Skip to main content

Advertisement

SpringerLink
Log in

Computed Tomography (CT) Protocols Associated with Cardiac and Bone Single-Photon Emission Computed Tomography/CT (SPECT/CT) in Korea

  • Original Article
  • Published:
Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Single-photon emission computed tomography/computed tomography (SPECT/CT) is an advanced hybrid nuclear medicine technology that generates both functional and anatomical images in a single study. As utilization of SPECT/CT in Korea has been increasing, the purpose of this study was to survey its application of cardiac and skeletal SPECT/CT imaging for protocol optimization.

Methods

We surveyed CT protocols established for cardiac and skeletal SPECT/CT. We searched the guidelines for the CT protocols for SPECT/CT and reviewed the literature recently published.

Results

Among 36 hybrid SPECT scanners equipped with four or more multi-channel detector CTs (MDCTs), 18 scanners were used to perform cardiac studies at both very low current CT (30–80 mA; 11.1%) and ultra-low current CT (13–30 mA; 88.9%). Among the 33 canners, very low current (≤ 80 mA) CT or low current CT (80–130 mA) was used in 23.5%, and 41.8% for spine disorders, and in 36.4% or 30.3% for foot/ankle disorders, respectively. In the CT reconstructions, slice thickness of 5 mm for cardiac studies was most commonly used (94.4%); thinner slices (0.6–1.0 mm) for spine and foot/ankle studies were used in 24.2% and 45.5%, respectively. We also reviewed the international guidelines.

Conclusions

The results and current recommendations will be helpful for optimizing CT protocols for SPECT/CT. Optimization of SPECT/CT protocols will be required for generating the proper strategy for the specific lesions and clinical purpose.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Delbeke D, Coleman RE, Guiberteau MJ, Brown ML, Royal HD, Siegel BA, et al. Procedure guideline for SPECT/CT imaging 1.0. J Nucl Med. 2006;47:1227–34.

    PubMed  Google Scholar 

  2. Clinical applications of SPECT/CT: new hybrid nuclear medicine imaging system. IAEA-TECDOC-1597. 2008.

  3. Van den Wyngaert T, Strobel K, Kampen WU, Kuwert T, van der Bruggen W, Mohan HK, et al. The EANM practice guidelines for bone scintigraphy. Eur J Nucl Med Mol Imaging. 2016;43:1723–38.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Dalrymple NC, Prasad SR, El-Merhi FM, Chintapalli KN. Price of isotropy in multi-detector CT. Radiographics. 2007;27:49–62.

    Article  PubMed  Google Scholar 

  5. The Korean Society of Radiology and Health Insurance Review and Assessment Service. CT Examination and Repeat CT Examination Guidelines. 2013 (Korean) http://www.hira.or.kr/title of subordinate document. Accessed 20. April 2020.

  6. The Korean Society of Radiology and Health Insurance Review and Assessment Service. CT Examination Guidelines for Justification and Optimization. 2012 (Korean) http://nifds.go.kr/brd/title of subordinate document. Accessed 20. April 2020.

  7. Gupta SK, Trethewey S, Brooker B, Rutherford N, Diffey J, Viswanathan S, et al. Radionuclide bone scan SPECT-CT: lowering the dose of CT significantly reduces radiation dose without impacting CT image quality. Am J Nucl Med Mol Imaging. 2017;7:63–73.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Huang K, Feng Y, Liu D, Liang W, Li L. Quantification evaluation of 99mTc-MDP concentration in the lumbar spine with SPECT/CT: compare with bone mineral density. Ann Nucl Med. 2020;34:136–43.

    Article  CAS  PubMed  Google Scholar 

  9. Gaddikeri S, Matesan M, Alvarez J, Hippe DS, Vesselle HJ. MDP-SPECT versus hybrid MDP-SPECT/CT in the evaluation of suspected pars interarticularis fracture in young athletes. J Neuroimaging. 2018;28:635–9.

    Article  PubMed  Google Scholar 

  10. Tamm AS, Abele JT. Bone and gallium single-photon emission computed tomography-computed tomography is equivalent to magnetic resonance imaging in the diagnosis of infectious spondylodiscitis: a retrospective study. Can Assoc Radiol J. 2017;68:41–6.

    Article  PubMed  Google Scholar 

  11. Russo VM, Dhawan RT, Dharmarajah N, Baudracco I, Lazzarino AI, Casey AT. Hybrid bone single photon emission computed tomography imaging in evaluation of chronic low back pain: correlation with modic changes and degenerative disc disease. World Neurosurg. 2017;104:816–23.

    Article  PubMed  Google Scholar 

  12. Russo VM, Dhawan RT, Baudracco I, Dharmarajah N, Lazzarino AI, Casey AT. Hybrid bone SPECT/CT imaging in evaluation of chronic low back pain: correlation with facet joint arthropathy. World Neurosurg. 2017;107:732–8.

