Clinical Applications of SPECT/CT: New Hybrid Nuclear Medicine Imaging System
Interest in multimodality imaging shows no sign of subsiding. New tracers are spreading out the spectrum of clinical applications and innovative technological solutions are preparing the way for yet more modality marriages: hybrid imaging.
Single photon emission computed tomography (SPECT) has enabled the evaluation of disease processes based on functional and metabolic information of organs and cells. Integration of X-ray computed tomography (CT) into SPECT has recently emerged as a brilliant diagnostic tool in medical imaging, where anatomical details may be delineated as well as functional and metabolic information.
SPECT/CT has proven to be valuable in oncology. For example, in the case of a patient with metastatic thyroid cancer, neither SPECT nor CT alone could identify the site of malignancy. SPECT/CT, a hybrid image, precisely identified where the surgeon should operate.
However SPECT/CT is not just advantageous in oncology. It may also be used as a one-stop-shop for various diseases.
Clinical applications with SPECT/CT have started and expanded in developed countries. It has been reported that moving from SPECT alone to SPECT/CT could change diagnoses in 30% of cases. Large numbers of people could therefore benefit from this shift all over the world.
This report presents an overview of clinical applications of SPECT/CT and a relevant source of information for nuclear medicine physicians, radiologists and clinical practitioners. This information may also be useful for decision making when allocating resources dedicated to the health care system, a critical issue that is especially important for the development of nuclear medicine in developing countries
- 2. OVERVIEW OF SPECT/CT TECHNOLOGY
- 3. GENERAL NUCLEAR MEDICINE SPECT/CT PROCEDURES
- 3.1. 131I-Iodide SPECT/CT in thyroid cancer
- 3.2. Neural crest and adrenal tumours
- 3.3. 111In-octreotide SPECT/CT for assessing neuroendocrine tumours
- 3.4. 67Ga-citrate SPECT/CT in lymphoma
- 3.5. Lymphoscintigraphy
- 3.6. Skeletal scintigraphy for staging malignant disease
- 3.7. Skeletal SPECT/CT in orthopaedics
- 3.8. 201Tl-chloride in cerebral masses
- 3.9 99mTc-depreotide in solitary pulmonary nodules
- 3.10. ProstaScintigraphy
- 3.11. SPECT/CT in the preoperative localization of parathyroid adenomas
- 3.12. SPECT/CT for diagnosing infection and inflammation
- 3.13. Cardiac SPECT/CT procedures
- 3.14. Added values of CT in patients with coronary artery disease
- 3.15. Pulmonary artery imaging in pulmonary embolism
- 4. ADVANTAGES OF UTILIZING SPECT/CT
- 4.1. Anatomical accuracy of image registration in SPECT/CT hybrid imaging
- 4.2. The effects of CT based attenuation correction of SPECT image data sets and potential future applications
- 4.3. Additional information or diagnosis from CT
- 4.4. Use of SPECT/CT data for estimating internal radiation dosimetry
- 4.5. Radiation dose of CT from SPECT/CT
- 5. FURTHER DEVELOPMENT OF SPECT/CT WITH NEW RADIOPHARMACEUTICALS
- 6. CT TRAINING IMAGING FOR NUCLEAR PHYSICIANS AND TECHNOLOGISTS
- 7. REFERRAL CRITERIA FOR SPECT/CT
- 8. CONCLUDING REMARKS