Clinical applications of SPECT imaging. An ECRI technology assessment

Many hospitals are considering acquiring the capability to do single photon emission computed tomography (SPECT) studies. An outgrowth of planar nuclear medicine imaging, combined with computerized methods for gathering and processing data, SPECT can provide three-dimensional radionuclide imaging information, determine regional blood flow, and measure organ volumes. The past decade's record of research using SPECT, coupled with improvements in instrumentation and the development of additional clinically useful radiopharmaceuticals, has fueled the interest in SPECT. It is apparent that SPECT, with recognized applications in cardiac, liver, and bone imaging, offers improvements over planar scanning and provides unique contributions when compared with other imaging techniques. Preliminary research, both about SPECT and in the development of new radiopharmaceuticals that can cross the blood/brain barrier, points to dramatic potential uses in neurology, including measuring brain physiology. There are, however, less data on the effect SPECT imaging can have on patient care outcomes and about its relative clinical and cost effectiveness. Until further research provides these data, SPECT will remain a difficult acquisition decision. If SPECT capability can be acquired relatively inexpensively through add-ons to existing equipment, or if a hospital has a burgeoning nuclear medicine or nuclear cardiology service, the decision is easier. Pending further information, other hospitals can facilitate future acquisition of SPECT by ensuring that any newly purchased gamma cameras and nuclear medicine computers can be upgraded and incorporated into a SPECT system. Hospitals should also follow the growing body of research about SPECT's clinical usefulness.