    Article  PubMed  Google Scholar 

  13. Russo VM, Duits A, Dhawan RT, Casey AT. Joint arthropathy at the cranio-vertebral junction. scintigraphic patterns on bone SPECT/CT. Br J Neurosurg. 2017;31:45–9.

    Article  PubMed  Google Scholar 

  14. Van de Kelft E, Verleye G, Van de Kelft AS, Melis K, Van Goethem J. Validation of topographic hybrid single-photon emission computerized tomography with computerized tomography scan in patients with and without nonspecific chronic low back pain. A prospective comparative study. Spine J. 2017;17:1457–63.

    Article  PubMed  Google Scholar 

  15. Kato S, Demura S, Matsubara H, Inaki A, Shinmura K, Yokogawa N, et al. Utility of bone SPECT/CT to identify the primary cause of pain in elderly patients with degenerative lumbar spine disease. Orthop Surg Res. 2019;20:185.

    Article  Google Scholar 

  16. Gnanasegaran G, Paycha F, Strobel K, van der Bruggen W, Kampen WU, Kuwert T, et al. Bone SPECT/CT in postoperative spine. Semin Nucl Med. 2018;48:410–24.

    Article  PubMed  Google Scholar 

  17. Al-Riyami K, Vöö S, Gnanasegaran G, Pressney I, Meir A, Casey A, et al. The role of bone SPECT/CT in patients with persistent or recurrent lumbar pain following lumbar spine stabilization surgery. Eur J Nucl Med Mol Imaging. 2019;46:989–98.

    Article  PubMed  Google Scholar 

  18. Zhang L, He Q, Jiang M, Zhang B, Zhong X, Zhang R. Diagnosis of insufficiency fracture after radiotherapy in patients with cervical cancer: contribution of technetium Tc 99m-labeled methylene diphosphonate single-photon emission computed tomography/computed tomography. Int J Gynecol Cancer. 2018;28:1369–76.

    Article  PubMed  Google Scholar 

  19. Duncan I, Ingold N. The clinical value of xSPECT/CT bone versus SPECT/CT. A prospective comparison of 200 scans. Eur J Hybrid Imaging. 2018;2:4.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Bhure U, Roos JE, Pérez Lago MDS, Steurer I, Grünig H, Hug U, et al. SPECT/CT arthrography. Br J Radiol. 2018;91:1082.

    Google Scholar 

  21. Bhure U, Roos JE, Perez-Lago MDS, Strobel K. Single-photon emission computed tomography/computed tomography arthrography of wrist, ankle, and knee joints. Nucl Med Commun. 2020;41:182–8.

    Article  PubMed  Google Scholar 

  22. Bae S, Kang Y, Song YS, Lee WW. Maximum standardized uptake value of foot SPECT/CT using Tc-99m HDP in patients with accessory navicular bone as a predictor of surgical treatment. Medicine (Baltimore). 2019;98:e14022.

    Article  CAS  Google Scholar 

  23. Kampen WU, Westphal F, Van den Wyngaert T, Strobel K, Kuwert T, Van der Bruggen W. SPECT/CT in postoperative foot and ankle pain. Semin Nucl Med. 2018;48:454–68.

    Article  PubMed  Google Scholar 

  24. Alvelo JL, Papademetris X, Mena-Hurtado C, Jeon S, Sumpio BE, Sinusas AJ, et al. Radiotracer imaging allows for noninvasive detection and quantification of abnormalities in angiosome foot perfusion in diabetic patients with critical limb ischemia and nonhealing wounds. Circ Cardiovasc Imaging. 2018;11:e006932.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Chou TH, Atway SA, Bobbey AJ, Sarac TP, Go MR, Stacy MR. SPECT/CT imaging: a noninvasive approach for evaluating serial changes in angiosome foot perfusion in critical limb ischemia. Adv Wound Care (New Rochelle). 2020;9:103–10.

    Article  Google Scholar 

  26. Claassen L, Yao D, Ettinger S, Lerch M, Daniilidis K, Stukenborg-Colsman C, et al. Relevance of SPECT-CT in complex cases of foot and ankle surgery: a comparison with MRI. Foot Ankle Spec. 2019; https://doi.org/10.1177/1938640019890987.

  27. Lu SJ, Ul Hassan F, Vijayanathan S, Gnanasegaran G. Radionuclide bone SPECT/CT in the evaluation of knee pain: comparing two-phase bone scintigraphy. SPECT and SPECT/CT Br J Radiol. 2018;91:20180168.

    Article  PubMed  Google Scholar 

  28. Mandegaran R, Agrawal K, Vijayanathan S, Gnanasegaran G. The value of 99mTc-MDP bone SPECT/CT in evaluation of patients with painful knee prosthesis. Nucl Med Commun. 2018;39:397–404.

