The clinical impact of a combined gamma camera/CT imaging system on somatostatin receptor imaging of neuroendocrine tumours.
OBJECTIVE
With a combined gamma camera/CT imaging system, CT images are obtained which are inherently registered to the emission images and can be used for the attenuation correction of SPECT and for mapping the functional information from these nuclear medicine tomograms onto anatomy. The aim of this study was to evaluate the clinical impact of SPECT/CT using such a system for somatostatin receptor imaging (SRI) of neuroendocrine tumours.


METHODS
SPECT/CT imaging with (111)In-Pentetreotide was performed on 29 consecutive patients, the majority of whom had carcinoid disease. All SPECT images were first reported in isolation and then re-reported with the addition of the CT images for functional anatomical mapping (FAM).


RESULTS
Fifteen of the 29 SPECT images were reported as abnormal, and in 11 of these abnormal images (73%) FAM was found to either establish a previously unknown location (7/11) or change the location (4/11) of at least one lesion. The revised location could be independently confirmed in 64% of these cases. Confirmation of location was not possible in the other patients due to either a lack of other relevant investigations, or the fact that lesions seen in the SPECT images were not apparent in the other investigations. FAM affected patient management in 64% of the cases where the additional anatomical information caused a change in the reported location of lesions.


CONCLUSIONS
These results imply that FAM can improve the reporting accuracy for SPECT SRI with significant impact on patient management.
Hillel
P G
PG
Department of Medical Physics and Clinical Engineering, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. phillip.hillel@sth.nhs.uk
van Beek
E J R
EJ
Taylor
C
C
Lorenz
E
E
Bax
N D S
ND
Prakash
V
V
Tindale
W B
WB
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D007414:Intestinal Neoplasms / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging*; D017481:Receptors, Somatostatin; D013004:Somatostatin / Q000031:analogs & derivatives*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods*
D017481:Receptors, Somatostatin; D013004:Somatostatin; C081788:pentetreotide