Roach Paul J, Schembri Geoffrey P, Ho Shon Ivan A, Bailey Elizabeth A, Bailey Dale L
Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, Australia.
Nucl Med Commun. 2006 Dec;27(12):977-87. doi: 10.1097/01.mnm.0000243372.26507.e7.
To evaluate the incremental benefit in routine clinical practice of computed tomography (CT) scans acquired for anatomical localization on an integrated SPECT/CT which incorporates a spiral CT scanner, in comparison with conventional planar and SPECT scanning.
The first 50 studies acquired on the integrated system were evaluated by two experienced nuclear medicine physicians who were aware of the patient's clinical history. These included bone scans, gallium scans, octreotide scans, sestamibi parathyroid scans and MIBG scans. For each patient study, abnormalities were assessed on planar and SPECT images for location and provisional diagnosis and a quantitative scale was used to assess reporter confidence. The fused SPECT/CT images were then reviewed and the location and provisional diagnosis noted and reporter confidence was assessed using the same quantitative scale.
There were 129 abnormalities detected in 50 patient studies. For localization of abnormalities, the inclusion of the CT resulted in a minor change in 16% of cases and a significant change in 11% over planar/SPECT imaging alone. The confidence of localization was improved moderately in 19% and improved significantly in 6%. For diagnosis, SPECT/CT resulted in a minor change in 10% and a significant change in 9% over planar/SPECT imaging. The confidence of diagnosis was improved moderately in 10% and improved significantly in a further 10% of cases. For the final scan interpretation, there would have been no change in 44% patients, a minor change in 30% and a significant change in 26% with the use of SPECT/CT.
Use of integrated SPECT/CT with a high spatial resolution, spiral CT used for anatomical localization improves accuracy and reporter confidence in clinical practice. As a result, final reports were different in 56% of the cases, including being significantly different in 26% patients compared to reporting with planar/SPECT alone.
评估在常规临床实践中，与传统平面和单光子发射计算机断层扫描（SPECT）相比，集成了螺旋CT扫描仪的SPECT/CT上用于解剖定位的计算机断层扫描（CT）扫描的增量效益。
由两名了解患者临床病史的经验丰富的核医学医师对集成系统上获取的前50项研究进行评估。这些研究包括骨扫描、镓扫描、奥曲肽扫描、甲氧基异丁基异腈甲状旁腺扫描和间碘苄胍（MIBG）扫描。对于每项患者研究，在平面和SPECT图像上评估异常的位置和初步诊断，并使用定量量表评估报告者的信心。然后查看融合的SPECT/CT图像，记录位置和初步诊断，并使用相同的定量量表评估报告者的信心。
在50项患者研究中检测到129处异常。对于异常的定位，与单独的平面/SPECT成像相比，CT的加入在16%的病例中导致了微小变化，在11%的病例中导致了显著变化。定位的信心在19%的病例中适度提高，在6%的病例中显著提高。对于诊断，与平面/SPECT成像相比，SPECT/CT在10%的病例中导致了微小变化，在9%的病例中导致了显著变化。诊断的信心在10%的病例中适度提高，在另外10%的病例中显著提高。对于最终的扫描解读，使用SPECT/CT时，44%的患者不会有变化，30%的患者有微小变化，26%的患者有显著变化。
使用具有高空间分辨率的集成SPECT/CT，利用螺旋CT进行解剖定位，可提高临床实践中的准确性和报告者的信心。结果，56%的病例最终报告有所不同，其中26%的患者与单独使用平面/SPECT报告相比有显著差异。
