The role of hybrid SPECT-CT in oncology: current and emerging clinical applications.

Single photon emission computed tomography - computed tomography (SPECT-CT) is an emerging dual-modality imaging technique with many established and potential clinical applications in the field of oncology. To date, there has been a considerable emphasis on the benefits of integrated positron emission tomography - computed tomography (PET-CT) in oncology, but relatively little focus on the clinical utility of SPECT-CT. As with PET-CT, accurate co-registration of anatomical and functional data from a combined SPECT-CT camera often provides complementary diagnostic information. Both sensitivity (superior disease localization) and specificity (exclusion of false-positives due to physiological tracer uptake) are improved, and the functional significance of indeterminate lesions detected on cross-sectional imaging can be defined. This article will review the scope of hybrid SPECT-CT in oncology and illustrate both current and emerging clinical applications.

[1]  A. Engel,et al.  The new technology of combined transmission and emission tomography in evaluation of endocrine neoplasms. , 2001, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[2]  T. Fahey Radiolabeled Somatostatin Analog [177Lu-DOTA0,Tyr3]Octreotate in Patients With Endocrine Gastroenteropancreatic Tumors , 2006 .

[3]  Kazuo Awai,et al.  Added value of SPECT/CT fusion in assessing suspected bone metastasis: comparison with scintigraphy alone and nonfused scintigraphy and CT. , 2006, Radiology.

[4]  B. Shulkin,et al.  Current concepts on the diagnostic use of MIBG in children. , 1998, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[5]  S. Bardet,et al.  Gallium-67 scintigraphy in lymphoma: is there a benefit of image fusion with computed tomography? , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[6]  Z. Keidar,et al.  Positron emission tomography in the evaluation of lymphoma. , 2004, Seminars in nuclear medicine.

[7]  J. Martín-Comín,et al.  Characterization of radiologically indeterminate lung lesions: 99mTc-depreotide SPECT versus 18F-FDG PET , 2006, Nuclear medicine communications.

[8]  D M Hansell,et al.  PET/CT in non-small cell lung cancer staging-promises and problems. , 2007, Clinical radiology.

[9]  Z. Keidar,et al.  The fusion of anatomic and physiologic imaging in the management of patients with cancer. , 2001, Seminars in nuclear medicine.

[10]  J. Haaga,et al.  CT and MR Imaging of the Whole Body , 2002 .

[11]  H. Amthauer,et al.  Impact of SPECT and integrated low-dose CT after radioiodine therapy on the management of patients with thyroid carcinoma , 2004, Nuclear medicine communications.

[12]  H. Handa,et al.  Sequential brain imaging as an aid in understanding disease etiology. , 1971, Seminars in nuclear medicine.

[13]  Orazio Schillaci,et al.  Functional-anatomical image fusion in neuroendocrine tumors. , 2004, Cancer biotherapy & radiopharmaceuticals.

[14]  William C. Barber,et al.  Dual-Modality Imaging of Cancer with SPECT/CT , 2002, Technology in cancer research & treatment.

[15]  C. Claussen,et al.  Evaluation of combined transmission and emission tomography for classification of skeletal lesions. , 2004, AJR. American journal of roentgenology.

[16]  Barbara Palumbo,et al.  67Ga-SPECT/CT with a hybrid system in the clinical management of lymphoma , 2005, European Journal of Nuclear Medicine and Molecular Imaging.

[17]  C. Meltzer,et al.  PET/CT: form and function. , 2007, Radiology.

[18]  W. Oyen,et al.  FDG-PET in staging lung cancer: how does it change the algorithm? , 2004, Lung cancer.

[19]  D. Stoker,et al.  Bone Tumours (2): Malignant Lesions , 2008 .

[20]  G. V. von Schulthess,et al.  Integrated-modality imaging: the best of both worlds. , 2002, Academic radiology.

[21]  Soo Chin Liew,et al.  Description of a simultaneous emission-transmission CT system , 1990, Medical Imaging.

[22]  A. Partin,et al.  Comparison of clinical staging algorithms and 111Indium‐capromab pendetide immunoscintigraphy in the prediction of lymph node involvement in high risk prostate carcinoma patients , 1999, Cancer.

[23]  J. Mazziotta,et al.  Rapid Automated Algorithm for Aligning and Reslicing PET Images , 1992, Journal of computer assisted tomography.

