title: Variations of clinical SPECT/CT operations: an international survey.
abstract: OBJECTIVE
  This survey gathers information about clinical SPECT/CT operations worldwide to help guide standardization of clinical SPECT/CT imaging.
  
  
  METHODS
  An international, web-based survey of SPECT/CT users was initiated in 12/2010 through an e-mail distribution. Users were asked 71 questions related to (A) demographics, (B) SPECT/CT operations/utilization and (C) variations in imaging protocols.
  
  
  RESULTS
  Collected responses originated from 117 imaging centers in the Americas (66%), Europe (20%), Asia-Pacific (11%) and the Middle-East (3%), with the majority of responding sites representing public health care institutions (69%). Most sites operate 1-2 SPECT/CT-systems (74%), typically installed in Nuclear Medicine departments (84%) with extensive prior SPECT-only experience (82%). Only 14% of SPECT/CTs are installed in Radiology departments. Clinical SPECT/CT imaging is performed either as routine (51%) or ad-hoc "add-on" procedure (49%) with a high inter-site and inter-examination variability. The main application of the integrated CT is to provide anatomical localization of the tracer uptake rather than to produce contrast-enhanced or other high-quality CT images. Consequently, in only 22% of the sites a CT contrast injector is installed. Only 6% of centers use SPECT/CT devices for stand-alone CT procedures.
  
  
  CONCLUSIONS
  An international survey among clinical SPECT/CT users revealed that SPECT/CT is a not a routine component of nuclear medicine procedures. The majority of the centers responding do not fully utilize the diagnostic potential of the CT components. Significant variations in standard imaging protocols were observed. These findings illustrate the need for training and standardization and underscore the need for revisiting the role of SPECT/CT in diagnostic imaging.
authors.affiliation: Zentrum für Radiologie und Nuklearmedizin (ZRN) Grevenbroich, Dormagen, Neuss, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Wieder
authors.forename: L S
authors.initials: LS
authors.lastname: Freudenberg
authors.forename: J
authors.initials: J
authors.lastname: Czernin
authors.forename: B N
authors.initials: BN
authors.lastname: Navar
authors.forename: O
authors.initials: O
authors.lastname: Israel
authors.forename: T
authors.initials: T
authors.lastname: Beyer
mesh_terms: D019538:Health Care Surveys; D038622:Internationality; D064847:Multimodal Imaging / Q000706:statistics & numerical data*; D009683:Nuclear Medicine / Q000706:statistics & numerical data*; D049268:Positron-Emission Tomography; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed