Advertisement

Clinical Applications of Technetium-99m Quantitative Single-Photon Emission Computed Tomography/Computed Tomography

  • Won Woo LeeEmail author
  • K-SPECT Group
Review
  • 22 Downloads

Abstract

Single-photon emission computed tomography/computed tomography (SPECT/CT) is an already established nuclear imaging modality. Co-registration of functional information (SPECT) with anatomical images (CT) paved the way to the wider application of SPECT. Recent advancements in quantitative SPECT/CT have made it possible to incorporate quantitative parameters, such as standardized uptake value (SUV) or %injected dose (%ID), in gamma camera imaging. This is indeed a paradigm shift in gamma camera imaging from qualitative to quantitative evaluation. In fact, such quantitative approaches of nuclear imaging have only been accomplished for positron emission tomography (PET) technology. Attenuation correction, scatter correction, and resolution recovery are the three main features that enabled quantitative SPECT/CT. Further technical improvements are being achieved for partial-volume correction, motion correction, and dead-time correction. The reported clinical applications for quantitative SPECT/CT are mainly related to Tc-99m-labeled radiopharmaceuticals: Tc-99m diphosphonate for bone/joint diseases, Tc-99m pertechnetate for thyroid function, and Tc-99m diethylenetriaminepentaacetic acid for measurement of glomerular filtration rate. Dosimetry before trans-arterial radio-embolization is also a promising application for Tc-99m macro-aggregated albumin. In this review, clinical applications of Tc-99m quantitative SPECT/CT will be discussed.

Keywords

Quantitation Single-photon emission computed tomography Computed tomography Gamma camera Tc-99m 

Notes

Acknowledgement

This work was supported in part by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2018R1D1A1A09081961) and by the Korean Society of Nuclear Medicine Clinical Trial Network (KSNM CTN) working group funded by the Korean Society of Nuclear Medicine (KSNM-CTN-2017-01-01).

Compliance with Ethical Standards

Conflicts of Interest

Won Woo Lee declares that there is no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

Not applicable.

