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Atlas and Anatomy of SPECT/CT

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Atlas and Anatomy of PET/MRI, PET/CT and SPECT/CT

Abstract

Single-photon emission computed tomography (SPECT) imaging has evolved rapidly during the past decades since the introduction of the Anger camera in 1970, the posterior rotating gantry and dual detectors with better reconstruction processes, and quantitative data analysis. In the late 1990s, hybrid SPECT/CT imaging appeared to improve diagnostic accuracy with precise anatomical location and image quality with attenuation correction. In the last 10 years, all these equipment have had important improvements to allow us the characterization of the pathology based on morphologic pattern recognition, hand in hand with the evolution in radiopharmaceuticals, to evaluate more and better physiological processes [1]. Conventional analog technologies have advanced to multidetector devices with direct conversion digital detectors that improve efficiency, resolution and image quality, resulting in faster studies with lower doses and even the ability to image multiple radionuclides simultaneously. This includes the last generation cadmium-zinc-telluride (CZT) scanners, which bring more possibilities in research and clinical practice, especially in nuclear cardiology [2–4]. There is no denying that SPECT is still the go-to choice for most cardiologists.

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References

  1. Van den Wyngaert T, Elvas F, De Schepper S, Kennedy JA, Israel O. SPECT / CT - standing on the shoulders of giants, it is time to reach for the sky! J Nucl Med. 2020:jnumed.119.236943.

    Google Scholar 

  2. Kinclab V, Drozdová A, Vašina J, Panovský R, Kamínek M. Cadmium – zinc – telluride SPECT scanners – new perspectives in nuclear cardiology. Cor Vasa. 2015;57(3):214–8.

    Article  Google Scholar 

  3. Alenazy AB, Wells RG, Ruddy TD. New solid-state cadmium-zinc-telluride technology for cardiac single photon emission computed tomographic myocardial perfusion imaging. Expert Rev Med Devices. 2017;14(3):213–22.

    Article  CAS  PubMed  Google Scholar 

  4. Garcia TR, Kivenson A, Malonson S, Kudrolli H. Enhanced molecular breast image quality through improved CZT detector performance. IEEE Nuclear Science Symposium and Medical Imaging Conference (NSS / MIC) 2014, pp 1–3.

    Google Scholar 

  5. Mariani G, Bruselli L, Kuwert T, Kim EE, Flotats A, Israel O, et al. A review of clinical uses of SPECT / CT. Eur J Nucl Med Mol Imaging. 2010;37(10):1959–85.

    Article  PubMed  Google Scholar 

  6. Roarke MC, Nguyen BD, Pockaj BA. Applications of SPECT / CT in nuclear radiology. AJR. 2008;191:W135–50.

    Article  PubMed  Google Scholar 

  7. Ichikawa H, Miwa K, Okuda K, Shibutani T, Kato T, Nagaki A, et al. Current state of bone scintigraphy protocols and practice in Japan. Asia Oceania J Nucl Med Biol. 2020;8(2):116–22.

    Google Scholar 

  8. Kapoor M, Kasi A. Octreotide scan. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2021. 2021 Jan–. PMID: 32644756.

    Google Scholar 

  9. Donohoe KJ, Aloff J, Avram AM, Bennet KG, Giovanella L, Greenspan B. Appropriate use criteria for nuclear medicine in the evaluation and treatment of differentiated thyroid cancer. J Nucl Med. 2020;61(3):375–96.

    Article  CAS  PubMed  Google Scholar 

  10. Gandhi SJ, Babu S, Subramanyam P, Shanmuga Sundaram P. Tc-99m macro aggregated albumin scintigraphy - indications other than pulmonary embolism: a pictorial essay. Indian J Nucl Med. 2013;28(3):152–62.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Garin E, Rolland Y, Boucher E, Ardisson V, Laffont S, Boudjema K, et al. First experience of hepatic radioembolization using microspheres labelled with yttrium-90 (TheraSphere): practical aspects concerning its implementation. Eur J Nucl Med Mol Imaging. 2010;37(3):453–61.

    Article  PubMed  Google Scholar 

  12. Ahn BC. Macroaggregated albumin (MAA) injected in hepatic artery visualized in a recanalized paraumbilical vein. Clin Nucl Med. 2012;37(9):874.

    Article  PubMed  Google Scholar 

  13. Gulec SA, Mesoloras G, Dezarn WA, McNeillie P, Kennedy AS. Safety and efficacy of Y-90 microsphere treatment in patients with primary and metastatic liver cancer: the tumor selectivity of the treatment as a function of tumor to liver flow ratio. J Transl Med. 2007;5:15.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Panzuto F, Boninsegna L, Fazio N, Campana D, Pia Brizzi M, Capurso G, et al. Metastatic and locally advanced pancreatic endocrine carcinomas: analysis of factors associated with disease progression. J Clin Oncol. 2011;29(17):2372–7.

