Abstract
Objectives: To assess initial experience with the use of a new single-photon emission computed tomography-computed tomography (SPECT-CT) in the evaluation of lesions.Methods: The folder number, radiopharmaceutical used and type of scan of patients examined with a new Siemens T6 SPECT-CT between 02 April 2016 and 31 December 2013 were retrieved. The number of 99mTc-MDP bone scans was sufficient for a detailed analysis. The scans were re-processed and reported by the observer before he was given any clinical information. Whole body planar, whole body planar plus SPECT and whole body planar plus SPECT-CT images were assessed successively in three separate sessions at least 2 weeks apart. At each session, the certainties of detection, localisation and categorisation of each lesion were recorded.Results: A total of 539 lesions were seen on the whole body, SPECT and computed tomography (CT) images in 133 patients. The whole body images showed no lesions in 3 patients and 378 lesions in 130 patients. SPECT detected 122 additional lesions in 79 patients. Thirty-nine (12.2%) lesions were seen only on CT in 32 (24.1%) patients. For the 261 lesions seen on the planar images in the SPECT field of view, lesion detection was definite in 233 (89.3%), localisation definite in 151 (57.9%) and categorisation definite in 123 (47.1%) lesions. On the SPECT, definite lesion detection, localisation and categorisation were recorded, respectively, for 259 (99.2%), 228 (87.4%) and 176 (67.4%) of the 261 lesions. Lesion detection, localisation and categorisation certainties were definite for 100%, 99.1% and 94.7% of the SPECT-CT lesions, respectively.Conclusion: SPECT markedly improves lesion detection and localisation, and CT enhances lesion categorisation.
Highlights
The use of hybrid imaging consisting of single-photon emission computed tomography (SPECT) and X-ray transmission computed tomography (CT) scan is increasing globally
The 133 patients referred for 99mTc-MDP bone scintigraphy comprised 92 (69.2%) females and 41 (30.8%) males with a mean age of 53.3 ± 15.7 years
This study reports the initial experience with new multi-slice SPECT-CT scanner as well as the impact of the addition of SPECT with and without a low-dose CT in the evaluation of lesions in patients referred for 99mTc-MDP bone scintigraphy
Summary
The use of hybrid imaging consisting of single-photon emission computed tomography (SPECT) and X-ray transmission computed tomography (CT) scan is increasing globally. It has the advantage of providing functional and morphologic information for a given lesion. The combination of SPECT and CT has improved staging of disease as well as the prognostic and treatment monitoring potentials of the functional and metabolic information provided by conventional nuclear medicine examinations.[2,3]. Prolonged acquisition time and poor spatial resolution have been addressed by the recent introduction of multi-slice CT scanners in newer versions of the SPECT-CT systems.[7,8] the use of a faster higher resolution CT may improve observer’s confidence
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