Single-Photon Emission Computed Tomography/Computed Tomography in Lung Cancer and Malignant Lymphoma
Section snippets
Radiopharmaceuticals
This section analyzes the uptake mechanisms of the currently most used single photon radiopharmaceuticals for lung cancer and malignant lymphomas imaging. Tc-99m sestamibi (SM) and tetrofosmin (TF) are 2 small cationic complexes of technetium introduced for myocardial perfusion imaging, which then were proposed as tumor-avid agents.5 SM uptake and retention in cancer cells depend on several factors, such as regional blood flow, plasma and mithocondrial membrane potentials, metabolic activity,
Imaging Fusion of SPECT Studies
It is well known that SPECT imaging demonstrates function, rather than anatomy, and it is very useful for early diagnosing various disorders because of its ability to detect changes before there are identifiable anatomical correlates and clinical manifestations. Nevertheless, the anatomical landmarks provided by SPECT studies are usually limited, and, especially in cancer imaging, this drawback is not trivial because it could be important to precisely identify and differentiate the sites of
Lung Cancer
The first data on SPECT/CT fusion in lung cancer imaging were reported in clinical trials using radiolabeled antibodies, both in nonsmall cell lung cancer (NSCLC) and SCLC patients.
A group of 14 patients with NSCLC (from stage IIa to stage IV) were studied after the intravenous administration of 99mTc-labeled IMMU-4 anti-CEA Fab’ antibody fragment to evaluate the potential role of immunoscintigraphy SPECT fusion with CT in NSCLC staging.42 Chest SPECT acquisitions were performed either at 5 to
Malignant Lymphoma
67Ga demonstrated useful in evaluating lymphoma patients: however, its accuracy depends on several factors, including the proper technical protocol of imaging.15 It is well known that SPECT should be always performed to improve the sensitivity of planar scans and to better localize the abnormal sites of tracer uptake.75 Nonetheless, the precise anatomical localization of malignant lesions can remain difficult despite optimal technical conditions and careful visual correlation with morphological
Dosimetry Estimations for Radionuclide Therapy
Another possible application of hybrid imaging is to use the structural information obtained from the CT data for an accurate activity quantification in SPECT studies. In a phantom model (ie, a cylinder containing 6 hot spherical inserts in a warm background), Erlandsson and coworkers86 have reported that a SPECT/CT acquisition shows an improvement in image contrast and in the measurement of SPECT activity concentration. This aspect is particularly important in RIT applications, where the exact
Conclusions
In the era of FDG-PET, SPECT imaging with several different radiopharmaceuticals still can play an important clinical role in the workup of patients with lung cancer and malignant lymphomas. The combination of scintigraphic data with anatomical images, such as CT, adds structure to function and helps in overcoming some intrinsic limitations of SPECT studies. The introduction of hybrid systems in the clinical practice has rendered the fusion of SPECT and CT images of routine availability. The
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Cited by (24)
Interest of hybrid SPECT-CT imaging for sentinel node detection in breast cancer.
2010, Medecine NucleaireUtilization of Advanced Imaging Technologies for Target Delineation in Radiation Oncology
2009, Journal of the American College of RadiologyCitation Excerpt :Recently, there has been increasing availability of advanced imaging technologies to guide target delineation, particularly MRI [6-11] and 2-[18F]fluoro-2-deoxyglucose (FDG) PET [12-19]. A variety of specialized imaging approaches have also been investigated to improve target delineation, including single-photon emission CT (SPECT) [20,21], MR spectroscopy (MRS) [11,22-28], non-FDG-PET [13,29,30], and 4-D CT [31,32]. Despite the growing interest in such advanced technologies for target delineation, little is known about their use in the general radiation oncology community.
Hybrid Imaging by SPECT/CT and PET/CT: Proven Outcomes in Cancer Imaging
2009, Seminars in Nuclear MedicineCitation Excerpt :We then identified all original articles within this database that had a bearing on oncology. Furthermore, we screened several review articles previously published on SPECT/CT for additional information.46-55 Bone scintigraphy with radiolabeled polyphosphonates is one of the most frequently performed in vivo nuclear medicine procedures worldwide.
The role of hybrid SPECT-CT in oncology: current and emerging clinical applications
2008, Clinical RadiologyCitation Excerpt :A reliable method of characterizing SPNs is essential, as a small minority prove to be early lung neoplasms.72 Attempts have been made to utilize SPECT-CT in the imaging of lung cancer and SPNs, using both tumour-seeking agents and radiolabelled antibodies.73 Sergiacomi et al.74 studied 23 SPNs with [99mTc]-MIBI SPECT-CT which correctly identified 10 of 11 malignant nodules and 11 of 12 benign nodules, giving the technique a sensitivity and specificity of 91 and 92% respectively.