SPECT/CT in oncology

Radionuclide imaging can demonstrate whole body functional/metabolic information and plays an important role in oncology clinical and research practice. It is integral to many clinical pathways, assisting in diagnosis and staging, pre-operative localisation, monitoring response and detecting recurrence. However, planar scintigraphy and SPECT lack anatomical and structural details resulting in low specificity and sensitivity with inconclusive reports often requiring further imaging correlation. To overcome these limitations hybrid SPECT/CT was introduced to clinical practice in 1999 and it has become a commonly used imaging modality. By combining the functional map of radionuclide imaging with the anatomical detail of CT, it allows accurate localisation, attenuation correction and characterisation of lesions in the same session. The result is improved specificity, sensitivity and diagnostic confidence leading to earlier diagnosis and shorter time to treatment. Potential issues of SPECT/CT include additional radiation, time for scanning and reporting, staff training and incidentalomas.

New radiotracers, advances in hardware and improved software have all led to a number of exciting developments in SPECT/CT in recent years. Despite rapid advances in other modalities such as CT, MRI, PETCT and PETMRI, radionuclide SPECT/CT continues to play an important role in clinical practice.

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