Variations of clinical SPECT/CT operations

 

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Summary

Aim: This survey gathers information about clinical SPECT/CT operations worldwide to help guide standardization of clinical SPECT/ CT imaging. Methods: An international, webbased 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. Conclusion: 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.

Zusammenfassung

Ziel: In dieser Umfrage wurden weltweit Informationen über die klinische Nutzung von SPECT/CT Systemen gesammelt um bei der Standardisierung klinischer SPECT/CT-Bildgebung zu unterstützen. Methoden: Diese internationale, web-basierte Umfrage wurde 12/2010 gestartet und die Umfrage per E-Mail an die SPECT/CT Nutzer weitergeleitet. Es wurden insgesamt 71 Fragen in Bezug auf (A) Demographie, (B) SPECT/CT-Nutzung bzw. Auslastung und (C) Untersuchungsprotokolle gestellt. Ergebnisse: Die Umfrage wurde von insgesamt 117 Instituten aus Nord-und Südamerika (66%), Europa (20%), Asien-Pazifik (11%) und dem Nahen Osten (3%) beantwortet. Öffentliche Einrichtungen stellten hier die Mehrheit der antwortenden Institute (69%). Die meisten Institute betreiben 1–2 SPECT/ CT-Systeme (74%), welche in der Regel in nuklear medizinischen Abteilungen (84%) installiert sind und ausgeprägte klinische Erfahrung mit der SPECT-Bildgebung (82%) besitzen. Nur 14% der SPECT/CT-Systeme sind in radiologischen Abteilungen installiert. Klinische SPECT/CT wird entweder als Routinebildgebung (51%) oder als Zusatzverfahren (49%) durchgeführt, wobei die Variabilität zwischen den einzelnen Instituten hoch ist. Die wichtigste Anwendung der integrierten CT-Komponente ist für die befragten Institute die anatomische Lokalisation der Traceraufnahme, jedoch nicht kontrastverstärkte diagnostische CT-Bilder zu erzeugen. Folglich haben nur 22% der Standorte eine Kontrastmittelpumpe installiert. Schlussfolgerung: Diese internationale Umfrage unter klinischen SPECT/CT-Anwendern zeigt, dass die SPECT/ CT kein Bestandteil in der klinischen nuklearmedizinischen Routine ist. Die Mehrheit der Zentren nutzt die diagnostischen Möglichkeiten ihrer CT-Komponente nicht in vollem Umfang. Es wurden deutliche Unterschiede in den Untersuchungsprotokollen der einzelnen Institute beobachtet. Die Ergebnisse verdeutlichen, dass die Ausbildung der SPECT/CTNutzer und die Standardisierung von Untersuchungsprotokollen zwingend notwendig ist und die Rolle der SPECT / CT in der diagnostischen Bildgebung diskutiert werden muss.

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