[24]  T. Lairmore,et al.  Medullary carcinoma of the thyroid: current diagnosis and management. , 1991, Seminars in surgical oncology.

[25]  Marco Brambilla,et al.  Potential advantage of studying the lymphatic drainage by sentinel node technique and SPECT-CT image fusion for pelvic irradiation of prostate cancer. , 2006, International journal of radiation oncology, biology, physics.

[26]  B. Nowak,et al.  Benign versus malignant osseous lesions in the lumbar vertebrae: differentiation by means of bone SPET , 2000, European Journal of Nuclear Medicine.

[27]  K. Oberg Management of neuroendocrine tumours. , 2004, Annals of oncology : official journal of the European Society for Medical Oncology.

[28]  Roland Bares,et al.  The role of single-photon emission computed tomography/computed tomography in benign and malignant bone disease. , 2006, Seminars in nuclear medicine.

[29]  M. Juweid Radioimmunotherapy of B-cell non-Hodgkin's lymphoma: from clinical trials to clinical practice. , 2002, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[30]  W. Martin,et al.  Impact of 131I-SPECT/CT images obtained with an integrated system in the follow-up of patients with thyroid carcinoma , 2004, European Journal of Nuclear Medicine and Molecular Imaging.

[31]  Y. Nishiyama,et al.  Clinical usefulness of fusion of 131I SPECT and CT images in patients with differentiated thyroid carcinoma. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[32]  Wei Chen,et al.  18F-FDOPA PET imaging of brain tumors: comparison study with 18F-FDG PET and evaluation of diagnostic accuracy. , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[33]  P. McKinney,et al.  Brain tumours: incidence, survival, and aetiology , 2004, Journal of Neurology, Neurosurgery & Psychiatry.

[34]  R. Antonelli Incalzi,et al.  The effects of chronic hypoxia on left ventricular peak filling rate evaluated by equilibrium radionuclide angiocardiography. , 1986, Nuclear medicine communications.

[35]  Michael Wilk,et al.  Gamma camera-mounted anatomical X-ray tomography: technology, system characteristics and first images , 2000, European Journal of Nuclear Medicine.

[36]  A. Nikiforov [Intracranial neoplasms]. , 1990, Meditsinskaia sestra.

[37]  R. Danieli,et al.  Is SPECT/CT with a hybrid camera useful to improve scintigraphic imaging interpretation? , 2004, Nuclear medicine communications.

[38]  Orazio Schillaci,et al.  Hybrid SPECT/CT: a new era for SPECT imaging? , 2005, European Journal of Nuclear Medicine and Molecular Imaging.

[39]  M P Sandler,et al.  Image fusion using an integrated, dual-head coincidence camera with X-ray tube-based attenuation maps. , 2000, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[40]  Orazio Schillaci,et al.  Fusion imaging in nuclear medicine--applications of dual-modality systems in oncology. , 2004, Cancer biotherapy & radiopharmaceuticals.

[41]  A. Engel,et al.  SPECT/CT hybrid imaging with 111In‐pentetreotide in assessment of neuroendocrine tumours , 2003, Clinical endocrinology.

[42]  E. Even-Sapir Imaging of malignant bone involvement by morphologic, scintigraphic, and hybrid modalities. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[43]  Kenneth H. Wong,et al.  Dual-modality imaging of function and physiology. , 2002, Academic radiology.

[44]  S. Swensen,et al.  Lung cancer screening with CT: Mayo Clinic experience. , 2003, Radiology.

[45]  J. Ferlay,et al.  Estimates of the cancer incidence and mortality in Europe in 2006. , 2006, Annals of oncology : official journal of the European Society for Medical Oncology.

[46]  A. Sherif,et al.  Hybrid SPECT-CT: an additional technique for sentinel node detection of patients with invasive bladder cancer. , 2006, European urology.

[47]  Value of combined XCT/SPECT technology for avoiding false positive planar 123I-MIBG scintigraphy , 2004 .

[48]  J. Peterse,et al.  Reliability of sentinel lymph node biopsy for staging melanoma , 2000, The British journal of surgery.

[49]  Michael Lassmann,et al.  Clinical radionuclide therapy dosimetry: the quest for the “Holy Gray” , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[50]  Richard P Baum,et al.  Imaging of neuroendocrine tumors. , 2006, Seminars in nuclear medicine.

