Optimization of the CT component of SPECT-CT and establishment of local CT diagnostic reference levels for clinical practice

Dennis, Jennifer L; Nicol, Alice

doi:10.1097/mnm.0000000000000831

Cited by 4 publications

(5 citation statements)

References 5 publications

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“…Moreover, modern SPECT-CT scanners are equipped with CT used for the purpose of attenuation correction (AC), AC-AL and diagnostic CT [3]. Intangibly, the co-registered acquisition from SPECT and CT protocol may lead in increased radiation burden to patients [4].…”

Section: Introductionmentioning

confidence: 99%

The establishment of national diagnostic reference levels for adult SPECT-CT in Saudi Arabia

Al-Qahtani,

Alidasroos,

Alkhybari

et al. 2023

J. Radiol. Prot.

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This study aims to introduce national diagnostic reference levels )NDRLs) for adult hybrid SPECT/CT in nuclear medicine (NM) departments in the Kingdom of Saudi Arabia. The Adminis-tered Activity (AA) of radiopharmaceuticals, volume-weighted computed tomography dose index (CTDIvol) and dose length product (DLP) for ten hybrid SPECT/CT examinations were collected and analyzed for one year. The median of AA, CTDIvol and DLP for each dose quantity was derived and the suggested national DRLs were determined based on the 75th percentile for all identified SPECT/CT examinations. A comparison of the defined adult NDRLs in Saudi Arabia with the pub-lished data of other countries was performed. Although there are no significant variations of the proposed NDRL of AA between countries, the proposed NDRLs of the integrated CT metrics ex-ceed the published data in most procedures. NM departments are urged to consider optimization for both image quality and radiation protection.

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Section: Introductionmentioning

confidence: 99%

The establishment of national diagnostic reference levels for adult SPECT-CT in Saudi Arabia

Al-Qahtani,

Alidasroos,

Alkhybari

et al. 2023

J. Radiol. Prot.

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“…The union of NM and CT imaging modalities is possible through hybrid equipment, such as Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) and Positron Emission Tomography/Computed tomography (PET/CT). These equipment allow the anatomical co-registration of metabolic and functional images [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Quality and Quantity Assessment of Tomographic Exams That Can Be Performed on Existing Hybrid Equipment at Botucatu Medical School Nuclear Medicine Services

et al. 2022

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Computed Tomography (CT) has been one of the greatest innovations for medical diagnosis. Among the main features of CT is its ability to provide high-quality anatomical and functional images. Other important imaging modalities are the ones conducted in Nuclear Medicine (NM), which, with the use of radiotracers, makes it possible to obtain metabolic and molecular images in vivo. The union of NM and CT imaging modalities is possible through hybrid equipment. The purpose of this research is to evaluate the quality and quantity of tomographic exams that can be performed in hybrid equipment. To complete this research analyzes of the ability to perform CT exams in the room that holds a Single Photon Emission Computed Tomography/ Computed Tomography SPECT/CT equipment in an NM facility were carried out. The evaluation criteria were: equipment quality control, image quality assessment by a subjective method as per European Guidelines on Quality Criteria for Computed Tomography (EUR), and assessment of shielding of the room, as an indicator of how many exams can be performed. Considering the results of the barrier thickness, the Botucatu Medical School and Nuclear Medicine facility is capable of performing 100 tomography exams per week. According to information obtained in the facility, currently, approximately 20 scans are performed weekly, so there is an increased opportunity of up to 80 exams weekly. Therefore, the hybrid equipment is qualified to perform diagnostic tests with superior image quality, compared to those performed in CT equipment.

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“…It is estimated that for 99m Tc‐MDP bone scintigraphy with SPECT/CT examination, even reduced exposure parameters may increase the total effective dose in the range of approximately 60–85% compared to SPECT without CT 10,11 . That is why many nuclear medicine specialists are interested in reducing patient exposure to ionizing radiation during SPECT/CT, especially emphasizing CT 3,12–16 . However, patient exposure during CT is directly related to CT image quality, which cannot lose its diagnostic value due to different exposure parameters.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7] In CT scans performed to localize pathological tracer uptake found in SPECT and attenuation correction (AC) (low-dose CT), effective doses in the range of 0.6 mSv-4 mSv were reported. 8,9 It is estimated that for 99m Tc-MDP bone scintigraphy with SPECT/CT examination, even reduced exposure parameters may increase the total effective dose in the range of approximately 60-85% compared to SPECT without CT. 10,11 That is why many nuclear medicine specialists are interested in reducing patient exposure to ionizing radiation during SPECT/CT, especially emphasizing CT. 3,[12][13][14][15][16] However, patient exposure during CT is directly related to CT image quality, which cannot lose its diagnostic value due to different exposure parameters. The selection of exposure parameters, mainly x-ray tube current and high voltage, has a major impact on both aspects of CT examination.…”

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confidence: 99%

On the optimization of bone SPECT/CT in terms of image quality and radiation dose

Tulik

Kowalska

2020

J Applied Clin Med Phys

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Introduction The purpose of this study was to present the optimization process of CT parameters to reduce patient exposure during bone SPECT/CT without affecting the quality of SPECT images with attenuation correction (AC). Material and methods A fillable phantom reflecting realistic bone scintigraphy conditions was developed and acquired on an AnyScan SC. SPECT/CT scans were carried out with different x‐ray tube current values (10, 20, 30, 40, 50, 60, 70, 90, 110, 130, 150, and 200 mA) at three different high‐voltage values (80, 100, and 120 kV). The contrast (C) and coefficients of variation (CV) in the SPECT images as well as the signal‐to‐noise ratio (SNR) and noise (SDCT) in the CT images with CTDIvol were measured. An optimal acquisition protocol that obtained SPECT/CT images with no artifacts on both CT and SPECT images, acceptable C, SNR, CV, and SDCT values, and the largest reduction in patient exposure compared to the reference acquisition procedure was sought. Results The optimal set of parameters for bone SPECT/CT was determined based on a phantom study. It has been implemented in clinical practice. Two groups of patients were examined according to the baseline and optimized protocols, respectively. The new SPECT/CT protocol substantially reduced patients’ radiation exposure compared to the old protocol while maintaining the required diagnostic quality of SPECT and CT images. Conclusions In the study, we present a methodology that finds a compromise between diagnostic information and patient exposure during bone SPECT/CT procedures.

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Optimization of the CT component of SPECT-CT and establishment of local CT diagnostic reference levels for clinical practice

Abstract: This work describes a process of optimization and the creation of practical and effective local DRLs. These can be used in local audit of practice. In future, improved descriptors and standardization of SPECT-CT use would allow more practicable UK national DRLs to be created.

Cited by 4 publications

References 5 publications

The establishment of national diagnostic reference levels for adult SPECT-CT in Saudi Arabia

The establishment of national diagnostic reference levels for adult SPECT-CT in Saudi Arabia

Quality and Quantity Assessment of Tomographic Exams That Can Be Performed on Existing Hybrid Equipment at Botucatu Medical School Nuclear Medicine Services

On the optimization of bone SPECT/CT in terms of image quality and radiation dose

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