Hanney Michael B, Hillel Philip G, Scott Andrew D, Lorenz Eleanor
Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Nucl Med Commun. 2017 Jul;38(7):623-628. doi: 10.1097/MNM.0000000000000686.
Typically, scintigraphic evaluation of metastatic bone disease uses planar imaging. Although single photon emission computed tomography (SPECT) offers increased clinical utility, the acquisition time necessary to cover the required scan range (at our centre, skull vertex to mid-femur) has made its use in place of planar imaging impracticable. Recently, reconstruction with resolution recovery (RR) has allowed SPECT acquisition times to be shortened while maintaining acceptable image quality. This study was carried out to establish whether half-body SPECT with RR could replace planar scintigraphy in routine practice.
A series of reduced acquisition time SPECT scans were reconstructed retrospectively and reviewed to establish optimal reconstruction parameters. Twenty patients referred for evaluation of bone metastases underwent planar imaging, followed by half-body SPECT, reconstructed using the optimized parameters. SPECT and planar images were reported by an experienced radiologist, who reviewed image quality and recorded the number of lesions observed, their location, clinical significance and reporter confidence.
SPECT images of acceptable quality and covering the range from skull vertex to mid-femur were acquired in 33 min. Audit indicated that SPECT identified clinically significant lesions not reported from planar views and improved lesion localization and reporter confidence.
Reduced acquisition times together with RR allowed half-body SPECT for the evaluation of bone metastases to be accommodated within our department's schedule. Audit indicated that SPECT delivered the expected clinical advantages. Half-body SPECT has replaced planar imaging for the routine evaluation of metastatic bone disease at our centre, with ∼2500 studies carried out to date.
通常，转移性骨病的闪烁显像评估采用平面成像。尽管单光子发射计算机断层扫描（SPECT）具有更高的临床实用性，但覆盖所需扫描范围（在我们中心，从颅顶到股骨中部）所需的采集时间使得用其取代平面成像不切实际。最近，分辨率恢复（RR）重建技术在保持可接受图像质量的同时缩短了SPECT的采集时间。本研究旨在确定RR技术辅助的半身SPECT在常规实践中是否可以取代平面闪烁显像。
回顾性重建一系列采集时间缩短的SPECT扫描图像，并进行评估以确定最佳重建参数。20例因骨转移评估而转诊的患者先进行平面成像，然后进行半身SPECT成像，并使用优化参数进行重建。由一位经验丰富的放射科医生对SPECT和平面图像进行报告，该医生评估图像质量，并记录观察到的病变数量、位置、临床意义以及报告者的信心。
在33分钟内获取了质量可接受且覆盖从颅顶到股骨中部范围的SPECT图像。审核表明，SPECT发现了平面视图未报告的具有临床意义的病变，并改善了病变定位和报告者的信心。
采集时间的缩短以及RR技术使得用于评估骨转移的半身SPECT能够纳入我们科室的日程安排。审核表明，SPECT带来了预期的临床优势。在我们中心，半身SPECT已取代平面成像用于转移性骨病的常规评估，迄今为止已进行了约2500例检查。
