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Nuklearmedizin 2012; 51(04): 154-160
DOI: 10.3413/Nukmed-0467-12-01
Original article
Schattauer GmbH

Variations of clinical SPECT/CT operations

An international surveyVarianten im klinischen Betrieb von SPECT/CTInternationaler Vergleich
H. Wieder
1   Zentrum für Radiologie und Nuklearmedizin (ZRN), Grevenbroich, Dormagen, Neuss, Germany
2   Department of Nuclear Medicine, Klinikum rechts der Isar, München, Germany
,
L. S. Freudenberg
1   Zentrum für Radiologie und Nuklearmedizin (ZRN), Grevenbroich, Dormagen, Neuss, Germany
3   Department of Nuclear Medicine, University Hospital Essen, Germany
,
J. Czernin
4   Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
,
B. N. Navar
5   AMI, Los Angeles, CA, USA;
,
O. Israel
6   Rambam Health Care Campus, Haifa, Israel
,
T. Beyer
3   Department of Nuclear Medicine, University Hospital Essen, Germany
7   cmi-experts GmbH, Zürich, Switzerland
› Author Affiliations
Further Information

Publication History

received: 10 January 2012

accepted in revised form: 14 March 2012

Publication Date:
30 December 2017 (online)

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Summary

Aim: This survey gathers information about clinical SPECT/CT operations worldwide to help guide standardization of clinical SPECT/ CT imaging. Methods: An international, webbased survey of SPECT/CT users was initiated in 12/2010 through an e-mail distribution. Users were asked 71 questions related to (A) demographics, (B) SPECT/CT operations/utilization and (C) variations in imaging protocols. Results: Collected responses originated from 117 imaging centers in the Americas (66%), Europe (20%), Asia-Pacific (11%) and the Middle-East (3%), with the majority of responding sites representing public health care institutions (69%). Most sites operate 1–2 SPECT/CT-systems (74%), typically installed in Nuclear Medicine departments (84%) with extensive prior SPECT-only experience (82%). Only 14% of SPECT/CTs are installed in Radiology departments. Clinical SPECT/CT imaging is performed either as routine (51%) or ad-hoc “add-on” procedure (49%) with a high inter-site and inter-examination variability. The main application of the integrated CT is to provide anatomical localization of the tracer uptake rather than to produce contrast enhanced or other high-quality CT images. Consequently, in only 22% of the sites a CT contrast injector is installed. Only 6% of centers use SPECT/CT devices for stand-alone CT procedures. Conclusion: An international survey among clinical SPECT/CT users revealed that SPECT/CT is a not a routine component of nuclear medicine procedures. The majority of the centers responding do not fully utilize the diagnostic potential of the CT components. Significant variations in standard imaging protocols were observed. These findings illustrate the need for training and standardization and underscore the need for revisiting the role of SPECT/CT in diagnostic imaging.

Zusammenfassung

Ziel: In dieser Umfrage wurden weltweit Informationen über die klinische Nutzung von SPECT/CT Systemen gesammelt um bei der Standardisierung klinischer SPECT/CT-Bildgebung zu unterstützen. Methoden: Diese internationale, web-basierte Umfrage wurde 12/2010 gestartet und die Umfrage per E-Mail an die SPECT/CT Nutzer weitergeleitet. Es wurden insgesamt 71 Fragen in Bezug auf (A) Demographie, (B) SPECT/CT-Nutzung bzw. Auslastung und (C) Untersuchungsprotokolle gestellt. Ergebnisse: Die Umfrage wurde von insgesamt 117 Instituten aus Nord-und Südamerika (66%), Europa (20%), Asien-Pazifik (11%) und dem Nahen Osten (3%) beantwortet. Öffentliche Einrichtungen stellten hier die Mehrheit der antwortenden Institute (69%). Die meisten Institute betreiben 1–2 SPECT/ CT-Systeme (74%), welche in der Regel in nuklear medizinischen Abteilungen (84%) installiert sind und ausgeprägte klinische Erfahrung mit der SPECT-Bildgebung (82%) besitzen. Nur 14% der SPECT/CT-Systeme sind in radiologischen Abteilungen installiert. Klinische SPECT/CT wird entweder als Routinebildgebung (51%) oder als Zusatzverfahren (49%) durchgeführt, wobei die Variabilität zwischen den einzelnen Instituten hoch ist. Die wichtigste Anwendung der integrierten CT-Komponente ist für die befragten Institute die anatomische Lokalisation der Traceraufnahme, jedoch nicht kontrastverstärkte diagnostische CT-Bilder zu erzeugen. Folglich haben nur 22% der Standorte eine Kontrastmittelpumpe installiert. Schlussfolgerung: Diese internationale Umfrage unter klinischen SPECT/CT-Anwendern zeigt, dass die SPECT/ CT kein Bestandteil in der klinischen nuklearmedizinischen Routine ist. Die Mehrheit der Zentren nutzt die diagnostischen Möglichkeiten ihrer CT-Komponente nicht in vollem Umfang. Es wurden deutliche Unterschiede in den Untersuchungsprotokollen der einzelnen Institute beobachtet. Die Ergebnisse verdeutlichen, dass die Ausbildung der SPECT/CTNutzer und die Standardisierung von Untersuchungsprotokollen zwingend notwendig ist und die Rolle der SPECT / CT in der diagnostischen Bildgebung diskutiert werden muss.

