[SPECT/CT - Technical aspects and optimization possibilities]

In contrast to positron emission tomography/computed tomography (PET/CT), the currently available single photon emission computed tomography/computed tomography (SPECT/CT) systems are very heterogeneous. On the side of the gamma cameras, dual-head systems are established, which are not very different from one manufacturer to the other. For the CT component, there are low dose tubes on the one side and flat detector-based cone beam CT and multislice-CT on the other. The CT image data can be used for anatomic correlation of suspicious findings as well as for attenuation correction of SPECT data. Attenuation correction enables on the one hand enhancement of SPECT image quality and on the other hand quantification of the radioactivity concentration becomes possible. Modern iterative reconstruction algorithms allow scatter correction and attenuation correction of SPECT data using the density values from CT. It still has to be shown to what extent attenuation-corrected whole body SPECT/CT studies will be able to improve the sensitivity of scintigraphy studies. As SPECT/CT primarily aims at morphologic correlation and not detection of additional lesions, an attempt should be made to balance the necessary anatomic information and the additional radiation exposure. Besides SPECT-guided CT all technical possibilities for dose reduction should be exhausted.