Cadmium zinc telluride (CdZnTe, or CZT) is a room-temperature semiconductor radiation detector that has been developed in recent years for a variety of applications. CZT has been investigated for many potential uses in medical imaging, especially in the field of single photon emission computed tomography (SPECT). CZT can also be used in positron emission tomography (PET) as well as photon-counting and integration-mode x-ray radiography and computed tomography (CT). The principal advantages of CZT are 1) direct conversion of x-ray or gamma-ray energy into electron-hole pairs; 2) energy resolution; 3) high spatial resolution and hence high space-bandwidth product; 4) room temperature operation, stable performance, high density, and small volume; 5) depth-of-interaction (DOI) available through signal processing. These advantages will be described in detail with examples from our own CZT systems. The ability to operate at room temperature, combined with DOI and very small pixels, make the use of multiple, stationary CZT 'mini-gamma cameras" a realistic alternative to today's large Anger-type cameras that require motion to obtain tomographic sampling. The compatibility of CZT with Magnetic Resonance Imaging (MRI)-fields is demonstrated for a new type of multi-modality medical imaging, namely SPECT/MRI. For pre-clinical (i.e., laboratory animal) imaging, the advantages of CZT lie in spatial and energy resolution, small volume, automated quality control, and the potential for DOI for parallax removal in pinhole imaging. For clinical imaging, the imaging of radiographically dense breasts with CZT enables scatter rejection and hence improved contrast. Examples of clinical breast images with a dual-head CZT system are shown.
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