Keywords

SPECT/CT - clinical operations - imaging protocols

Schlüsselwörter

SPECT/CT - klinischer Einsatz - internationale Umfrage
 

  • References

  • 1 Bar-Shalom R, Yefremov N, Guralnik L. et al. SPECT/CT using 67Ga and 111In-labeled leukocyte scintigraphy for diagnosis of infection. J Nucl Med 2006; 47: 587-594.
    PubMedGoogle Scholar
  • 2 Beyer T, Antoch G, Muller S. et al. Acquisition protocol considerations for combined PET/CT imaging. J Nucl Med 2004; 45 (Suppl. 01) 25S-35S.
    PubMedGoogle Scholar
  • 3 Beyer T, Czernin J, Freudenberg LS. Variations in clinical PET/CT operations: results of an international survey of active PET/CT users. J Nucl Med 2011; 52: 303-310.
    CrossrefPubMedGoogle Scholar
  • 4 Beyer T, Freudenberg L, Townsend D, Czernin J. The future of hybrid imaging – part 1: hybrid imaging technologies and SPECT/CT. Insights Imaging 2011; 2: 161-169.
    CrossrefPubMedGoogle Scholar
  • 5 Bischof Delaloye A, Carrio I, Cuocolo A. et al. White paper of the European Association of Nuclear Medicine (EANM) and the European Society of Radiology (ESR) on multimodality imaging. Eur J Nuc Med Mol Imaging 2007; 34: 1147-1151.
    CrossrefPubMedGoogle Scholar
  • 6 Blankespoor SC. Attenuation correction of SPECT using X-ray CT on an emission-transmission CT system: Myocardial perfusion assessment. IEEE Transactions on Nuclear Science 1996; 43: 2263-2274.
    CrossrefGoogle Scholar
  • 7 Buck AK, Nekolla SG, Ziegler SI, Drzezga A. SPECT/CT. J Nucl Med 2008; 49: 1305-1319.
    CrossrefPubMedGoogle Scholar
  • 8 Chowdhury FU, Scarsbrook AF. The role of hybrid SPECT-CT in oncology: current and emerging clinical applications. Clin Radiol 2008; 63: 241-251.
    CrossrefPubMedGoogle Scholar
  • 9 Cuocolo A, Breatnach E. Multimodality imaging in Europe: a survey by the European Association of Nuclear Medicine (EANM) and the European Society of Radiology (ESR). Eur J Nucl Med Mol Imaging 2010; 37: 163-167.
    CrossrefPubMedGoogle Scholar
  • 10 Delbeke D, Coleman RE, Guiberteau MJ. et al. Procedure Guideline for SPECT/CT Imaging 1.0. J Nucl Med 2006; 47: 1227-1234.
    PubMedGoogle Scholar
  • 11 Even-Sapir E, Keidar Z, Sachs J. et al. The new technology of combined transmission and emission tomography in evaluation of endocrine neoplasms. J Nucl Med 2001; 42: 998-1004.
    PubMedGoogle Scholar
  • 12 Even-Sapir E, Lerman H, Lievshitz G. et al. Lymphoscintigraphy for sentinel node mapping using a hybrid SPECT/CT system. J Nucl Med 2003; 44: 1413-1420.
    PubMedGoogle Scholar
  • 13 Filippi L, Schillaci O. Usefulness of hybrid SPECT/CT in 99mTc-HMPAO-labeled leukocyte scintigraphy for bone and joint infections. J Nucl Med 2006; 47: 1908-1913.
    PubMedGoogle Scholar
  • 14 Fukuoka M, Taki J, Mochizuki T, Kinuya S. Comparison of diagnostic value of 123I-MIBG and high-dose 131I-MIBG scintigraphy including incremental value of SPECT/CT over planar image in patients with malignant pheochromocytoma/paraganglioma and neuroblastoma. Clin Nucl Med 2011; 36: 1-7.
    CrossrefPubMedGoogle Scholar
  • 15 Gallowitsch HJ, Kraschl P, Igerc I. et al. Sentinel node SPECT-CT in breast cancer. Can we expect any additional and clinically relevant information?. Nuklearmedizin 2007; 46: 252-256.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Graham MM, Badawi RD, Wahl RL. Variations in PET/CT methodology for oncologic imaging at U.S. academic medical centers: an imaging response assessment team survey. J Nucl Med 2011; 52: 311-317.
    CrossrefPubMedGoogle Scholar
  • 17 Groch MW, Erwin WD. Single-photon emission computed tomography in the year 2001: instrumentation and quality control. J Nucl Med Technol 2001; 29: 12-18.
