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SPECT - CT
SPECT-CT
자료: Simens
Gantry Overview – 전면부
XTA – X-ray Tube Assembly
Blowers –
CT 겐트리의 냉각장치로써 냉각 및 정화된 공기를 주입
High Voltage Tank –
고전압 발생장치로 X-
Ray 의 Part.
DMS – Data Measurement System
Ultra Fast Ceramic (UFC) 및 DAS
component로 구성되어 있습니다.
Gantry Overview – 후면부
XTA – X-ray Tube
High Voltage Tank
HV Tank로 부터 XTA에
고전압을 공급하는 케이블
Power Box –
Main Inverter를
장착하고 있으며 HV
tank 전체에 고전압을
공급합니다. XRS – 고전압 발생기의
Control Center 입니다.
PSR – Power Supply Rotating.
Tube와 디텍터를 회전시키는
프레임에 전원을 공급합니다.
PCU –
DMS의
전원
공급
장치.
SRS – Slip ring system.
별도의 Wire 없이 Tube와 Frame간에
전기적 신호를 전송하는 장치
자료: Simens
자료: Simens SPECT-CT Fusion image
Proven Outcomes
LAD LCx RCA All Vessels
NC CTAC NC CTAC NC CTAC NC CTAC
Sensitivity 69 93* 61 72 78 81 69 88*
Specificity 25 38 63 78 31 75* 45 69*
Accuracy 60 81* 62 73 59 78* 60 79*
* p<0.05
25% improvement in most MPI diagnostic parameters
James R. Corbett, MD, University of Michigan Health System, Ann Arbor, MI
We see a way to ... Increase specificity, sensitivity, and accuracy of Myocardial Perfusion SPECT by more than 25%
자료: Simens
Data Courtesy of University of Michigan, Ann Arbor, MI, Dr. James Corbett
Uncor Stress
COR Stress
Uncor Stress
COR Stress
Uncor Stress
COR Stress
Uncorrected Stress – FPB, Endocardial Perfusion Blackout Corrected Stress, Endocardial Perfusion Blackout
Myocardial perfusion - effect of attenuation correction using CTAC
66 year old male, 94 kg (207 lbs) – typical angina with multiple coronary risk factors and two vessel disease. Abnormal scan. Stress slices displayed are FPB uncorrected verses CT corrected. Total proximal RCA and total mid LAD occlusions both with extensive collaterals from normal LCx.
자료: Simens
111In Octreotide SPECT·CT study. SPECT·CT Octretide study performed 48 hours after injection with 3 phase Liver contrast CT study. Fusion of venous phase of 3phase contrast CT study with In 111 Octreotide SPECT shows small focal contrast blush in segment VII of liver which corresponds to focal area of uptake of In 111 Octreotide suggestive of metastasis from Carcinoid tumour. Another small foci of In 111 Octreotide uptake in the inferior margin of the right lobe of liver in segment V suggestive of metastasis but without any abnormality on contrast CT.
Data courtesy of Dr.Shahid Mahmood Radiology Clinic Parkway Hospitals Singapore
Liver Metastasis from Intestinal Carcinoid Tumor
자료: Simens
SPECT is distributed; PET is mostly oncology The overlap of PET and SPECT is only in
oncology….
Source: IMV SPECT Census Report, 2003; IMV PET Census Report 2003; PET and Molecular Imaging Report Europe 2004; SMI CRM Understand and Strategic Planning
SPECT ~40 million procedures
PET ~2 million procedures
WORLD
92%
4%4%
Oncology
Cardiology
Neurology
31%
35%
4%
30%
Oncology
Cardiology
Neurology
General Imaging
25%
55%
1%
19%
Oncology
Cardiology
Neurology
General Imaging
자료: Simens
Clinical Results – Diagnostic Confidence
Benefits of SPECT/CT in bone cancer imaging
More than 90% of cancer patients leave the clinic with a definite diagnosis
W. Römer, MD, University Clinic of Nuclear Medicine, Erlangen, Germany
Malignant
Indeterminate
Benign
44
52
28
0
25
50
75
100
125
SPECT
Lesions
43
77
SPECT•CT
4
SPECT vs. SPECT•CT Diagnostic in Oncology Clarify more than 90% of
SPECT findings initially classified as indeterminate.
Reduce patient radiation exposure by limiting the CT scan to the body region of interest identified by SPECT
Preliminary results suggest change in patient management in 20~30% of cases.
자료: Simens
PM- tube Crystal
Collimator
SPECT Phantom
Jaszczak ACR SPECT Phantom
SPECT Phantoms
SPECT phantom을 이용한 횡단면상의 분해능 성능검사
Jaszczak Phantom
자료: 핵의과학
IAEA Phantom
자료: 핵의과학
SPECT 방사성 의약품
1) Brain - 99mTc-HMPAO, 99mTc-ECD, 201Tl, 123I-IMP,
HIPDM
2) Heart - 99mTc-sestaMIBI, Tetrofosmin, 201Tl
3) Bone - 99mTc-MDP, HMDP, EHDP, MHDP
4) Kidney - 99mTc-DMSA
5) Liver - 99mTc-phytate (colloid), 99mTc-PYP, RBC
6) Lung - 99mTc-MAA, HAM
7) Tumor – 67Ga-citrate, 99mTc-sestaMIBI, Tetrofosmin
A : Transverse, B : Sagittal, C: Coronal
A : Transverse, B : Sagittal, C: Coronal
Hoffman Brain Phantom
3-D Hoffman Brain Phantom
심근관류 SPECT에서 단층영상 구성
Cardiac Insert Phantom
Lung phantom
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