AIM: To review the benefits of single photon emission computed tomography(SPECT)/computed tomography(CT) hybrid imaging for diagnosis of various endocrine disorders.METHODS: We performed MEDLINE and Pub Med searches u...AIM: To review the benefits of single photon emission computed tomography(SPECT)/computed tomography(CT) hybrid imaging for diagnosis of various endocrine disorders.METHODS: We performed MEDLINE and Pub Med searches using the terms: "SPECT/CT"; "functional anatomic mapping"; "transmission emission tomography"; "parathyroid adenoma"; "thyroid cancer"; "neuroendocrine tumor"; "adrenal"; "pheochromocytoma"; "paraganglioma"; in order to identify relevant articles published in English during the years 2003 to 2015. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts(case reports, reviews, meta-analyses and abstracts) concerning the application of SPECT/CT to endocrine imaging were analyzed to provide a descriptive synthesis of the utility of this technology.RESULTS: The emergence of hybrid SPECT/CT camera technology now allows simultaneous acquisition of combined multi-modality imaging, with seamless fusion of three-dimensional volume datasets. The usefulness of combining functional information to depict the biodistribution of radiotracers that map cellular processes of the endocrine system and tumors of endocrine origin, with anatomy derived from CT, has improved the diagnostic capability of scintigraphy for a range of disorders of endocrine gland function. The literature describes benefits of SPECT/CT for ^(99m)Tc-sestamibi parathyroid scintigraphy and ^(99m)Tc-pertechnetate thyroid scintigraphy, ^(123)I- or ^(131)I-radioiodine for staging of differentiated thyroid carcinoma, ^(111)In- and ^(99m)Tclabeled somatostatin receptor analogues for detection of neuroendocrine tumors, ^(131)I-norcholesterol(NP-59) scans for assessment of adrenal cortical hyperfunction, and ^(123)I- or ^(131)I-metaiodobenzylguanidine imaging for evaluation of pheochromocytoma and paraganglioma.CONCLUSION: SPECT/CT exploits the synergism between the functional information from radiopharmaceutical imaging and anatomy from CT, translating to improved diagnostic accuracy and meaningful 展开更多
Osteonecrosis(ON) is caused by inadequate blood supply leading to bone death, which results in the collapse of the architectural bony structure. Femoral head is the most common site involved in ON. Magnetic resonance ...Osteonecrosis(ON) is caused by inadequate blood supply leading to bone death, which results in the collapse of the architectural bony structure. Femoral head is the most common site involved in ON. Magnetic resonance imaging(MRI) is a commonly used imaging modality to detect early ON. When MRI is inconclusive, bone scan is helpful in detecting ON during early phase of the disease. As newer nuclear medicine equipment, like single photon emission computed tomography/computed tomography(CT) and positron emission tomography/CT, are emerging in medical science, we review the role of these imaging modalities in ON of femoral head.展开更多
文摘目的:功能亢进的甲状旁腺病灶需手术切除,^(99m)锝-甲氧基异丁基异腈(^(99m)Tc-methoxyisobutylisonitrile,^(99m)Tc-MIBI)单光子发射计算机体层摄影/计算机体层摄影(single-photon emission computed tomography/computed tomography,SPECT/CT)在甲状旁腺病灶定位诊断中起重要作用,而部分结节性甲状腺肿摄取^(99m)Tc-MIBI较高,与功能亢进的甲状旁腺病灶难以鉴别。本研究旨在探讨^(99m)Tc-MIBI SPECT/CT在甲状旁腺病灶与结节性甲状腺肿鉴别诊断中的价值。方法:回顾性分析通过^(99m)Tc-MIBI SPECT/CT拟诊为甲状旁腺病灶的68例患者,共计81个病灶。根据手术切除后病理检查结果将病灶分为甲状旁腺病灶组(69个)和结节性甲状腺肿组(12个)。测量所有病灶的放射性计数最大值(target maximum radioactivity count,Tmax),以主动脉弓平均放射性计数作为本底放射性计数平均值(background mean radioactivity count,Bmean),并计算二者的比值(Tmax/Bmean),比较2组间Tmax/Bmean的差异;测量病灶CT密度最小值、平均值和最大值,比较2组间各CT密度值的差异;绘制甲状旁腺病灶患者与结节性甲状腺肿患者受试者操作特征(receiver operating characteristic,ROC)曲线,评估各CT密度值的诊断效能。结果:甲状旁腺病灶与结节性甲状腺肿病灶^(99m)Tc-MIBI放射性摄取明显浓聚;2种病灶的CT密度值均低于正常甲状腺组织,2种病灶与甲状腺的分界均可表现为清晰或模糊2种情况。2组Tmax/Bmean值比较差异无统计学意义(P=0.221)。2组CT密度最小值、平均值及最大值比较,差异均有统计学意义(均P<0.05)。CT密度最大值的诊断效能最优,曲线下面积(area under the curve,AUC)为0.894(P<0.001),其阈值为91 HU,敏感度为83.3%,特异度为94.2%。结论:病灶^(99m)Tc-MIBI放射性摄取程度对甲状旁腺病灶与结节性甲状腺肿的鉴别价值有限,病灶CT密度最大值具有较高诊断效能。
文摘AIM: To review the benefits of single photon emission computed tomography(SPECT)/computed tomography(CT) hybrid imaging for diagnosis of various endocrine disorders.METHODS: We performed MEDLINE and Pub Med searches using the terms: "SPECT/CT"; "functional anatomic mapping"; "transmission emission tomography"; "parathyroid adenoma"; "thyroid cancer"; "neuroendocrine tumor"; "adrenal"; "pheochromocytoma"; "paraganglioma"; in order to identify relevant articles published in English during the years 2003 to 2015. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts(case reports, reviews, meta-analyses and abstracts) concerning the application of SPECT/CT to endocrine imaging were analyzed to provide a descriptive synthesis of the utility of this technology.RESULTS: The emergence of hybrid SPECT/CT camera technology now allows simultaneous acquisition of combined multi-modality imaging, with seamless fusion of three-dimensional volume datasets. The usefulness of combining functional information to depict the biodistribution of radiotracers that map cellular processes of the endocrine system and tumors of endocrine origin, with anatomy derived from CT, has improved the diagnostic capability of scintigraphy for a range of disorders of endocrine gland function. The literature describes benefits of SPECT/CT for ^(99m)Tc-sestamibi parathyroid scintigraphy and ^(99m)Tc-pertechnetate thyroid scintigraphy, ^(123)I- or ^(131)I-radioiodine for staging of differentiated thyroid carcinoma, ^(111)In- and ^(99m)Tclabeled somatostatin receptor analogues for detection of neuroendocrine tumors, ^(131)I-norcholesterol(NP-59) scans for assessment of adrenal cortical hyperfunction, and ^(123)I- or ^(131)I-metaiodobenzylguanidine imaging for evaluation of pheochromocytoma and paraganglioma.CONCLUSION: SPECT/CT exploits the synergism between the functional information from radiopharmaceutical imaging and anatomy from CT, translating to improved diagnostic accuracy and meaningful
文摘Osteonecrosis(ON) is caused by inadequate blood supply leading to bone death, which results in the collapse of the architectural bony structure. Femoral head is the most common site involved in ON. Magnetic resonance imaging(MRI) is a commonly used imaging modality to detect early ON. When MRI is inconclusive, bone scan is helpful in detecting ON during early phase of the disease. As newer nuclear medicine equipment, like single photon emission computed tomography/computed tomography(CT) and positron emission tomography/CT, are emerging in medical science, we review the role of these imaging modalities in ON of femoral head.
