Miscellaneous: SPECT and SPECT/CT for Brain and Inflammation Imaging and Radiation Planning
Combination of SPECT (single-photon emission computed tomography) with CT (computed tomography) provides the opportunity for a direct correlation of anatomic information and functional data and leads to a better localization and definition of scintigraphi
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Ali Gholamrezanezhad
14.1
Introduction
Combination of SPECT (single-photon emission computed tomography) with CT (computed tomography) provides the opportunity for a direct correlation of anatomic information and functional data and leads to a better localization and definition of scintigraphic findings. Besides anatomic referencing, the other advantage of CT co-registration is the attenuation correction capabilities of CT. These advantages together result in a higher specificity of imaging and a significant reduction in indeterminate findings. This chapter highlights the potential clinical applications of integrated SPECT/CT in neurology, inflammation imaging, and radiation planning and summarizes future directions for SPECT/CT in these fields.
14.2
SPECT/CT for Inflammation Imaging
Depending on the type of suspected disease and the clinical presentation, diagnosis of inflammatory diseases usually requires laboratory and imaging procedures to confirm clinical diagnosis. Therefore, the context in which specific imaging procedures are needed should be selected as in a case-by-case approach. Cross-sectional imaging modalities, mainly CT and MRI, provide high-quality anatomical details, but structural changes that are developed due to inflammatory processes are usually nonspecific. The role of nuclear medicine imaging procedures, including SPECT/CT and PET (positron emission tomography) imaging using different radiopharmaceuticals, has been specifically appreciated in the diagnosis of infection of joint prostheses, infected vascular grafts, and a number of other inflammatory processes [1–34].
A. Gholamrezanezhad, MD, FEBNM Department of Medicine, Yale-New Haven Hospital-Saint Raphael Campus, Yale School of Medicine, New Haven, CT, USA e-mail: [email protected] H. Ahmadzadehfar, H.-J. Biersack (eds.), Clinical Applications of SPECT-CT, DOI 10.1007/978-3-642-35283-6_14, © Springer-Verlag Berlin Heidelberg 2014
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Gallium citrate, 111Indium, and 99mTechnetium HMPAO-labeled white blood cell (WBC) and bone scintigraphies are widely used in the assessment of suspected infection/inflammation. These scintigraphies suffer from poor spatial resolution and still somewhat low specificity, because of the absence or paucity of anatomical landmarks, a shortcoming which has been partly overcome by the co-registration to CT images. It has been confirmed that combined functional/anatomical imaging techniques, such as SPECT/CT, facilitate more precise localization and accurate characterization of inflammatory lesions and improve the specificity of the test. Here we describe in brief, the application of SPECT/CT in such cases.
14.2.1 Infection of Joint Prostheses More than 500,000 hip and knee arthroplasties are performed annually in the USA, and this number may exceed 700,000 by the year 2030 [11, 15, 18]. Aseptic loosening, dislocation, fracture, and infection are the most important complications of these procedures. As the clinical presentations and histopathologic changes of infe
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