    Article  PubMed  Google Scholar 

  15. Berglund AS, Hulthen UL, Manheim P, Thorsson O, Wollmer P, Tornquist C. Metaiodobenzylguanidine (MIBG) scintigraphy and computed tomography (CT) in clinical practice. Primary and secondary evaluation for localization of pheochromocytomas. J Intern Med. 2001;249(3):247–51.

    Article  CAS  PubMed  Google Scholar 

  16. Lebtahi R, Le Cloirec J, Houzard C, Daou D, Sobhani I, Sassolas G, et al. Detection of neuroendocrine tumors: 99mTc-P829 scintigraphy compared with 111In-pentetreotide scintigraphy. J Nucl Med. 2002;43(7):889–95.

    CAS  PubMed  Google Scholar 

  17. Zini L, Porpiglia F, Fassnacht M. Contemporary management of adrenocortical carcinoma. Eur Urol. 2011;60(5):1055–65.

    Article  PubMed  Google Scholar 

  18. Rufini V, Calcagni ML, Baum RP. Imaging of neuroendocrine tumors. Semin Nucl Med. 2006;36(3):228–47.

    Article  PubMed  Google Scholar 

  19. Bushnell DL, Baum RP. Standard imaging techniques for neuroendocrine tumors. Endocrinol Metab Clin N Am. 2011;40(1):153–62, ix.

    Article  CAS  Google Scholar 

  20. Bombardieri E, Ambrosini V, Aktolun C, Baum RP, Bischof-Delaloye A, Del Vecchio S, et al. 111In-pentetreotide scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010;37(7):1441–8.

    Article  PubMed  Google Scholar 

  21. Pepe G, Moncayo R, Bombardieri E, Chiti A. Somatostatin receptor SPECT. Eur J Nucl Med Mol Imaging. 2012;39(Suppl 1):S41–51.

    Article  PubMed  Google Scholar 

  22. Ilias I, Divgi C, Pacak K. Current role of metaiodobenzylguanidine in the diagnosis of pheochromocytoma and medullary thyroid cancer. Semin Nucl Med. 2011;41(5):364–8.

    Article  PubMed  PubMed Central  Google Scholar 

  23. van der Harst E, de Herder WW, Bruining HA, Bonjer HJ, de Krijger RR, Lamberts SW, et al. [(123)I]metaiodobenzylguanidine and [(111)In]octreotide uptake in benign and malignant pheochromocytomas. J Clin Endocrinol Metab. 2001;86(2):685–93.

    PubMed  Google Scholar 

  24. Bombardieri E, Giammarile F, Aktolun C, Baum RP, Bischof Delaloye A, Maffioli L, et al. 131I/123I-metaiodobenzylguanidine (mIBG) scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010;37(12):2436–46.

    Article  PubMed  Google Scholar 

  25. Perri M, Erba P, Volterrani D, Lazzeri E, Boni G, Grosso M, et al. Octreo-SPECT/CT imaging for accurate detection and localization of suspected neuroendocrine tumors. Q J Nucl Med Mol Imaging. 2008;52(4):323–33.

    CAS  PubMed  Google Scholar 

  26. Wong KK, Wynn EA, Myles J, Ackermann RJ, Frey KA, Avram AM. Comparison of single time-point [111-In] pentetreotide SPECT/CT with dual time-point imaging of neuroendocrine tumors. Clin Nucl Med. 2011;36(1):25–31.

    Article  PubMed  Google Scholar 

  27. Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S. The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. Pancreas. 2010;39(6):707–12.

    Article  PubMed  Google Scholar 

  28. Oberg K, Castellano D. Current knowledge on diagnosis and staging of neuroendocrine tumors. Cancer Metastasis Rev. 2011;30(Suppl 1):3–7.

    Article  PubMed  Google Scholar 

  29. Rufini V, Treglia G, Castaldi P, Perotti G, Calcagni ML, Corsello SM, et al. Comparison of 123I-MIBG SPECT-CT and 18F-DOPA PET-CT in the evaluation of patients with known or suspected recurrent paraganglioma. Nucl Med Commun. 2011;32(7):575–82.

    Article  PubMed  Google Scholar 

  30. Maroun J, Kocha W, Kvols L, Bjarnason G, Chen E, Germond C, et al. Guidelines for the diagnosis and management of carcinoid tumours. Part 1: the gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group. Curr Oncol. 2006;13(2):67–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Modlin IM, Oberg K, Chung DC, Jensen RT, de Herder WW, Thakker RV, et al. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol. 2008;9(1):61–72.

    Article  CAS  PubMed  Google Scholar 

  32. Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM. Bronchopulmonary neuroendocrine tumors. Cancer. 2008;113(1):5–21.

