI and PET/SPECT/CT. With this technique a patient is scanned in a single session and the desired structural and functional information of the organ of interest is achieved. Recent clinical imaging studies in the areas of cardiology, endocrinology, infection, musculoskeletal and neurology has shown, that with multimodality diagnostic imaging, a significant increase in diagnostic accuracy is achieved, as compared to single diagnostic imaging modality. In this review, emphasis is given to the technical aspects and clinical applications of the SPECT/CT hybrid imaging modality.
Novelties and New Potentials in the Clinical Application of SPECT/CT Imaging
Journal of Nuclear Medicine & Radiation Therapy, 2016
The application of hybrid devices that is fused technologies is getting more and more important in the field of imaging diagnostics. The greatest advantage of this method is the combined use of several modalities, which can provide data about the morphological, functional and possibly molecular changes in different diseases simultaneously. In this paper the potentials, advantages and applicabilities of SPECT/CT (single photon emission computer tomograph/computer tomograph) are summarized mainly in oncological diseases but in other diseases as well. Multimodality devices detecting functional and morphological abnormalities simultaneously increase the specificity and diagnostic accuracy of nuclear medicine methods and therefore the effectiveness of therapy too.
2020
Abstract–The development of the first clinical simultaneous Single Photon Emission Computed Tomography (SPECT) and Magnetic Resonance Imaging (MRI) system was carried out within the INSERT project. The INSERT scanner was constructed under the initial project, but its performance was not fully evaluated; here we have reconstructed the first images on the SPECT system. Calibration and acquisition protocols were developed and used to establish the clinical feasibility of the system. The image reconstruction procedures were implemented on the first phantom images in order to assess the system’s imaging capabilities. This study solved issues involving incomplete data sets and pixel failure in the prototype detector system. The final images determined a measure of trans-axial image resolution, giving average values of 9.14 mm and 6.75 mm in the radial and tangential directions respectively. The work carried out on the complete system produced several clinical phantom images which utilize...