    Article  CAS  PubMed  Google Scholar 

  29. Verschueren J, Albert A, Carp L, Ceyssens S, Huyghe I, Stroobants, et al. Bloodpool SPECT as part of bone SPECT/CT in painful total knee arthroplasty (TKA): validation and potential biomarker of prosthesis biomechanics. Eur J Nucl Med Mol Imaging. 2019;46:1009–18.

    Article  PubMed  Google Scholar 

  30. Kim J, Lee HH, Kang Y, Kim TK, Lee SW, So Y, et al. Maximum standardised uptake value of quantitative bone SPECT/CT in patients with medial compartment osteoarthritis of the knee. Clin Radiol. 2017;72:580–9.

    Article  CAS  PubMed  Google Scholar 

  31. De Laroche R, Simon E, Suignard N, Williams T, Henry MP, Robin P, et al. Clinical interest of quantitative bone SPECT-CT in the preoperative assessment of knee osteoarthritis. Medicine (Baltimore). 2018;97:e11943.

    Article  Google Scholar 

  32. Rechsteiner J, Hirschmann MT, Dordevic M, Falkowski AL, Testa EA, Amsler F, et al. Meniscal pathologies on MRI correlate with increased bone tracer uptake in SPECT/CT. Eur Radiol. 2018;28:4696–704.

    Article  PubMed  Google Scholar 

  33. Egloff C, Huber L, Wurm M, Pagenstert G. No added value using SPECT/CT to analyze persistent symptoms after anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg. 2019;139:807–16.

    Article  PubMed  Google Scholar 

  34. Van der Bruggen W, Hirschmann MT, Strobel K, Kampen WU, Kuwert T, Gnanasegaran G, et al. SPECT/CT in the postoperative painful knee. Semin Nucl Med. 2018;48:439–53.

    Article  PubMed  Google Scholar 

  35. Han YH, Jeong HJ, Sohn MH, Yoon SJ, Lim ST. Incidence and severity of femoral head avascularity after femoral neck or intertrochanteric fractures on preoperative bone single photon emission computed tomography/computed tomography: preliminary study. Nucl Med Commun. 2019;40:199–205.

    Article  CAS  PubMed  Google Scholar 

  36. Han S, Oh M, Yoon S, Kim J, Kim JW, Chang JS, et al. Risk stratification for avascular necrosis of the femoral head after internal fixation of femoral neck fractures by post-operative bone SPECT/CT. Nucl Med Mol Imaging. 2017;51:49–57.

    Article  PubMed  Google Scholar 

  37. Ryoo HG, Lee WW, Kim JY, Kong E, Choi WH, Yoon JK, et al. Minimum standardized uptake value from quantitative bone single-photon emission computed tomography/computed tomography for evaluation of femoral head viability in patients with femoral neck fracture. Nucl Med Mol Imaging. 2019;53:287–95.

    Article  PubMed  Google Scholar 

  38. Bäcker HC, Steurer-Dober I, Beck M, Agten CA, Decking J, Herzog RF, et al. Magnetic resonance imaging (MRI) versus single photon emission computed tomography (SPECT/CT) in painful total hip arthroplasty: a comparative multi-institutional analysis. Br J Radiol. 2020;93:20190738.

    Article  PubMed  Google Scholar 

  39. Van den Wyngaert T, Paycha F, Strobel K, Kampen WU, Kuwert T, van der Bruggen W, et al. SPECT/CT in postoperative painful hip arthroplasty. Semin Nucl Med. 2018;48:425–38.

    Article  PubMed  Google Scholar 

  40. Strobel K, van der Bruggen W, Hug U, Gnanasegaran G, Kampen WU, Kuwert T, et al. SPECT/CT in postoperative hand and wrist pain. Semin Nucl Med. 2018;48:396–409.

    Article  PubMed  Google Scholar 

  41. Arıcan P, Okudan B, Şefizade R, Naldöken S. Diagnostic value of bone SPECT/CT in patients with suspected osteomyelitis. Mol Imaging Radionucl Ther. 2019;28:89–95.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Thélu-Vanysacker M, Frédéric P, Charles-Edouard T, Alban B, Nicolas B, Tanguy B. SPECT/CT in postoperative shoulder pain. Semin Nucl Med. 2018;48:469–82.

    Article  PubMed  Google Scholar 

  43. Lee CH, Goo JM, Ye HJ, Ye SJ, Park CM, Chun EJ, et al. Radiation dose modulation techniques in the multidetector CT era: from basics to practice. Radiographics. 2008;28:1451–9.

