Pictorial review of SPECT/CT imaging applications in clinical nuclear medicine (original) (raw)
Related papers
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'
2016
Abstract: 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
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).
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.
Procedure Guideline for SPECT/CT Imaging 1.0
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2006
The purpose of this Procedure Guideline is to assist physicians in recommending, performing, interpreting, and reporting the results of SPECT/CT for imaging of adult and pediatric patients.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2007
The purpose of this prospective study was to assess the role of SPECT/multislice low-dose (Msl) CT as a constituent in the imaging algorithm of nononcologic patients referred for 99mTc-methylene diphosphonate bone scintigraphy (BS). SPECT/CT was performed using a novel hybrid system, which incorporates a gamma-camera and a multislice low-dose CT, on 76 consecutive nononcologic patients with nonspecific scintigraphic findings, which required further correlation with morphologic data. SPECT/MslCT was of added clinical value in 89% of the patients. Characterizing scintigraphic lesions by their morphologic appearance, SPECT/MslCT reached a final diagnosis in 49 of 85 (58%) nonspecific scintigraphic bone lesions found in 59% (45/76) of patients, obviating the need to perform additional imaging. In another 30% of patients (23/76), SPECT/MslCT data optimized the patients' imaging algorithm as the performance of a full-dose CT, MRI, or labeled-leukocyte scintigraphy as the next imaging ...
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.
American journal of nuclear medicine and molecular imaging, 2017
The CT component of SPECT-CT is required for attenuation correction and anatomical localization of the uptake on SPECT but there is no guideline about the optimal CT acquisition parameters. In our department, a standard CT acquisition protocol was changed in 2013 to give lower radiation dose to the patient. In this study, we retrospectively compared the effects on patient dose as well as the CT image quality with current versus older CT protocols. Ninety nine consecutive patients [n=51 Standard dose 'old' protocol (SDP); n=48 lower dose 'new' protocol (LDP)] with lumbar spine SPECT-CT for bone scan were examined. The main differences between the two protocols were that SDP used 130 kVp tube voltage and reference current-time product of 70 mAs whereas the LDP used 110 kVp and 40 mAs respectively. Various quantitative parameters from the CT images were obtained and the images were also rated blindly by two experienced nuclear medicine physicians for bony definition and...