[51]  Thomas Beyer,et al.  Non-small cell lung cancer: dual-modality PET/CT in preoperative staging. , 2003, Radiology.

[52]  Y. Jhanwar,et al.  The role of PET in lymphoma. , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[53]  F. Kainberger,et al.  Value of combined XCT/SPECT technology for avoiding false positive planar 123I-MIBG scintigraphy , 2004, Nuklearmedizin.

[54]  Thomas F Hany,et al.  PET diagnostic accuracy: improvement with in-line PET-CT system: initial results. , 2002, Radiology.

[55]  R L Wahl,et al.  CT-SPECT fusion plus conjugate views for determining dosimetry in iodine-131-monoclonal antibody therapy of lymphoma patients. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[56]  J. Aarsvold,et al.  Sentinel node staging of early breast cancer using lymphoscintigraphy and the intraoperative gamma-detecting probe. , 2000, Seminars in nuclear medicine.

[57]  Thomas F Hany,et al.  Integrated PET/CT: current applications and future directions. , 2006, Radiology.

[58]  G. Snow,et al.  Head and neck squamous cell carcinoma: US-guided fine-needle aspiration of sentinel lymph nodes for improved staging--initial experience. , 2001, Radiology.

[59]  O. Schillaci Single-photon emission computed tomography/computed tomography in lung cancer and malignant lymphoma. , 2006, Seminars in nuclear medicine.

[60]  M. Schlumberger,et al.  Papillary and follicular thyroid carcinoma. , 1998, The New England journal of medicine.

[61]  J. Bouček,et al.  Validation of prospective whole-body bone marrow dosimetry by SPECT/CT multimodality imaging in 131I-anti-CD20 rituximab radioimmunotherapy of non-Hodgkin’s lymphoma , 2005, European Journal of Nuclear Medicine and Molecular Imaging.

[62]  U Pietrzyk,et al.  An interactive technique for three-dimensional image registration: validation for PET, SPECT, MRI and CT brain studies. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[63]  R. Danieli,et al.  Usefulness of SPECT/CT with a hybrid camera for the functional anatomical mapping of primary brain tumors by [Tc99m] tetrofosmin. , 2006, Cancer biotherapy & radiopharmaceuticals.

[64]  O. Israel,et al.  The continuing clinical role of gallium 67 scintigraphy in the age of receptor imaging. , 1997, Seminars in nuclear medicine.

[65]  O. Miettinen,et al.  Screening for lung cancer : Lung Cancer , 2000 .

[66]  T. Turkington,et al.  ProstaScint (capromab pendetide) imaging using hybrid gamma camera-CT technology. , 2005, AJR. American journal of roentgenology.

[67]  A. Belldegrun,et al.  Comparison of helical computerized tomography, positron emission tomography and monoclonal antibody scans for evaluation of lymph node metastases in patients with prostate specific antigen relapse after treatment for localized prostate cancer. , 1999, The Journal of urology.

[68]  A. Kirby,et al.  The role of FDG PET in the management of lymphoma: what is the evidence base? , 2007, Nuclear medicine communications.

[69]  Christopher J. Taylor,et al.  The clinical impact of a combined gamma camera/CT imaging system on somatostatin receptor imaging of neuroendocrine tumours , 2006 .

[70]  C. Claussen,et al.  Benefit of anatomical-functional image fusion in the diagnostic work-up of neuroendocrine neoplasms , 2003, European Journal of Nuclear Medicine and Molecular Imaging.

[71]  G. Bakale,et al.  Update on fused capromab pendetide imaging of prostate cancer. , 2005, Clinical prostate cancer.

[72]  G. Lucignani,et al.  Position of nuclear medicine techniques in the diagnostic work-up of brain tumors. , 2004, The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of....

[73]  D. Krag,et al.  Sentinel Lymph Node Radiolocalization in Head and Neck Squamous Cell Carcinoma , 2000, The Laryngoscope.

[74]  K Herholz,et al.  Three-dimensional alignment of functional and morphological tomograms. , 1990, Journal of computer assisted tomography.

[75]  D. Capuzzi,et al.  Scintigraphic imaging of body neuroendocrine tumors. , 2007, Radiographics : a review publication of the Radiological Society of North America, Inc.