    Article  PubMed  Google Scholar 

  44. Tsukagoshi S, Ota T, Fujii M, Kazama M, Okumura M, Johkoh T. Improvement of spatial resolution in the longitudinal direction for isotropic image in helical CT. Phys Med Biol. 2007;52:791–801.

    Article  PubMed  Google Scholar 

  45. Rogalla P, Kloeters C, Hein PA. CT technology overview: 64-slice and beyond. Radiol Clin N Am. 2009;47:1–11.

    Article  PubMed  Google Scholar 

  46. Rydberg J, Buckwalter KA, Caldemeyer KS, Phillips MD, Conces DJ, Aisen AM, et al. Multisection CT: scanning techniques and clinical applications. Radiographics. 2000;20:1787–806.

    Article  CAS  PubMed  Google Scholar 

  47. Johnson PT, Fayad LM, Fishman EK. Sixteen slice CT with volumetric analysis of foot fractures. Emerg Radiol. 2006;12:171–6.

    Article  PubMed  Google Scholar 

  48. Santos DT, Oliveira JX, Vannier MW, Cavalcanti MGP. Computed tomography imaging strategies and perspectives in orbital fractures. J Appl Oral Sci. 2007;15:135–9.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Alshipli M, Kabir NA. Effect of slice thickness on image noise and diagnostic content of single-source-dual energy computed tomography. J Physics: Conf Series. 2017;851012005:1–6.

    Google Scholar 

Download references

Acknowledgments

This study was performed as one of the 2018 Quality Control Committee activities of the Korean Society of Nuclear Medicine (KSNM) with cooperation of the Korean Society of Nuclear Medicine Technology (KSNMT). We give special thanks to the members of the KSNMT for participating in this survey, Hong Jae Lee from Seoul National University Hospital, Keun Bae Choe from Hanyang University Hospital, Byung Ho Ahn from Samsung Medical Center, and Soo Young Park from the Catholic University of Korea, Seoul St. Mary’s Hospital.

Author information

Author notes

  1. Eun Jeong Lee and Ji Young Kim contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Seoul Medical Center, Seoul, Republic of Korea

    Eun Jeong Lee

  2. Department of Nuclear Medicine, Hanyang University Guri Hospital, Guri-si, Republic of Korea

    Ji Young Kim

  3. Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Bucheon-si, Republic of Korea

    Jung Mi Park

  4. Department of Nuclear Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea

    Bong-Il Song

  5. Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Republic of Korea

    Hongyoon Choi

  6. Department of Nuclear Medicine, Injae University Haeundae Paik Hospital, Busan, Republic of Korea

    Hye-kyeong Shim

  7. Division of Nuclear Medicine, Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Hey Lim Park

  8. Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea

    Ho-Young Lee & Kyung Jae Lee

  9. Department of Nuclear Medicine, Ajou University Medical Center, Suwon-si, Republic of Korea

    Joon-Kee Yoon

  10. Department of Electronic Engineering, Pai Chai University, Daejeon, Republic of Korea

    Seongho Seo

  11. Department of Nuclear Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea

    Seong Min Kim

  12. Department of Nuclear Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea

    Soo Bin Park

  13. Department of Nuclear Medicine, Samsung Medical Center, Seoul, Republic of Korea

    Young Seok Cho

  14. Korean Society of Nuclear Medicine Quality Control Committee, Seoul, Republic of Korea

    Seong Hoon Kim

Authors
  1. Eun Jeong Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ji Young Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jung Mi Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bong-Il Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hongyoon Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hye-kyeong Shim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hey Lim Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ho-Young Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kyung Jae Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Joon-Kee Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Seongho Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Seong Min Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Soo Bin Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Young Seok Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Seong Hoon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All the authors contributed to the study design, data collection, and discussion of the result. Data analysis and the first draft were performed by Eun Jung Lee, Ji Young Kim, and Jung Mi Park. Jung Mi Park, Joon-Kee Yoon, and Seong Min Kim commented on revision of the manuscript. All the authors read and approved the first and final manuscript.

Corresponding author

Correspondence to Jung Mi Park.

Ethics declarations

Conflict of Interest

Eun Jeong Lee, Ji Young Kim, Jung Mi Park, Bong-Il Song, Hongyoon Choi, Hye-kyeong Shim, Hye Lim Park, Ho-Young Lee, Kyung Jae Lee, Joon-Kee Yoon, Seongho Seo, Seong Min Kim, Soo Bin Park, Young Seok Cho, Seong Hoon Kim declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent is not applicable.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, E.J., Kim, J.Y., Park, J.M. et al. Computed Tomography (CT) Protocols Associated with Cardiac and Bone Single-Photon Emission Computed Tomography/CT (SPECT/CT) in Korea. Nucl Med Mol Imaging 54, 139–146 (2020). https://doi.org/10.1007/s13139-020-00644-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13139-020-00644-9

Keywords

Search

Navigation