Is SPECT/CT with a hybrid camera useful to improve scintigraphic imaging interpretation?

Abstract

Objectives: To assess the usefulness of a hybrid imaging system (single-photon emission computed tomography/computed tomography, SPECT/CT) for functional anatomical mapping (FAM) using various radiotracers and the additional value of fused SPECT/CT images compared with SPECT alone.

Methods: Eighty-one consecutive patients studied for various clinical situations were evaluated: 10 with 111In-pentetreotide, four with 123I-meta-iodobenzylguanidine (I-MIBG), five with 99mTc-labelled red blood cells, two with 99mTc-antigranulocyte antibodies, four with 99mTc-nanocolloids, 10 with 67Ga, seven with 99mTc-methylene diphosphonate (99mTc-MDP), nine with 99mTc-sestamibi, 21 with 99mTc-tetrofosmin, two with 201Tl, three with 99mTc-ethylcysteinate dimer (ECD), one with 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) and three with 123I-N-w-fluoropropyl-2-beta-carbomethoxy-3-beta-(4-iodophenyl) nortropanel (FPCIT). The acquisition of both anatomical (CT) and functional (SPECT) data was performed during a single session. SPECT data were first interpreted alone and then re-evaluated with the addition of FAM.

Results: Transmission anatomical maps allowed for the precise anatomical localization of SPECT images in 79 of the 81 cases. SPECT/CT had a significant impact on the results in 33 (40.7%) of the 81 patients: FAM provided the correct localization of SPECT findings in 23 cases, allowed the definition of the functional significance of CT lesions in two and enabled the exclusion of disease in sites of physiological tracer uptake in eight.

Conclusions: SPECT/CT with this hybrid system is a feasible technique yielding co-registered dual-modality images. FAM allows a more precise interpretation of scintigraphic studies in several cases and fused images can improve the diagnostic accuracy of SPECT in various clinical situations.