Health Imaging & IT - June 2008 - (Page 19)

“ “Before, we were able to determine that something was in the neck; but now we can tell speciﬁcally if it is in the thyroid gland, the lymph node, the muscle, or the bone.” Hemalatha Rao, MD, chair of nuclear medicine, Coney Island Hospital, Brooklyn, N.Y. the detection and localization of these poorly differentiated tumors, according to the authors. In a study of 71 patients with thyroid cancer under[ This image of a 40-year old patient going SPECT/CT (Europewith suspicious osteochondroma of an Journal of Nuclear the right humerus was taken on the Symbia T2. The study helped to reveal Medicine and Molecular hypermetabolism and corresponding CT alterations visible in the humerus Imaging, October 2004), head, conﬁrming the initial suspicion. researchers demonstrated Image courtesy of Landeskrankenhaus Klagenfurt, Nuclear Medicine, Klagenfurt, that SPECT/CT increased Austria, Prim. Univ. Doz. Dr. Peter Lind. ] diagnostic accuracy in 57 percent of patients by identifying sites of additional disease, correctly characterizing physiological tracer uptake, precisely locating areas of pathological uptake to the skeleton, and differentiating between uptake in remnant tissue in the thyroid bed from activity within local nodal disease. Hemalatha Rao, MD, who uses a GE Hawkeye 4-slice SPECT/ CT system in her practice as chair of nuclear medicine at Coney Island Hospital, a multi-site community medical center serving southern Brooklyn, has found the modality extremely useful for endocrine neoplasms. “The utilization of SPECT/CT has improved our diagnostic capabilities in patients presenting with thyroid cancer,” she says. “It is particularly useful for patients who come in after surgery, where the anatomy can be distorted. Before, we were able to determine that something was in the neck; but now we can tell specifically if it is in the thyroid gland, the lymph node, the muscle, or the bone.” Her experience correlates with research conducted at Johns Hopkins University in Baltimore and published in the Journal of Nuclear Medicine (July 2007). Clinicians at the institution compared SPECT/ CT, SPECT, and planar imaging to determine whether dual-phase imaging is advantageous for parathyroid exams. “Early SPECT/CT in combination with any delayed imaging HealthImaging.com method was statistically significantly superior to any single- or dual-phase planar or SPECT study for parathyroid adenoma localization,” they report. “Localization with dual-phase acquisition was more accurate than with single-phase Tc99m-sestamibi scintigraphy for planar imaging, SPECT, and SPECT/CT.” The technology has also benefitted patients and the facility by reducing the amount of time needed to conduct studies; thereby increasing throughput and enabling more patients to receive exams. “Depending on the indication, exams could take upward of four hours,” she notes. “However, with SPECT/CT we’re able to conduct studies in approximately 20 minutes.” Another oncologic indication which is seeing currency with SPECT/CT is prostate cancer imaging. Radioimmunoscintigraphy using capromab penedetide, marketed as ProstaScint by its developer Cytogen, is a relatively new technique that has demonstrated improved detection of lymph node involvement in patients at high risk of extra-prostatic disease. ProstaScint is a murine monoclonal antibody conjugated to a linker-chelator that is directed against the cytoplasmic epitope of the glycoprotein prostate specific membrane antigen, which is highly expressed by patients presenting with prostate adenocarcinoma. ProstaScint imaging with SPECT/CT is facilitated by labeling it with Indium-111. A study reported in the journal Clinical Prostate Cancer (May 2005) demonstrated the incremental value of fused ProstaScint SPECT/CT in prostate cancer and suggested that the technique may have a valuable role in identifying primary, metastatic and recurrent disease, in guiding therapy and in the monitoring of treatment response. David Davidson, a certified nuclear medicine technologist and clinical coordinator of the nuclear medicine department at the Medical University of South Carolina (MUSC) in Charleston, S.C., says that his facility is using its SPECT/CT technology (a GE Hawkeye and three Siemens Symbia TruePoint systems) for ProstaScint imaging. June 2008 | Health Imaging & IT 19 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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