References

  1. 1.
    Lang TF, Hasegawa BH, Liew SC, Brown JK, Blankespoor SC, Reilly SM, et al. Description of a prototype emission-transmission computed tomography imaging system. J Nucl Med. 1992;33:1881–7.Google Scholar
  2. 2.
    Keidar Z, Israel O, Krausz Y. SPECT/CT in tumor imaging: technical aspects and clinical applications. Semin Nucl Med. 2003;33:205–18.CrossRefGoogle Scholar
  3. 3.
    Na CJ, Kim J, Choi S, Han YH, Jeong HJ, Sohn MH, et al. The clinical value of hybrid sentinel lymphoscintigraphy to predict metastatic sentinel lymph nodes in breast cancer. Nucl Med Mol Imaging. 2015;49:26–32.CrossRefGoogle Scholar
  4. 4.
    Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med. 2009;50(Suppl 1):11S–20S.CrossRefGoogle Scholar
  5. 5.
    Yi HK, Park YJ, Bae JH, Lee JK, Lee KH, Choi SH, et al. Inverse prognostic relationships of (18)F-FDG PET/CT metabolic parameters in patients with distal bile duct cancer undergoing curative surgery. Nucl Med Mol Imaging. 2018;52:334–41.CrossRefGoogle Scholar
  6. 6.
    Ritt P, Vija H, Hornegger J, Kuwert T. Absolute quantification in SPECT. Eur J Nucl Med Mol Imaging. 2011;38(Suppl 1):S69–77.CrossRefGoogle Scholar
  7. 7.
    Bailey DL, Willowson KP. An evidence-based review of quantitative SPECT imaging and potential clinical applications. J Nucl Med. 2013;54:83–9.CrossRefGoogle Scholar
  8. 8.
    Bailey DL. Transmission scanning in emission tomography. Eur J Nucl Med. 1998;25:774–87.CrossRefGoogle Scholar
  9. 9.
    Vandervoort E, Celler A, Harrop R. Implementation of an iterative scatter correction, the influence of attenuation map quality and their effect on absolute quantitation in SPECT. Phys Med Biol. 2007;52:1527–45.CrossRefGoogle Scholar
  10. 10.
    Hutton BF, Buvat I, Beekman FJ. Review and current status of SPECT scatter correction. Phys Med Biol. 2011;56:R85–112.CrossRefGoogle Scholar
  11. 11.
    Cachovan M, Vija AH, Hornegger J, Kuwert T. Quantification of 99mTc-DPD concentration in the lumbar spine with SPECT/CT. EJNMMI Res. 2013;3:45.CrossRefGoogle Scholar
  12. 12.
    Kuji I, Yamane T, Seto A, Yasumizu Y, Shirotake S, Oyama M. Skeletal standardized uptake values obtained by quantitative SPECT/CT as an osteoblastic biomarker for the discrimination of active bone metastasis in prostate cancer. Eur J Hybrid Imaging. 2017;1:2.CrossRefGoogle Scholar
  13. 13.
    Suh MS, Lee WW, Kim YK, Yun PY, Kim SE. Maximum standardized uptake value of (99m) Tc hydroxymethylene diphosphonate SPECT/CT for the evaluation of temporomandibular joint disorder. Radiology. 2016;280:890–6.CrossRefGoogle Scholar
  14. 14.
    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.CrossRefGoogle Scholar
  15. 15.
    Miller TT, Staron RB, Feldman F, Parisien M, Glucksman WJ, Gandolfo LH. The symptomatic accessory tarsal navicular bone: assessment with MR imaging. Radiology. 1995;195:849–53.CrossRefGoogle Scholar
  16. 16.
    Chiu NT, Jou IM, Lee BF, Yao WJ, Tu DG, Wu PS. Symptomatic and asymptomatic accessory navicular bones: findings of Tc-99m MDP bone scintigraphy. Clin Radiol. 2000;55:353–5.CrossRefGoogle Scholar
  17. 17.
    Chong A, Ha JM, Lee JY. Clinical meaning of hot uptake on bone scan in symptomatic accessory navicular bones. Nucl Med Mol Imaging. 2016;50:322–8.CrossRefGoogle Scholar
  18. 18.
    Romanowski CA, Barrington NA. The accessory navicular—an important cause of medial foot pain. Clin Radiol. 1992;46:261–4.CrossRefGoogle Scholar
  19. 19.
    Shah S, Achong DM. The painful accessory navicular bone: scintigraphic and radiographic correlation. Clin Nucl Med. 1999;24:125–6.CrossRefGoogle Scholar
  20. 20.
    Bae S, Kang Y, Song YS, Lee WW, K-SPECT Group. 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;e14022:98.Google Scholar
  21. 21.
    Machado Jdo M, Monteiro MS, Vieira VF, Collinot JA, Prior JO, Vieira L, et al. Value of a lower-limb immobilization device for optimization of SPECT/CT image fusion. J Nucl Med Technol. 2015;43:98–102.CrossRefGoogle Scholar
  22. 22.
