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SPECT-CT in cancer diagnostics and treatment

A gamma camera allows monitoring the accumulation and distribution of a radioisotope in the body. SPECT imaging is often combined with such planar imaging, in which case a rotating movement of the camera produces 3D images of the desired object. Computed tomography (CT) can be utilised in the same imaging, and the images thus obtained can be combined.

The most common uses of SPCT-CT at our Cancer Center include:

  • Gamma imaging of bone: this imaging allows examining whether the cancer has sent metastases to the bones. In some cases it is also possible to follow up the therapeutic response of cancer developed in bones.
  • Sentinel lymph node examination: this imaging allows looking for lymph nodes through which the lymph around the tumor areas circulates. If the tumor is sending metastases, it will first occur in just these lymph nodes. Any sentinel lymph nodes detected will be removed and examined during surgery. If no disease is detected in them, other lymph nodes in the area need not be removed and thus it is possible to perform a smaller operation. However, if tumor cells are detected in the lymph nodes, all lymph nodes in the area will usually be removed. This examination is part of the preoperative diagnostics of breast cancer.
  • Ejection fraction examination: in this examination, a tin compound which is taken up by red blood cells is injected into the patient’s bloodstream. When a radioisotope is additionally administered intravenously, it is taken up by the tin compound, labelling the red blood cells. At the same time, electrodes attached to the skin monitor the heartbeat, whereby it is possible to gain information on the functioning of the left chamber of the heart, the follow-up of which is important in connection with many cancer treatments.
  • Thyroid diagnostics: Thyroid diagnostics is based on the iodine need of the thyroid gland as part of the synthesis of the thyroid hormone. Accordingly, radioactive iodine can be used for the diagnostics of thyroid diseases, where the most common examinations are related to the assessment of the staging of thyroid cancer and the examination of the amount of excessive thyroid function. Two different iodine isotopes are available (I-123 and I-131). The imaging technique depends on the indication for the imaging. In some cases, a hormone increasing thyroid function (rTSH) can additionally be used to improve the imaging results.
  • Parathyroid diagnostics: Parathyroid diagnostics is based on a substance that is taken up by both the thyroid gland and the parathyroid gland. The removal of the tracer from the thyroid gland is faster, so serial imaging allows looking for functional deviations related to the parathyroid gland.

Equipment

Our hospital is equipped with Siemens Symbia T2 SPECT-CT, which has a number of different uses.

Technical specifications

  • Siemens Symbia T2 SPECT/CT
  • SPECT gamma imaging unit equipped with a 2-slice CT scanner
  • 70 cm bore
  • Versatile image analysis software for the diagnosis of cancer and functional examinations
  • Low-energy and high-energy collimators
  • DICOM interface to Docrates’ PACS archive

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