Presentation on theme: "Overview of SPECT/CT Applications"— Presentation transcript:
1Overview of SPECT/CT Applications way to “new & clear” medicinePeeyush Bhargava M.D, M.SAttending in Nuclear Medicine, MEDVAMCAssociate Professor of Radiology, BCM
2SPECT & CT - Definitions SPECT (Single Photon Emission Computed Tomography) – “tomographic scintigraphy where computer generated three dimensional images of radioactive tracer distribution are produced by detection of single photons from acquired multiple planar images”CT (Computed Tomography) – “tomographic imaging performed with an external x-ray source to derive three dimensional anatomic image data”
3SPECT/CT - Definitions Integrated SPECT/CT Systems“that can perform both functions on one gantry and provide fused functional and anatomic data in a single imaging session”“enables a direct correlation of anatomic information and functional information resulting in better localization and definition of scintigraphic findings”
4SPECT/CT – pubmed search KeywordAllArticlesReview1.SPECT-CT700862.SPECT/CT213PET-CT49037414.PET/CT3744530Hybrid SPECT/CT: the end of "unclear" medicine.Patel CN, Chowdhury FU, Scarsbrook AF.Postgrad Med J Nov;85(1009):“Single photon emission computed tomography/CT (SPECT/CT) is a dual modality technique which increases the sensitivity and specificity of existing radionuclide imaging and helps characterize equivocal lesions detected by other imaging methods.”
5SPECT/CT - References SPECT/CT. Buck AK, Nekolla S, Ziegler S, Beer A, Krause BJ, Herrmann K, Scheidhauer K, Wester HJ, Rummeny EJ, Schwaiger M, Drzezga A.J Nucl Med Aug;49(8):SPECT/CT imaging: clinical utility of an emerging technology.Bybel B, Brunken RC, DiFilippo FP, Neumann DR, Wu G, Cerqueira MD. Radiographics Jul-Aug;28(4):A review on the clinical uses of SPECT/CT.Mariani G, Bruselli L, Kuwert T, Kim EE, Flotats A, Israel O, Dondi M, Watanabe N.Eur J Nucl Med Mol Imaging Oct;37(10):
6Current SPECT/CT Systems VendorGESIEMENSPHILIPSCameraModelsInfinia Hawkeye 4Symbia TSymbia T2Symbia T6Symbia T16BrightView XCTDiscovery NM/CT 670Precedence SPECT/CTGamma camera-mounted anatomical X-ray tomography: technology, system characteristics and first images.Bocher M, Balan A, Krausz Y, Shrem Y, Lonn A, Wilk M, Chisin R.Eur J Nucl Med Jun;27(6):“In order to produce anatomical images that are inherently registered with images of emission computerized tomography acquired with a gamma camera, an X-ray transmission system was mounted on the slip-ring gantry of a GEMS Millennium VG gamma camera.”
7SPECT/CT Image Processing ModalityImage Reconstruction1.SPECTIterative Reconstruction using CT Attenuation Map2.CTMultiplanar Reconstruction3.Image CoregistrationAutomated SoftwareSPECT/CT imaging: clinical utility of an emerging technology.Bybel B, Brunken RC, DiFilippo FP, Neumann DR, Wu G, Cerqueira MD.Radiographics Jul-Aug;28(4):“The attenuation map is then used by an iterative reconstruction algorithm to perform attenuation correction of the emission data”
8SPECT/CT in Bone Scintigraphy SearchKeywordAllArticlesReviewSPECT-CT and Bone12918Multislice SPECT/CT in benign and malignant bone disease: when the ordinary turns into the extraordinary.Gnanasegaran G, Barwick T, Adamson K, Mohan H, Sharp D, Fogelman I.Semin Nucl Med Nov;39(6):Bone SPECT-CT with 99mTc-labelled bisphosphonates.Rasilla JM, Arboniés JC, Gutiérrez LL.Rev Esp Med Nucl Nov-Dec;28(6):307-8.
26SPECT/CT in Endocrine Scintigraphy SearchKeywordAllArticlesReviewSPECT-CT and Endocrine3310Comparison of SPECT/CT, SPECT, and planar imaging with single- and dual-phase (99m)Tc-sestamibi parathyroid scintigraphy.Lavely WC, Goetze S, Friedman KP, Leal JP, Zhang Z, Garret-Mayer E, Dackiw AP, Tufano RP, Zeiger MA, Ziessman HA.J Nucl Med Jul;48(7):“These findings strongly suggest that dual-phase imaging, with early SPECT/CT whenever possible, should be part of the routine preoperative evaluation of patients with primary hyperparathyroidism in this new age of minimally invasive parathyroidectomy.”
40SPECT/CT in Thyroid Scintigraphy SearchKeywordAllArticlesReviewSPECT-CT and Thyroid646Hybrid SPECT-CT and PET-CT imaging of differentiated thyroid carcinoma.Wong KK, Zarzhevsky N, Cahill JM, Frey KA, Avram AM.Br J Radiol Oct;82(982):Incremental value of 131I SPECT/CT in the management of patients with differentiated thyroid carcinoma.Chen L, Luo Q, Shen Y, Yu Y, Yuan Z, Lu H, Zhu R.J Nucl Med Dec;49(12):
45SPECT/CT in Prostascint Imaging SearchKeywordAllArticlesReviewSPECT-CT and Prostascint161Synergistic value of single-photon emission computed tomography/computed tomography fusion to radioimmunoscintigraphic imaging of prostate cancer.Sodee DB, Sodee AE, Bakale G.Semin Nucl Med Jan;37(1):17-28.
50SPECT/CT in Lymphoscintigraphy SearchKeywordAllArticlesReviewSPECT-CT and Sentinel Node657SPECT/CT for preoperative sentinel node localization.Vermeeren L, van der Ploeg IM, Olmos RA, Meinhardt W, Klop WM, Kroon BB, Nieweg OE.J Surg Oncol Feb 1;101(2):Evaluation and localization of lymphatic drainage and sentinel lymph nodes in patients with head and neck melanomas by hybrid SPECT/CT lymphoscintigraphic imaging.Mar MV, Miller SA, Kim EE, Macapinlac HA.J Nucl Med Technol Mar;35(1):10-6
59SPECT/CT in Nuclear Cardiology SearchKeywordAllArticlesReviewSPECT-CT and Cardiac7219Hybrid SPECT-CT: integration of CT coronary artery calcium scoring and angiography with myocardial perfusion.Mahmarian JJ.Curr Cardiol Rep Apr;9(2):“Hybrid imaging with SPECT and CT angiography may prove important from a diagnostic and therapeutic view point in several clinical scenarios, and it is likely that over the next decade fusion imaging may more precisely tailor therapy, reduce healthcare costs, and improve patient outcome.”
65SPECT/CT: Conclusions and Issues Improved Sensitivity and SpecificityExcellent anatomical localizationMorphological characterization* More confident reporting* Less indeterminate findings* Biopsy assistance* Dosimetry* CT quality* Reimbursement* Radiation exposure* Study time