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

Abstract

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.

Synthesis and Evaluation of Novel Norfloxacin Isonitrile 99mTc Complexes as Potential Bacterial Infection Imaging Agents

“…In recent decades, the development of SPECT/CT hardware has greatly improved. Among them, the successful manufacture of cadmium-zinc-telluride (CZT) detectors promotes the sensitivity and resolution of SPECT/CT to offer accurate absolute radiotracer uptake quantification compared to PET/CT [31]. Technetium-99m, as a generator-produced SPECT radionuclide, is a very good choice for radiopharmaceuticals due to its ideal nuclide properties, availability, and affordability.…”

Maximal covering location problem for nuclear medicine clinics allocation in Nigeria

“…Recent advances in imaging technology and radiopharmaceutical development point to a boom in nuclear medicine applications for diagnosis and treatment globally [23,24]. NM is vital to the detection and treatment of cancers, yet most sub-Saharan African countries face challenges with the provision of NM services [25].…”

Underutilisation of nuclear medicine scans at a regional hospital in Nigeria: need for implementation research

“…In the southern hemisphere of Africa, the availability of PET is limited to South Africa and, recently, Kenya. Recent advances in SPECT technology are projected to advance SPECT closer to PET imaging [58]. However, it will require matching advances in SPECT radiopharmacy and affordability within the reach of low-resource countries.…”