    Article  CAS  PubMed  Google Scholar 

  33. Tan EH, Tan CH. Imaging of gastroenteropancreatic neuroendocrine tumors. World J Clin Oncol. 2011;2(1):28–43.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Kaemmerer D, Posorski N, von Eggeling F, Ernst G, Horsch D, Baum RP, et al. The search for the primary tumor in metastasized gastroenteropancreatic neuroendocrine neoplasm. Clin Exp Metastasis. 2014;31(7):817–27.

    Article  CAS  PubMed  Google Scholar 

  35. Elaini AB, Shetty SK, Chapman VM, Sahani DV, Boland GW, Sweeney AT, et al. Improved detection and characterization of adrenal disease with PET-CT. Radiographics. 2007;27(3):755–67.

    Article  PubMed  Google Scholar 

  36. McNicol AM. Update on tumours of the adrenal cortex, pheochromocytoma and extra-adrenal paraganglioma. Histopathology. 2011;58(2):155–68.

    Article  PubMed  Google Scholar 

  37. Jeong SY, Lee SW, Kim HW, Song BI, Ahn BC, Lee J. Clinical applications of SPECT/CT after first I-131 ablation in patients with differentiated thyroid cancer. Clin Endocrinol. 2014;81(3):445–51.

    Article  CAS  Google Scholar 

  38. Yamamoto Y, Nishiyama Y, Monden T, Matsumura Y, Satoh K, Ohkawa M. Clinical usefulness of fusion of 131I SPECT and CT images in patients with differentiated thyroid carcinoma. J Nucl Med. 2003;44(12):1905–10.

    PubMed  Google Scholar 

  39. Griggs WS, Divgi C. Radioiodine imaging and treatment in thyroid disorders. Neuroimaging Clin N Am. 2008;18(3):505–15.

    Article  PubMed  Google Scholar 

  40. Gayed IW, Kim EE, Broussard WF, Evans D, Lee J, Broemeling LD, et al. The value of 99mTc-sestamibi SPECT/CT over conventional SPECT in the evaluation of parathyroid adenomas or hyperplasia. J Nucl Med. 2005;46(2):248–52.

    PubMed  Google Scholar 

  41. Im HJ, Lee IK, Paeng JC, Lee KE, Cheon GJ, Kang KW, et al. Functional evaluation of parathyroid adenoma using 99mTc-MIBI parathyroid SPECT/CT: correlation with functional markers and disease severity. Nucl Med Commun. 2014;35(6):649–54.

    Article  CAS  PubMed  Google Scholar 

  42. Mariani G, Gulec SA, Rubello D, Boni G, Puccini M, Pelizzo MR, et al. Preoperative localization and radioguided parathyroid surgery. J Nucl Med. 2003;44(9):1443–58.

    PubMed  Google Scholar 

  43. Qureshi NR, Gleeson FV. Imaging of pleural disease. Clin Chest Med. 2006;27(2):193–213.

    Article  PubMed  Google Scholar 

  44. Sugarbaker DJ, Wolf AS. Surgery for malignant pleural mesothelioma. Expert Rev Respir Med. 2010;4(3):363–72.

    Article  PubMed  Google Scholar 

  45. Kendi AT, Kara S, Altinok D, Keskil S. Sinonasal ossifying fibroma with fluid-fluid levels on MR images. AJNR Am J Neuroradiol. 2003;24(8):1639–41.

    PubMed  PubMed Central  Google Scholar 

  46. Even-Sapir E, Metser U, Mishani E, Lievshitz G, Lehman H, Leibovitch I. The detection of bone metastases in patients with high-risk prostate cancer: 99mTc-MDP planar bone scintigraphy, single- and multi-field-of-view SPECT, 18F-fluoride PET, and 18F-fluoride PET/CT. J Nucl Med. 2006;47(2):287–97.

    PubMed  Google Scholar 

  47. Maris JM, Hogarty MD, Bagatell R, Cohn SL. Neuroblastoma. Lancet. 2007;369(9579):2106–20.

    Article  CAS  PubMed  Google Scholar 

  48. Fish JD, Grupp SA. Stem cell transplantation for neuroblastoma. Bone Marrow Transplant. 2008;41(2):159–65.

    Article  CAS  PubMed  Google Scholar 

  49. Wertman M, Milgrom C, Agar G, Milgrom Y, Yalom N, Finestone AS. Comparison of knee SPECT and MRI in evaluating meniscus injuries in soldiers. Isr Med Assoc J. 2014;16(11):703–6.

    PubMed  Google Scholar 

  50. Palestro CJ, Love C, Schneider R. The evolution of nuclear medicine and the musculoskeletal system. Radiol Clin N Am. 2009;47(3):505–32.

    Article  PubMed  Google Scholar 

  51. Van der Wall H, Lee A, Magee M, Frater C, Wijesinghe H, Kannangara S. Radionuclide bone scintigraphy in sports injuries. Semin Nucl Med. 2010;40(1):16–30.

