Health Imaging & IT - June 2008 - (Page 18)

special secTiOn MOlecular iMaging By Jonathan Batchelor SPECT/CT Proving its Potential The combination of single-photon emission computed tomography (SPECT) with computed tomography (CT) into a single modality has provided interpreting clinicians with greater diagnostic certainty, expanded their capability to localize disease, reduced patient exam time, and delivered images and reports to referring physicians that better assist in their delivery of quality care. “Hybrid imaging with sequential acquisition of structural (CT) and functional data in the same imaging session without alteration in patient position overcomes many of the shortcomings and enables more accurate co-registration,” according to the researchers. One of the oncologic indications where SPECT/CT has proved its imaging primacy is in the visualization of endocrine neoplasms. “Hybrid SPECT/CT combines accurate anatomic localization and functional characterization of endocrine neoplasms in one examination and is a major advance in the management of selected patients with endocrine malignancy,” reported the authors of a recent study in the American Journal of Oncologic clarity Roentgenology (March 2008). “The inherent physical pertur“Within endocrine imaging, bations of radionuclide imagSPECT/CT improves diagnostic ing due to photon attenuation, accuracy by aiding localization, scattered radiation, and partial defining functional significance, volume effects result in relaand excluding sites of physiologtively poor spatial resolution, ic uptake.” and the absence of a detailed This is particularly true for anatomical context for image [ GE Inﬁnia Hawkeye 4 SPECT/CT exam to determine spread of breast cancer. poorly differentiated thyroid interpretation can limit the The bright green spot is the sentinel node. Image and caption courtesy of tumors, which are much more overall usefulness of functional Hemalatha Rao, MD, Coney Island Hospital, New York. ] aggressive and are associated imaging,” observed the authors with a poorer prognosis. Because these tumors are unable to of SPECT/CT research published in the journal Clinical Radiolconcentrate iodine, their detection with radioiodine scintigraogy (March 2008). “Information provided by structural and phy is difficult, making patient management more challenging. functional imaging in tandem is, however, complementary.” FDG-PET imaging has shown some success with this indication; Although co-registration of SPECT and CT images taken on however cost and availability of the technology has limited its usethe respective modalities in different exams is possible using fulness. SPECT/CT, which has been approved for a wider combinaside-by-side comparison or through the use of software tools, tion of radiopharmaceuticals, such as 111-Inpentreotide, 201-Tl artifacts can be introduced due to patient motion or other events chloride, and 99mTc MIBI, has demonstrated that it can improve that cause image misregistration. The hybrid technology, which was introduced commercially by GE Healthcare in 1999, has seen steady deployment as Siemens Medical Solutions and Philips Healthcare have also launched SPECT/CT systems during the past decade. Peer-reviewed research published during this time has demonstrated improved sensitivity (superior disease localization) and specificity (exclusion of false-positives due to physiological tracer uptake) for a variety of clinical indications such as oncology, cardiac, and infection/inflammation imaging, which has also bolstered demand for the modality in clinical practice. 18 Health Imaging & IT | June 2008 HealthImaging.com http://HealthImaging.com

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Health Imaging & IT - June 2008 Contents On The Web The Enterprise News Update Cover Story: Pushing Productivity: How Imaging is Building Efficiency and Cutting Costs Technology Outlook: Imaging Procedures Poised for Growth Great Expectations: PET/CT Delivers SPECT/CT Proving it's Potential MR/PET Holds Promise Good Image Management: Infiltrating Molecular Imaging SNM Preview Modality Review: Mammography’s Next Step: The Dawning of Breast Tomosynthesis Managing Technology: Radiation Oncology: Opening the Doors to IT Reader's Resource Stat Sheet

Health Imaging & IT - June 2008

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