REVIEW  BLOOD POOL PHASE SPECT: THE MISSING LINK OF BONE SCINTIGRAPHY Free access

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2023 September;67(3):183-90

DOI: 10.23736/S1824-4785.23.03506-9

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Technical concepts on blood pool phase SPECT (acquisition, reconstruction)

Sarah C. CADE ¹ ✉, Richard N. GRAHAM ²

¹ Department of Medical Physics and Bioengineering; Royal United Hospitals Bath NHS Foundation Trust, Bath, UK; ² Department of Radiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK

Guidelines for bone scintigraphy are well established and recommend the use of planar early phase images to investigate a number of clinical indications. With recent advances in gamma camera technology the use of SPECT/CT imaging in the early phases is now possible, offering the potential of improved diagnostic confidence and prognostic value. To date little work has been carried out to optimize the acquisition of early phase bone images using SPECT/CT with most of the available studies acquiring SPECT images after the traditional planar images to allow comparison of the two techniques. Imaging durations of 7 to 10 minutes have been commonly used. However, the use of iterative reconstruction algorithms has been investigated with rapid SPECT imaging to allow imaging durations as low as 4 minutes. The use of CZT based systems with increased sensitivity and improved energy and spatial resolution also offers the potential to reduce imaging times. The optimization of projection measurement order has been investigated as a method of reducing image artefacts as a result of changing tracer distribution during the SPECT acquisition. In this article we consider the current state of early phase SPECT imaging and possible areas for future investigation as well as recommendations for departments looking to adopt blood pool SPECT imaging as part of their routine clinical practice.

KEY WORDS: Bone and bones; Diagnostic imaging; Tomography, emission-computed, single-photon; Tomography, X-ray computed