Spect/Ct

Abstract

In view of the commercial success of integrated PET/CT scanners, there is an increasing interest in comparable SPECT/CT systems. SPECT in combination with CT enables a direct correlation of anatomic information and functional information, resulting in better localization and definition of scintigraphic findings. Besides anatomic referencing, the added value of CT coregistration is based on the attenuation correction capabilities of CT. The number of clinical studies is limited, but pilot studies have indicated a higher specificity and a significant reduction in indeterminate findings. The superiority of SPECT/CT over planar imaging or SPECT has been demonstrated in bone scintigraphy, somatostatin receptor scintigraphy, parathyroid scintigraphy, and adrenal gland scintigraphy. Also, rates of detection of sentinel nodes by biopsy can be increased with SPECT/CT. This review highlights recent technical developments in integrated SPECT/CT systems and summarizes the current literature on potential clinical uses and future directions for SPECT/CT in cardiac, neurologic, and oncologic applications.

Advances in multimodality molecular imaging of bone structure and function

“…29 An imaging chamber or bed that rigidly fixes the subject together with fiducial markers visible in all modalities will improve registration and therefore allow more accurate image fusion; 30 however, involuntary movement and changes in the shape of organs remain complications. 23 …”

“…However, in metastases with discordant PET and CT findings, the positive predictive value is markedly diminished. Independently, the positive predictive value of all lesions is significantly higher with PET than with CT. 63 The distinction between benign and malignant lesions can usually be achieved by registration of 18 F-FDG -PET with CT. 64 Furthermore, 99m Tc-MDP SPECT can differentiate between malignant and benign metastases when 99m Tc-MDP SPECT and CT are registered, 23 indicating the importance of multimodality imaging.…”

“…These scanners thus provide the most precise fusion of images and enable a more specific diagnosis, but have a complicated design that often involves compromising the image quality, and they are also very expensive. 21 The most commonly used multimodality scanners in clinical practice are PET / CT 22 and SPECT / CT. 23 Multimodality scanners that combine PET / MRI, 24 PET / optical imaging, 25 FMT / CT 26 and FMT / MRI 27 have been developed as well and are mostly confined to preclinical research.…”

How Useful is an Integrated SPECT/CT in Clinical Setting and Research?: Evaluation of a Low Radiation Dose 4 Slice System§

“…In non-cardiac protocols, these authors highlighted the superiority of SPECT/CT over planar/SPECT with a CT unit that can be used as a low-dose non-enhanced spiral CT or high-dose contrast-enhanced diagnostic CT. In cardiac protocols, low-dose non-enhanced CT may be used for attenuation correction in MPI or combined to a diagnostic 64-slice cardiac CT for coronary angiography and calcium scoring [35].…”

Skeletal metastases: what is the future role for nuclear medicine?

“…Hybrid SPECT/CT with diagnostic quality CT has partly been driven by the success of PET/CT, and as a relatively recently available modality, the evidence for incremental benefit in imaging bone metastases is only just starting to accrue [4][5][6][7]. Utsunomiya et al have shown an incremental benefit of fused SPECT/CT compared to separate SPECT and CT images or planar and SPECT images [4].…”