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Acquisition Parameters for Oncologic Imaging with a New SPECT/Multislice CT Scanner

Abstract

Introduction

Single photon emission computed tomography/computed tomography (SPECT/CT) delivers in a single imaging modality the functional–metabolic information from the SPECT image, combined with the detailed anatomical information from a diagnostic quality CT scanner.

Method

In this review, we provide the details for the acquisition, processing, and display of the SPECT, as well as the CT, and the fused SPECT/CT images, with one of the newest devices that combines a dual-headed gamma camera with a multislice CT scanner. Also, we go over the performance characteristics, including the planning and installation requirements for this type of scanners. In addition, we describe what are the current and feasible near-future applications of this new and exciting hybrid imaging modality.

Discussion

The ability to combine an optimized state-of-the-art SPECT image, with resolutions down to 5 mm, with a diagnostic quality CT image—using slices as thin as 1.25 mm—provides a diagnostic advantage that potentially can deliver a more convenient and faster diagnosis, with clinical implications in a significant percentage of patients. This imaging technique has been investigated in a wide range of studies for the oncologic patient, including but not limited to bone scintigraphy, 111In-pentetreotide scintigraphy, lymphoscintigraphy, 67Ga and labeled leukocyte infection imaging, 131I-metaiodobenzylguanidine, parathyroid scintigraphy, 131I diagnostic scintigraphy, and 111In ProstaScint, and for planning of radionuclide therapy.

Conclusion

Therefore, this evolving and exciting imaging modality will continue to grow and define its place as an integral part of the evaluation of the cancer patient.

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Correspondence to Rodolfo Núñez.

Appendices

Appendix 1

SPECT Acquisition Parameters

The following are the acquisition parameters employed:

  • 128 views over 360° (64 views per head with a 180° gantry rotation; 64 views over 360° for 131I and 123I)

  • 128 × 128 matrix

  • 4.8 mm per pixel (3.3 mm for brain)

  • Step-and-shoot noncircular orbit

  • Axial FOV 38.7 cm (26.7 cm for brain)

  • Each photopeak of each radionuclide acquired separately

  • Upper and lower scatter windows adjacent to each photopeak acquired

SPECT Acquisition Times Per View for Various SPECT/CT Studies

  • 99mTc-MDP 21 s per view

  • 99mTc-CEA (3 h) 30 s per view

  • 99mTc-CEA (24 h) 60 s per view

  • 99mTc-RBC (hemangioma) 25 s per view

  • 99mTc-SC (liver/spleen) 25 s per view

  • 99mTc-SC (lymphoscintigraphy) 22 s per view

  • 99mTc-MIBI parathyroid 22 s per view

  • 99mTc-MAA (lung) 19 s per view

  • 99mTc-MAA (liver for SIR-Spheres) 34 s per view

  • 67Ga-citrate 25 s per view

  • 123I-MIBG (4 h) 18 s per view

  • 123I-MIBG (24 h) 42 s per view

  • 111In-octreotide 28 s per view

  • 111In-zevalin 28 s per view

  • 111In-WBC 38 s per view

  • 111In-ProstaScint 42 s per view

  • 131I-NaI 36 s per view

  • 131I-NP59 56 s per view

  • 90Y SIR-Spheres (bremsstrahlung, 78 keV ± 15% window) 28 s per view

CT Acquisition Parameters

  • kVp 130

  • Reference effective 90 mAs (200 for brain)

  • CARE dose 4D radiation dose reduction algorithm (incorporating both automatic exposure control and depth of material on-the-fly milliampere adjustment)

  • Collimation 6 × 2.0 mm (6 × 1.0 for bone extremity and parathyroid head and neck, H & N)

  • Pitch 1.2 (0.8 for brain)

  • Rotation speed 0.6 s per 360° rotation (1.0 for brain and parathyroid H & N)

  • Time 16 s (28 for brain, 32 for bone extremity, 54 for parathyroid H & N)

  • Scan length: same as SPECT axial FOV

Appendix 2

CT Reconstruction

Diagnostic CT

  • Slice thickness/step 2.5/2.0 mm (brain, all H & N, chest, abdomen, and pelvis), 1.25/1.0 mm (bone extremity and parathyroid H & N)

  • Reconstruction FOV 36 cm (all H & N, chest, and abdomen), 25 cm (brain, parathyroid H & N thin slice [1.25/1.0], 44 cm (pelvis, bone extremity)

  • Reconstructions (Fig. 2): soft tissue: B31s (H31s brain) medium smooth + filter; lung: B70s sharp filter (head and neck, chest); bone: B70s sharp (99mTc bone SPECT–CT only); parathyroid: B50s moderate sharp

Attenuation Correction CT

  • Slice thickness/step 5/5 mm (chest, abdomen, pelvis, and bone extremity), 3.0/3.0 mm (brain, H & N)

  • Reconstruction FOV 50 cm (25 cm for brain)

  • Reconstruction: B08s (H08s brain) smooth filter (for generating SPECT AC map)

SPECT Iterative Reconstruction

  • Ordered subset expectation maximization (OSEM) algorithm

  • 16 subsets (eight for 131I and 123I)

  • Eight iterations

  • 3D system resolution recovery

  • Each photopeak reconstructed separately and outputs summed

  • Separate reconstructions without and with attenuation and scatter correction

  • Scatter correction: dual-energy window (photopeaks with lower scatter window only); triple-energy window (photopeaks with both upper and lower scatter windows)

  • Scatter window weighting factors 0.5 (except 111In 172 keV upper and 247 lower), 172 keV upper 0.9375; 247 keV lower 0.75

  • Gaussian 3D postreconstruction filter

SPECT Reconstruction Gaussian Filtering

For the full widths at half maximum of the 3D Gaussian filter that is applied to finish the SPECT reconstruction as follows:

  • For all 99mTc radiotracers 5 mm

  • 67Ga-citrate 8.4 mm

  • 123I-MIBG 9.6 mm

  • For all 111In-radiotracers (except ProstaScint) 9.6 mm

  • 111In ProstaScint 10 mm

  • 131I 12 mm

  • 90Y SIR-Spheres 9.6 mm

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Núñez, R., Erwin, W.D., Wendt, R.E. et al. Acquisition Parameters for Oncologic Imaging with a New SPECT/Multislice CT Scanner. Mol Imaging Biol 12, 110–138 (2010). https://doi.org/10.1007/s11307-009-0266-4

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Key words

  • SPECT/multislice CT scanner
  • Acquisition parameters
  • Oncologic imaging