    PubMedGoogle Scholar
  • 18 Horger M, Bares R. The role of single-photon emission computed tomography/computed tomography in benign and malignant bone disease. Semin Nucl Med 2006; 36: 286-294.
    CrossrefPubMedGoogle Scholar
  • 19 Husarik DB, Steinert HC. Single-photon emission computed tomography/computed tomography for sentinel node mapping in breast cancer. Semin Nucl Med 2007; 37: 29-33.
    CrossrefPubMedGoogle Scholar
  • 20 Jaszczak RJ. The early years of single photon emission computed tomography (SPECT): an anthology of selected reminiscences. Phys Med Biol 2006; 51: R99-R115.
    CrossrefPubMedGoogle Scholar
  • 21 Karcher G, Als C, Goldman S. et al. EANM-ESR white paper on multimodality imaging. A white paper for a black project: towards the decline of nuclear medicine as an independent specialty in Europe?. Eur J Nucl Med Mol Imaging 2008; 35: 674-676.
    CrossrefPubMedGoogle Scholar
  • 22 Kinahan PE, Hasegawa BH, Beyer T. X-ray-based attenuation correction for positron emission tomography/computed tomography scanners. Semin Nucl Med 2003; 33: 166-179.
    CrossrefPubMedGoogle Scholar
  • 23 Knoll P, Kotalova D, Kochle G. et al. Comparison of advanced iterative reconstruction methods for SPECT/CT. Z Med Phys 2011; 22: 58-69.
    PubMedGoogle Scholar
  • 24 Krausz Y, Bettman L, Guralnik L. et al. Technetium-99m-MIBI SPECT/CT in primary hyperparathyroidism. World J Surg 2006; 30: 76-83.
    CrossrefPubMedGoogle Scholar
  • 25 LaCroix KJ. Investigation of the use of X-ray CT images for attenuation correction in SPECT. IEEE Transactions on Nuclear Science 1994; 41: 2793-2799.
    CrossrefGoogle Scholar
  • 26 Manfreda KL BM, Berzelak J. Web surveys versus other survey modes. A Meta-Analysis Comparing Response Rates. Int J Market Res 2008; 50: 79-104.
    CrossrefGoogle Scholar
  • 27 Mariani G, Bruselli L, Kuwert T. et al. A review on the clinical uses of SPECT/CT. Eur J Nucl Med Mol Imaging 2010; 37: 1959-1985.
    CrossrefPubMedGoogle Scholar
  • 28 Patton JA, Delbeke D, Sandler MP. Image fusion using an integrated, dual-head coincidence camera with X-ray tube-based attenuation maps. J Nucl Med 2000; 41: 1364-1368.
    PubMedGoogle Scholar
  • 29 Ritt P, Vija H, Hornegger J, Kuwert T. Absolute quantification in SPECT. Eur J Nucl Med Mol Imaging 2011; 38 (Suppl. 01) S69-S77.
    CrossrefPubMedGoogle Scholar
  • 30 Ruf J, Seehofer D, Denecke T. et al. Impact of image fusion and attenuation correction by SPECT-CT on the scintigraphic detection of parathyroid adenomas. Nuklearmedizin 2007; 46: 15-21.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Schmidt D, Szikszai A, Linke R. et al. Impact of 131I SPECT/spiral CT on nodal staging of differentiated thyroid carcinoma at the first radioablation. J Nucl Med 2009; 50: 18-23.
    PubMedGoogle Scholar
  • 32 Tharp K, Israel O, Hausmann J. et al. Impact of 131I-SPECT/CT images obtained with an integrated system in the follow-up of patients with thyroid carcinoma. Eur J Nucl Med Mol Imaging 2004; 31: 1435-1442.
    PubMedGoogle Scholar
  • 33 Townsend DW. Multimodality imaging of structure and function. Phys Med Biol 2008; 53: R1-R39.
    CrossrefPubMedGoogle Scholar
  • 34 Wagner HN. A personal history of Nuclear Medicine.. London: Springer; 2005
  • 35 Willowson K, Bailey DL, Baldock C. Quantitative SPECT reconstruction using CT-derived corrections. Phys Med Biol 2008; 53: 3099-3112.
    CrossrefPubMedGoogle Scholar
  • 36 Wong KK, Komissarova M, Avram AM. et al. Adrenal cortical imaging with 131I NP-59 SPECT-CT. Clin Nucl Med 2010; 35: 865-869.
    CrossrefPubMedGoogle Scholar