Integrated modality imaging with PET-CT and SPECT-CT: CT issues.
The advantages of combining PET with CT are multiple and due to the anatomic referencing and the attenuation correction capabilities, which CT introduces, as well as a resulting increase in imaging speed and more efficient use of radiopharmaceuticals. These synergistic advantages are gained with combining PET-CT, but less so when combining SPECT-CT and almost not at all, when combining PET or SPECT with MR. PET-CT in oncology has firmly established itself as the best imaging modality in many settings of tumor staging and therapy monitoring. Whether the CT used in the combined imaging approach should be a full scale contrast enhanced CT or a low mAs unenhanced scan is currently a matter of debate. The use of contrast enhanced CT in PET-CT should be guided primarily by the availability of a prior recent enhanced CT-only scan and the diagnostic questions to be answered by the PET-CT examination and not by turf issues between nuclear physicians and radiologists. The future of combined imaging seems bright, as applications in SPECT-CT and in other disease entities are emerging.
von Schulthess
Gustav K
GK
Department of Radiology Clinic for Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland. Gustav.vonSchulthess@usz.ch
D006801:Humans; D007091:Image Processing, Computer-Assisted; D009367:Neoplasm Staging; D009369:Neoplasms / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed / Q000379:methods*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
D019275:Radiopharmaceuticals