[76]  F MURRAY,et al.  Diagnosis and treatment of lung cancer. , 1955, Geriatrics.

[77]  R. Danieli,et al.  Integrated multislice CT and Tc–99m Sestamibi SPECT–CT evaluation of solitary pulmonary nodules , 2006, La radiologia medica.

[78]  G. Grasselli,et al.  Assessment of mediastinal involvement in lung cancer with technetium-99m-sestamibi SPECT. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[79]  Paul Kinahan,et al.  A combined PET/CT scanner for clinical oncology. , 2000, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[80]  Ora Israel,et al.  SPECT/CT in tumor imaging: technical aspects and clinical applications. , 2003, Seminars in nuclear medicine.

[81]  E. Krenning,et al.  Somatostatin receptor imaging. , 2002, Seminars in nuclear medicine.

[82]  Gustav K. von Schulthess,et al.  Integrated-Modality Imaging , 2002 .

[83]  R. Wahl,et al.  Three-Dimensional Radiobiologic Dosimetry: Application of Radiobiologic Modeling to Patient-Specific 3-Dimensional Imaging–Based Internal Dosimetry , 2007, Journal of Nuclear Medicine.

[84]  D. Podoloff,et al.  Procedure guideline for lymphoscintigraphy and the use of intraoperative gamma probe for sentinel lymph node localization in melanoma of intermediate thickness 1.0. , 2002, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[85]  B. Majumder Reliability of sentinel lymph node biopsy for staging melanoma , 2000, The British journal of surgery.

[86]  B. Shulkin,et al.  The current status of meta-iodobenzylguanidine and related agents for the diagnosis of neuro-endocrine tumors. , 1995, The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology.

[87]  R. Mansberg,et al.  Yttrium 90 Bremsstrahlung SPECT/CT scan demonstrating areas of tracer/tumour uptake , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[88]  Orazio Schillaci,et al.  Single-photon emission computed tomography/computed tomography in brain tumors. , 2007, Seminars in nuclear medicine.

[89]  G H Hinkle,et al.  Immunoscintigraphy with indium-111-capromab pendetide: evaluation before definitive therapy in patients with prostate cancer. , 1999, Urology.

[90]  Kurt Schicho,et al.  SPECT-CT for topographic mapping of sentinel lymph nodes prior to gamma probe-guided biopsy in head and neck squamous cell carcinoma. , 2004, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[91]  E. P. Krenning,et al.  Somatostatin receptor scintigraphy with [111In-DTPA-d-Phe1]- and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1000 patients , 1993, European Journal of Nuclear Medicine.

[92]  Torsten Kuwert,et al.  SPECT-guided CT for evaluating foci of increased bone metabolism classified as indeterminate on SPECT in cancer patients. , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[93]  Dale L Bailey,et al.  SPECT/CT imaging using a spiral CT scanner for anatomical localization: Impact on diagnostic accuracy and reporter confidence in clinical practice , 2006, Nuclear medicine communications.

[94]  P. McKinney Brain tumours: incidence, survival, and aetiology , 2004, Journal of neurology, neurosurgery, and psychiatry.

[95]  H. Steinert,et al.  Single-photon emission computed tomography/computed tomographyfor sentinel node mapping in breast cancer. , 2007, Seminars in nuclear medicine.

[96]  Brad J Kemp,et al.  Single-photon emission computed tomography/computed tomography: basic instrumentation and innovations. , 2006, Seminars in nuclear medicine.

[97]  E. Krenning,et al.  Somatostatin receptors in human cancer: Incidence, characteristics, functional correlates and clinical implications , 1992, The Journal of Steroid Biochemistry and Molecular Biology.

[98]  L. Fig,et al.  Artifacts, anatomical and physiological variants, and unrelated diseases that might cause false-positive whole-body 131-I scans in patients with thyroid cancer. , 2000, Seminars in nuclear medicine.

[99]  O. Israel,et al.  Gallium-67 scintigraphy: a cornerstone in functional imaging of lymphoma , 2003, European Journal of Nuclear Medicine and Molecular Imaging.

[100]  E. Even-Sapir,et al.  Lymphoscintigraphy for sentinel node mapping using a hybrid SPECT/CT system. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.