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Overview of SPECT/CT Applications

Overview of SPECT/CT Applications. way to “new & clear” medicine. Peeyush Bhargava M.D, M.S Attending in Nuclear Medicine, MEDVAMC Associate Professor of Radiology, BCM www.nuclearmd.com. SPECT & CT - Definitions.

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Overview of SPECT/CT Applications

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  1. Overview of SPECT/CT Applications way to “new & clear” medicine PeeyushBhargavaM.D, M.S Attending in Nuclear Medicine, MEDVAMC Associate Professor of Radiology, BCM www.nuclearmd.com

  2. SPECT & CT - Definitions • SPECT (Single Photon Emission Computed Tomography) – “tomographicscintigraphy 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”

  3. SPECT/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”

  4. SPECT/CT – pubmed search Hybrid SPECT/CT: the end of "unclear" medicine. Patel CN, Chowdhury FU, Scarsbrook AF. Postgrad Med J. 2009 Nov;85(1009):606-13. “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.”

  5. SPECT/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. 2008 Aug;49(8):1305-19. SPECT/CT imaging: clinical utility of an emerging technology. Bybel B, Brunken RC, DiFilippo FP, Neumann DR, Wu G, Cerqueira MD. Radiographics. 2008 Jul-Aug;28(4):1097-113. 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. 2010 Oct;37(10):1959-85.

  6. Current SPECT/CT Systems Gamma 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. 2000 Jun;27(6):619-27. “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.”

  7. SPECT/CT Image Processing SPECT/CT imaging: clinical utility of an emerging technology. Bybel B, Brunken RC, DiFilippo FP, Neumann DR, Wu G, Cerqueira MD. Radiographics. 2008 Jul-Aug;28(4):1097-113. “The attenuation map is then used by an iterative reconstruction algorithm to perform attenuation correction of the emission data”

  8. SPECT/CT in Bone Scintigraphy Multislice 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. SeminNucl Med. 2009 Nov;39(6):431-42. Bone SPECT-CT with 99mTc-labelled bisphosphonates. Rasilla JM, Arboniés JC, Gutiérrez LL. Rev Esp Med Nucl. 2009 Nov-Dec;28(6):307-8.

  9. Case # 1 – Whole Body Bone Scan

  10. Case # 1 – Whole Body Bone Scan

  11. Case # 2 – Whole Body Bone Scan

  12. Case # 2 – Whole Body Bone Scan

  13. Case # 3 – Whole Body Bone Scan

  14. Case # 3 – Whole Body Bone Scan

  15. Case # 4 – Three Phase Bone Scan

  16. Case # 4 – Three Phase Bone Scan

  17. SPECT/CT in Imaging Infection Diabetic foot infection: usefulness of SPECT/CT for 99mTc-HMPAO-labeled leukocyte imaging. Filippi L, Uccioli L, Giurato L, Schillaci O. J Nucl Med. 2009 Jul;50(7):1042-6.

  18. Case # 5 – Leukocyte Scintigraphy

  19. Case # 5 – Leukocyte Scintigraphy

  20. Case # 6 – Leukocyte Scintigraphy

  21. Case # 6 – Leukocyte Scintigraphy

  22. Case # 7 – Leukocyte Scintigraphy

  23. Case # 7 – Leukocyte Scintigraphy

  24. Case # 8 – Leukocyte Scintigraphy

  25. Case # 8 – Leukocyte Scintigraphy

  26. SPECT/CT in Endocrine Scintigraphy Comparison 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. 2007 Jul;48(7):1084-9. “Thesefindings strongly suggest that dual-phase imaging, with earlySPECT/CT whenever possible, should be part of the routine preoperativeevaluation of patients with primary hyperparathyroidism in thisnew age of minimally invasive parathyroidectomy.”

  27. Case # 9 – Parathyroid Scan

  28. Case # 9 – Parathyroid Scan

  29. Case # 10 – Parathyroid Scan

  30. Case # 10 – Parathyroid Scan

  31. Case # 11 – Parathyroid Scan

  32. Case # 11 – Parathyroid Scan

  33. Case # 12 – Octreotide Scan

  34. Case # 12 – Octreotide Scan

  35. Case # 12 – Octreotide Scan

  36. Case # 13 – Octreotide Scan

  37. Case # 13 – Octreotide Scan

  38. Case # 14 – MIBG Scan

  39. Case # 14 – MIBG Scan

  40. SPECT/CT in Thyroid Scintigraphy Hybrid SPECT-CT and PET-CT imaging of differentiated thyroid carcinoma. Wong KK, Zarzhevsky N, Cahill JM, Frey KA, Avram AM. Br J Radiol. 2009 Oct;82(982):860-76. 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. 2008 Dec;49(12):1952-7.

  41. Case # 15 – I-131 Whole Body Scan

  42. Case # 15 – I-131 Whole Body Scan

  43. Case # 15 – I-131 Whole Body Scan

  44. Case # 16 – I-123 Thyroid Scan

  45. SPECT/CT in Prostascint Imaging Synergistic value of single-photon emission computed tomography/computed tomography fusion to radioimmunoscintigraphic imaging of prostate cancer. Sodee DB, Sodee AE, Bakale G. SeminNucl Med. 2007 Jan;37(1):17-28.

  46. Case # 17 – Prostascint Scan

  47. Case # 17 – Prostascint Scan

  48. Case # 18 – Prostascint Scan

  49. Case # 18 – Prostascint Scan

  50. SPECT/CT in Lymphoscintigraphy SPECT/CT for preoperative sentinel node localization. Vermeeren L, van derPloeg IM, Olmos RA, Meinhardt W, Klop WM, Kroon BB, Nieweg OE. J SurgOncol. 2010 Feb 1;101(2):184-90. 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. 2007 Mar;35(1):10-6

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