NUCLEAR MEDICINE

IMAGING TECHNIQUES
SPECT IMAGING

PREPARED BY:R.T/RANDA ALARIQI

 SPECT IMAGING

 Single Photon Emission

Computerized Tomography.
 Single photon to differentiate
from two annihilation photons.
 Generation of cross - sectional
images
 Images from various angular
projections
 WHAT DO WE GAIN FROM SPECT?

 3D view of the organ/structure (depth

information)
 Improved contrast
 Quantitation
 SPECT IMAGING

The basic raw data in SPECT are

acquired under computer control as a
series of discrete planar projections,
images at uniform angular increments
about the longitudinal axis of the
patient
On the basis of its location, each
detected event, or count, is assigned
to the corresponding computer-
defined bin address
Collectively, the bin contents
represent the basic raw data, which is
then mathematically reconstructed to
yield the transverse section images.
 ACQUISITION PARAMETERS

Patient orientation
Rotation (180/360)
Acquisition type (Elliptical / circular)
Acquisition Time
Matrix Size
Magnification
Number of projections
 PATIENT ORIENTATION

SPECT acquisition allows you one of two options,

LEGS-IN / LEGS-OUT
The LEGS-OUT choice is normally made as the
viewer has the right side of the patient on view in
front of him/her as an anterior projection
Incorrect choice will affect L:R orientation
 ROTATION: STEP/SHOOT VERSUS
CONTINUOUS
First generation SPECT cameras: Single-head,
rotating 360º around the patient.
The camera was stopped and a picture taken at
each desired projection angle, a technique known
as “step-shoot”.
This technique is still widely used.
The time required to move from one image angle
to the next, can be as much as 4 seconds, during
which no data are required.
 ROTATION (CONT.)

One method to avoid this “dead-time” is to

perform continuous rotation acquisition.
There may be a decrease in image resolution,
since the camera is moving during acquisition,
causing motion blur.
The cameras resolution at the radius of rotation is
the deciding factor when a choice is made between
step/shoot and continuous acquisition.
 ROTATION (COMBINED)

Some cameras has the ability to get the benefits of

both rotation methods.
These cameras collects data in each frame and
also while moving from frame to frame.
 ACQUISITION TYPE( CIRCULAR/
ELLIPTICAL)
For best resolution, detector head should be as
close to the organ of interest as possible
Elliptical better in this case
Circular has a wider radius
Most cameras have an option to acquire an
elliptical orbit instead of the normal circular orbit,
permitting the detector to be positioned closer to the
patient.
 ROTATION: 180º OR 360º?

When using SPECT imaging as a

diagnostic tool, the anatomical position of
the structure should be taken into
consideration.
Distribution of pathological lesions within
the organ/area of interest will influence
orbit size.
The simplest way to think about SPECT is
to separate studies into two types:
◼ 180º
◼ 360º
This is dependent on the location of the
organ of interest within the body i.e. Is the
organ anterior or posterior?
 Lumbar spine = posterior
Heart = anterior
Only 180 degrees of data are necessary to acquire for enough
useful information.
 The lumbar spine and
myocardium are positioned closer
to the body surface and images
acquired from the opposite surface
do not add quality information to
the tomographic study.
In these cases a 360º SPECT will
only extend the acquisition time
without improving the tomographic
image quality.
Thus 180 º acquisition is sufficient
 ACQUISITION TIME

Determined by the patient.

The patient can only lie still for 30 - 40
minutes
15 -18 seconds frame time is advised on
single head system if 3º intervals are selected.
This time should be doubled if 6º intervals
are selected.
 MATRIX SIZE

Acquisition parameters available in Nuclear Medicine

computers typically vary from 32x32, 64x64, 128x128 , 256x256
up to 1024x1024
The choice should not be guesswork
Ensure that minimal information is lost.
The higher the matrix size the higher the resolution
and the longer the time of acquisition and vice versa.
128x128 allows better resolution but the space required on
your computer is 4 times greater than that needed for a 64x64
matrix study
If limited space is available than a 64x64 matrix can be used.
Use a zoom to effectively reduce the field size.
 MAGNIFICATION

During acquisition the matrix size covers the whole

field size and Pixel size=field size/matrix size
When applying zoom, the field size is divided by the
zoom factor, which means the resultant field size is
Smaller.
 NUMBER OF PROJECTIONS

How many projection views should be used

60 at 6º intervals
OR
120 at 3º intervals
Spacing between the angles is dependant
on the size of the object in question, and the
systems resolution.
Thus large objects need more projections
than small objects.
 CLINICAL APPLICATIONS

Bone SPECT
Cardiac SPECT
Brain SPECT
 INDICATIONS FOR BONE SPECT

Bone SPECT has been demonstrated to be the

most sensitive noninvasive test for evaluation of the
extent of arthritis in patients with chronic knee pain .
Bone studies using SPECT have mainly involved
patients with suspected disease of :
 Lumbar spine
 Tempero-mandibular joints (TMJ)/skull
 Hip /Sacro-iliac joints
 Knees
 ACQUISITION PROTOCOL

Matrix size 64x64, 128x128 (preferred)

Zoom 1 or according to the ROI
Orbit circular/non circular
Time/frame 20-40 seconds
Angular step 4º -6º (90-60 stops)
SS/continuous step and shoot
Collimator LEHR (preferred)/LEGP
Rotation 360
Rotation velocity 20 cm/min

140 keV with 20% window

 OSTEOARTHRITIS

SPECT

Planar
INDICATIONS FOR CARDIAC SPECT

Cardiac SPECT is a valuable imaging technique used for

various clinical indications, including :
Diagnosis of Coronary Artery Disease (CAD): It helps in
identifying narrowed or blocked heart arteries.
Assessment of Myocardial Ischemia: Evaluates areas of
the heart muscle that may not be receiving adequate
blood flow.
Evaluation of Myocardial Infarction: Determines the
extent and location of heart damage from a heart
attack.
Evaluation of Heart Function: Assesses overall heart
function and helps in the management of heart failure.
 CARDIAC SPECT ACQUISITION
PROTOCOL
Matrix size 64x64
Zoom 1.4-1
Orbit non circular
Time/frame 20-40 seconds
Angular step 3º -6º
SS/continuous step and shoot
Collimator LEGP
Rotation 180
Rotation velocity 20 cm/min

140 keV with 20% window

CARDIAC SPECT
 INDICATIONS FOR BRAIN SPECT

Brain SPECT is used for various clinical indications,

including :
Diagnosis of Neurological Conditions: It helps in
diagnosing conditions like epilepsy, stroke, and
Alzheimer’s disease.
Detection of Brain Tumors and Metastases: Assists in
identifying both primary and metastatic brain
tumors.
Evaluation of Traumatic Brain Injuries (TBIs): Useful in
detecting mild TBIs that might not be visible on CT or
MRI scans.
 BRAIN SPECT ACQUISITION
PROTOCOL
Matrix size 128x128 (preferred)
Zoom 1.4 -1
Orbit circular/non circular
Time/frame 20-40 seconds
Angular step 3º -6º
SS/continuous step and shoot
Collimator LEHRF (preferred) or LEUHR
Rotation 360
Rotation velocity 20 cm/min

140 keV with 20% window