    Article  PubMed  Google Scholar 

  52. Grant FD, Fahey FH, Packard AB, Davis RT, Alavi A, Treves ST. Skeletal PET with 18F-fluoride: applying new technology to an old tracer. J Nucl Med. 2008;49(1):68–78.

    Article  PubMed  Google Scholar 

  53. Huellner MW, Strobel K. Clinical applications of SPECT/CT in imaging the extremities. Eur J Nucl Med Mol Imaging. 2014;41(Suppl 1):S50–8.

    Article  PubMed  Google Scholar 

  54. Ryan PJ, Evans PA, Gibson T, Fogelman I. Chronic low back pain: comparison of bone SPECT with radiography and CT. Radiology. 1992;182(3):849–54.

    Article  CAS  PubMed  Google Scholar 

  55. DiGiovanni CW, Patel A, Calfee R, Nickisch F. Osteonecrosis in the foot. J Am Acad Orthop Surg. 2007;15(4):208–17.

    Article  PubMed  Google Scholar 

  56. Bentley DE, Richardson JD. The role of tagged red blood cell imaging in the localization of gastrointestinal bleeding. Arch Surg. 1991;126(7):821–4.

    Article  CAS  PubMed  Google Scholar 

  57. Howarth DM. The role of nuclear medicine in the detection of acute gastrointestinal bleeding. Semin Nucl Med. 2006;36(2):133–46.

    Article  PubMed  Google Scholar 

  58. Leder KS, Barlam TF. A case of paraspinal abscess and discitis due to Peptostreptococcus micros. Clin Infect Dis. 2000;30(3):622–3.

    Article  CAS  PubMed  Google Scholar 

  59. Ibrahim NA, Fadeyibi IO. Ectopic thyroid: etiology, pathology and management. Hormones (Athens). 2011;10(4):261–9.

    Article  Google Scholar 

  60. Marmarou A, Young HF, Aygok GA. Estimated incidence of normal pressure hydrocephalus and shunt outcome in patients residing in assisted-living and extended-care facilities. Neurosurg Focus. 2007;22(4):E1.

    Article  PubMed  Google Scholar 

  61. Joffe HV, Goldhaber SZ. Upper-extremity deep vein thrombosis. Circulation. 2002;106(14):1874–80.

    Article  PubMed  Google Scholar 

  62. Leijte JA, Valdes Olmos RA, Nieweg OE, Horenblas S. Anatomical mapping of lymphatic drainage in penile carcinoma with SPECT-CT: implications for the extent of inguinal lymph node dissection. Eur Urol. 2008;54(4):885–90.

    Article  PubMed  Google Scholar 

  63. Sondak VK, King DW, Zager JS, Schneebaum S, Kim J, Leong SP, et al. Combined analysis of phase III trials evaluating [(99)mTc]tilmanocept and vital blue dye for identification of sentinel lymph nodes in clinically node-negative cutaneous melanoma. Ann Surg Oncol. 2013;20(2):680–8.

    Article  PubMed  Google Scholar 

  64. Hartman TE. Radiologic evaluation of the solitary pulmonary nodule. Radiol Clin N Am. 2005;43(3):459–65.

    Article  PubMed  Google Scholar 

  65. Kligerman SJ, Groshong S, Brown KK, Lynch DA. Nonspecific interstitial pneumonia: radiologic, clinical, and pathologic considerations. Radiographics. 2009;29(1):73–87.

    Article  PubMed  Google Scholar 

  66. Kim SH, Lee JM, Han JK, Lee JY, Kim KW, Cho KC, et al. Intrapancreatic accessory spleen: findings on MR imaging, CT, US and scintigraphy, and the pathologic analysis. Korean J Radiol. 2008;9(2):162–74.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Li W, Uppal D, Wang YC, et al. Nuclear imaging for the diagnosis of cardiac amyloidosis in 2021. Diagnostics (Basel). 2021;11(6):996.

    Article  CAS  Google Scholar 

  68. Wong TH, Shagera QA, Ryoo HG, Ha S, Lee DS. Basal and acetazolamide brain perfusion SPECT in internal carotid artery stenosis. Nucl Med Mol Imaging. 2020;54(1):9–27.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

The authors gratefully acknowledge Dr. Dong Soo Lee and Dr. Keon Wook Kang for their contributions to this chapter as it appeared in the previous edition.

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Kim, E.E., Murad, V., Paeng, JC., Im, HJ., Kim, JY., Cheon, GJ. (2022). Atlas and Anatomy of SPECT/CT. In: Kim, E.E., Murad, V., Paeng, JC., Cheon, GJ. (eds) Atlas and Anatomy of PET/MRI, PET/CT and SPECT/CT. Springer, Cham. https://doi.org/10.1007/978-3-030-92349-5_3

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