    Chung JK. Sodium iodide symporter: its role in nuclear medicine. J Nucl Med. 2002;43:1188–200.Google Scholar
  23. 23.
    Chung JK, Youn HW, Kang JH, Lee HY, Kang KW. Sodium iodide symporter and the radioiodine treatment of thyroid carcinoma. Nucl Med Mol Imaging. 2010;44:4–14.CrossRefGoogle Scholar
  24. 24.
    Meller J, Becker W. The continuing importance of thyroid scintigraphy in the era of high-resolution ultrasound. Eur J Nucl Med Mol Imaging. 2002;29(Suppl 2):S425–38.CrossRefGoogle Scholar
  25. 25.
    Lee H, Kim JH, Kang YK, Moon JH, So Y, Lee WW. Quantitative single-photon emission computed tomography/computed tomography for technetium pertechnetate thyroid uptake measurement. Medicine (Baltimore). 2016;95:e4170.CrossRefGoogle Scholar
  26. 26.
    Kim HJ, Bang JI, Kim JY, Moon JH, So Y, Lee WW. Novel application of quantitative single-photon emission computed tomography/computed tomography to predict early response to methimazole in Graves’ disease. Korean J Radiol. 2017;18:543–50.CrossRefGoogle Scholar
  27. 27.
    Kim JY, Kim JH, Moon JH, Kim KM, Oh TJ, Lee DH, et al. Utility of quantitative parameters from single-photon emission computed tomography/computed tomography in patients with destructive thyroiditis. Korean J Radiol. 2018;19:470–80.CrossRefGoogle Scholar
  28. 28.
    Lee R, So Y, Song YS, Lee WW. Evaluation of hot nodules of thyroid gland using Tc-99m pertechnetate: a novel approach using quantitative single-photon emission computed tomography/computed tomography. Nucl Med Mol Imaging. 2018;52:468–72.CrossRefGoogle Scholar
  29. 29.
    Gates GF. Glomerular filtration rate: estimation from fractional renal accumulation of 99mTc-DTPA (stannous). AJR Am J Roentgenol. 1982;138:565–70.CrossRefGoogle Scholar
  30. 30.
    Gates GF. Computation of glomerular filtration rate with Tc-99m DTPA: an in-house computer program. J Nucl Med. 1984;25:613–8.Google Scholar
  31. 31.
    Kang YK, Park S, Suh MS, Byun SS, Chae DW, Lee WW. Quantitative single-photon emission computed tomography/computed tomography for glomerular filtration rate measurement. Nucl Med Mol Imaging. 2017;51:338–46.CrossRefGoogle Scholar
  32. 32.
    Kim YI, Ha S, So Y, Lee WW, Byun SS, Kim SE. Improved measurement of the glomerular filtration rate from Tc-99m DTPA scintigraphy in patients following nephrectomy. Eur Radiol. 2014;24:413–22.CrossRefGoogle Scholar
  33. 33.
    Suh M, Kang YK, Ha S, Kim YI, Paeng JC, Cheon GJ, et al. Comparison of two different segmentation methods on planar lung perfusion scan with reference to quantitative value on SPECT/CT. Nucl Med Mol Imaging. 2017;51:161–8.CrossRefGoogle Scholar
  34. 34.
    Song YS, Paeng JC, Kim HC, Chung JW, Cheon GJ, Chung JK, et al. PET/CT-based dosimetry in 90Y-microsphere selective internal radiation therapy: single cohort comparison with pretreatment planning on (99m)Tc-MAA imaging and correlation with treatment efficacy. Medicine (Baltimore). 2015;94:e945.CrossRefGoogle Scholar
  35. 35.
    Lee EW, Alanis L, Cho SK, Saab S. Yttrium-90 selective internal radiation therapy with glass microspheres for hepatocellular carcinoma: current and updated literature review. Korean J Radiol. 2016;17:472–88.CrossRefGoogle Scholar
  36. 36.
    Dittmann H, Kopp D, Kupferschlaeger J, Feil D, Groezinger G, Syha R, et al. A prospective study of quantitative SPECT/CT for evaluation of lung shunt fraction before SIRT of liver tumors. J Nucl Med. 2018;59:1366–72.CrossRefGoogle Scholar
  37. 37.
    Lau WY, Leung WT, Ho S, Leung NW, Chan M, Lin J, et al. Treatment of inoperable hepatocellular carcinoma with intrahepatic arterial yttrium-90 microspheres: a phase I and II study. Br J Cancer. 1994;70:994–9.CrossRefGoogle Scholar

Copyright information

© Korean Society of Nuclear Medicine 2019

Authors and Affiliations

  1. 1.Department of Nuclear MedicineSeoul National University Bundang Hospital, Seoul National University College of MedicineSeoulSouth Korea
  2. 2.Institute of Radiation Medicine, Medical Research CenterSeoul National UniversitySeoulSouth Korea

Personalised recommendations