SPECT/CT hybrid imaging; with which CT?

Bach‐Gansmo, Tore; Schwarzlmüller, Thomas; Jøraholmen, Vivi; Salbu, Jan; Biermann, Martin; Naum, Alexandru; Kleven-Madsen, Nina

doi:10.1002/cmmi.375

Cited by 7 publications

(6 citation statements)

References 49 publications

(113 reference statements)

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“…As a result, striking the balance between image quality, price, and safeguarding of patient throughput-all critical issues from a marketing point of view-proved difficult. Also, high-end CT capabilities were considered unnecessary given the low SPECT resolution and concerns regarding the CT-related additional radiation burden (12). On top of this, the flexibility in terms of the mechanical NOTEWORTHY n Current state-of-the-art hybrid SPECT/CT devices offer significant improvements in SPECT spatial resolution and sensitivity, accurate absolute tracer uptake quantification comparable to PET/CT, and many advanced CT features.…”

Section: If a Little Is Great Is More Better?mentioning

confidence: 99%

SPECT/CT: Standing on the Shoulders of Giants, It Is Time to Reach for the Sky!

et al. 2020

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Twenty years ago, SPECT/CT became commercially available, combining the strengths of both techniques: the diagnostic sensitivity of SPECT and the anatomic detail of CT. Other benefits initially included attenuation correction of SPECT reconstructions, ultimately evolving to correction techniques that would enable absolute tracer uptake quantification. Recent developments in SPECT hardware include solid-state digital systems with higher sensitivity and resolution, using novel collimator designs based on tungsten. Similar advances in CT technology have been introduced in hybrid SPECT/ CT systems, replacing low-end x-ray tubes with high-end multislice CT scanners equipped with iterative reconstruction, metal artifact reduction algorithms, and dual-energy capabilities. More recently, the design of whole-body SPECT/CT systems has taken another major leap with the introduction of a ring-shaped gantry equipped with multiple movable detectors surrounding the patient. These exciting developments have fueled efforts to develop novel SPECT radiopharmaceuticals, creating new chelators and prosthetic groups for radiolabeling. Innovative SPECT radionuclide pairs have now become available for radiolabeling with the potential for use as theranostic agents. The growth of precision medicine and the associated need for accurate radionuclide treatment dosimetry will likely drive the use of SPECT/CT in the near future. In addition, expanding clinical applications of SPECT/CT in other areas such as orthopedics offer exciting opportunities. Although it is true that the SPECT/CT ecosystem has seen several challenges during its development over the past 2 decades, it is now a feature-rich and mature tool ready for clinical prime time.

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Section: If a Little Is Great Is More Better?mentioning

confidence: 99%

SPECT/CT: Standing on the Shoulders of Giants, It Is Time to Reach for the Sky!

et al. 2020

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“…With the hybrid systems featuring a multislice spiral CT scanner, a CT examination of the skeleton of full diagnostic quality is possible, at least in principle. A literature survey shows, however, that even when such CT scanners are available, low-dose CT protocols with tube current-time products ranging from 15 to 60 mAs are generally used [10]. Furthermore, and contrary to the practice encountered in radiology, in a significant proportion of the studies so far published, the CT field of view is restricted to the region of the body harboring abnormalities of tracer uptake visible on the planar scintigraphic images.…”

Section: Technical Considerationsmentioning

confidence: 99%

Skeletal SPECT/CT: a review

Kuwert

2014

Clin Transl Imaging

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Skeletal scintigraphy is one of the most frequent in vivo procedures in the field of nuclear medicine. Visualizing bone metabolism, it exhibits a fairly high sensitivity to detect skeletal lesions, but has limitations in terms of specificity and spatial resolution, even when single-photon emission computed tomography (SPECT) is used. Combining SPECT with X-ray computed tomography helps overcome these limitations. This has, in particular, been shown when diagnosing bone involvement in malignant tumors. Emerging evidence indicates the benefit of hybrid imaging for bone scintigraphy during the workup of painful conditions affecting the back and the extremities. Methodological advances holding considerable promise for further improving its value are the quantitation of skeletal tracer uptake in absolute units, as well as multimodal image reconstruction techniques that have recently become available for use in clinical routine.

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“…Single photon emission computed tomography/X-ray computed tomography (SPECT/CT) with 99m Tc-MIBI and contrast-enhanced computed tomography (CECT) [21] identified ectopic parathyroid adenomas in the APW in both patients (axial diameter 35 (#1) and 12 mm (#2), respectively) (Figure 1). Cervical ultrasound was negative.…”

Section: Case Presentationmentioning

confidence: 99%

High cardiac background activity limits 99mTc-MIBI radioguided surgery in aortopulmonary window parathyroid adenomas

et al. 2014

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BackgroundRadioguided surgery using 99m-Technetium-methoxyisobutylisonitrile (99mTc-MIBI) has been recommended for the surgical treatment of mediastinal parathyroid adenomas. However, high myocardial 99mTc-MIBI uptake may limit the feasibility of radioguided surgery in aortopulmonary window parathyroid adenoma.Case presentationTwo female patients aged 72 (#1) and 79 years (#2) with primary hyperparathyroidism caused by parathyroid adenomas in the aortopulmonary window were operated by transsternal radioguided surgery. After intravenous injection of 370 MBq 99mTc-MIBI at start of surgery, the maximum radioactive intensity (as counts per second) was measured over several body regions using a gamma probe before and after removal of the parathyroid adenoma. Relative radioactivity was calculated in relation to the measured ex vivo radioactivity of the adenoma, which was set to 1.0.Both patients were cured by uneventful removal of aortopulmonary window parathyroid adenomas of 4400 (#1) and 985 mg (#2). Biochemical cure was documented by intraoperative measurement of parathyroid hormone as well as follow-up examination. Ex vivo radioactivity over the parathyroid adenomas was 196 (#1) and 855 counts per second (#2). Before parathyroidectomy, relative radioactivity over the aortopulmonary window versus the heart was found at 1.3 versus 2.6 (#1) and 1.8 versus 4.8 (#2). After removal of the adenomas, radioactivity within the aortopulmonary window was only slightly reduced.ConclusionHigh myocardial uptake of 99mTc-MIBI limits the feasibility of radioguided surgery in aortopulmonary parathyroid adenoma.

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SPECT/CT hybrid imaging; with which CT?

Abstract: 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.

Cited by 7 publications

References 49 publications

SPECT/CT: Standing on the Shoulders of Giants, It Is Time to Reach for the Sky!

SPECT/CT: Standing on the Shoulders of Giants, It Is Time to Reach for the Sky!

Skeletal SPECT/CT: a review

High cardiac background activity limits 99mTc-MIBI radioguided surgery in aortopulmonary window parathyroid adenomas

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