Optimization of the bone single photon emission computed tomography in oncology patients

Introduction: The introduction of hybrid imaging systems such as single photon emission computed tomography/computed tomography (SPECT/CT) has completely changed the scanning procedure of conventional diagnostic nuclear medicine protocols. Modern bone scintigraphy protocols include standardized uptake value quantification and whole body (WB) SPECT/CT scanning modality. The major limitation of these new technologies is the relatively long scanning time. New detector systems with modern reconstruction software have been developed for fast scanning SPECT protocols. These new technologies can produce images of reduced acquisition with the same quality as full scanning acquisition. As a result, new studies suggest that planar WB scintigraphy should be replaced with WB SPECT/CT. Methods: One hundred oncology patients performed SPECT/CT as a part of their clinical follow-up. Three different scanning and three reconstruction protocols have been evaluated. Two nuclear medicine physicians evaluated with Likert scale image sharpness, lesion visibility, and lesion background detectability. The overall image quality was determined as the sum of these three parameters. Results: In terms of scan duration reduction on image quality, Volumetrix Evolution for Bone performed during ultra-fast SPECT acquisition achieved the highest score, which is superior compared to the standard SPECT acquisition protocol. The overall image quality was the best with the Volumetrix MI Evolution for Bone protocol for ultra-fast acquisition. Conclusion: The Evolution for Bone protocol for ultra-fast acquisition showed the best results compared to other protocols. The adoption of the new acquisition SPECT protocol may offer more comfortable examinations, resulting in higher patient satisfaction. The implementation of this new protocol can lead to an improvement in SPECT sensitivity, primarily due to the reduction of SPECT motion artifacts: SPECT has significantly improved nuclear medicine diagnostics. The disadvantage of SPECT methods is the relatively low signal-to-noise ratio and contrast-to-noise ratio. The low number of image photons is a major problem with SPECT imaging, as the signal decreases as the noise (image background) increases.