It is important that you let staff at the hospital or
SPECT-CT
Consumer Information
Contributors:
Dr Geoffrey Soo, MBBS, FRANZCR
Dr Timothy Cain, MBBS, FRANZCR, MBA
Dr Dee Nandurkar, Ms Ann Revell, Dr Christine Walker,
A/Prof Stacy Goergen
What is a SPECT-CT scan?
SPECT-CT is where two different types of scans are
taken and the images or pictures from each are
fused or merged together. The fused scan can
provide more precise information about how
different parts of the body function and more clearly
identify problems such as tumours (lumps) or
Alzheimer’s disease, etc.
Single photon emission computed tomography
(SPECT): SPECT images are obtained following an
injection of a radiopharmaceutical that is used for
nuclear medicine scans. The injected medication
sticks to specific areas in the body, depending on
what radiopharmaceutical is used and the type of
scan being performed, for example. it will show
bone for a bone scan, and gall bladder and bile
ducts for a hepatobiliary scan.
The radiopharmaceutical is detected by a nuclear
medicine gamma camera. The camera or cameras
rotate over a 360 degree arc around the patient,
allowing for reconstruction of an image in three
dimensions (see Nuclear Medicine).
Computed tomography (CT): CT images are
obtained while you lie on a bed that moves into a
ring, or ‘donut’ shaped X-ray machine. Again, the X-
ray machine rotates over a 360 degree arc around
the patient, allowing for image reconstruction in
three dimensions. The X-ray machine from the CT
scanner rotates much faster than the gamma
camera, so the CT part of the study takes less time
than the SPECT study.
The similarity between SPECT and CT in the method
of image processing allows the images to be
combined. Combining the information from a nuclear
medicine SPECT study and a CT study allows the
information about function from the nuclear
medicine study to be easily combined with the
information about how the body structure “looks” in
the CT study.
How do I prepare for a SPECT-CT
scan?
No extra preparation is required for being imaged on
a SPECT-CT machine, as this is usually done at the
same time you are having other types of scans that
use a nuclear medicine gamma camera.
©RANZCR® 2009 A Quality Use of Diagnostic Imaging (QUDI) Initiative
radiology practice where you are having the scan
done know if you are (or think you could be)
pregnant or are breast feeding.
This study may not be suitable for pregnant women
because of the radiation dose to the growing foetus.
Please discuss this with your doctor.
Women who are breastfeeding and people who are
the primary or sole carer for small children may
need to make special preparations for after the test,
to stop breastfeeding for a short time, and to avoid
close contact with young children. This is due to the
small amount of radioactivity your body may release
for a while after the test. Talk to your referring
doctor or the nuclear medicine practice where you
will have the test for details. The Australian
Radiation Protection and Nuclear Safety Agency has
recommendations about breastfeeding and close
contact with children after nuclear medicine tests.
If you are having a SPECT-CT scan along with
another type of scan you will need to follow the
preparation instructions for that particular scan. If
you are unsure of the preparations you should speak
with the hospital nuclear medicine department or
private radiology practice where you are having the
scan done before you go for the appointment.
What happens during a SPECT-CT
scan?
You are required to lie still in a ring shaped scanner
for at least 30-40 minutes. The first 3-5 minutes
involves the CT scan component, with the remainder
of time is required for the SPECT study. It is very
important that you remain still for the entire
duration of the two studies so that the SPECT and
CT can be accurately combined. If you do not lie
still, the images from one study will not exactly
correspond to the images from the other study, and
the study may be difficult to interpret.
When you are positioned for the scan, please make
sure you are in a position that will allow you to keep
still. If you do not think you will be able to lie still for
30-40 minutes during the scan please inform your
doctor or the nuclear medicine staff.
Are there any after effects of a SPECT-
CT scan?
There are no after effects from a SPECT-CT scan.
However, if you are breastfeeding or caring for
young children, see the “how do I prepare” section
for more information about special precautions you
may need to take.
How long does a SPECT-CT scan
take?
It takes 30-40 minutes to obtain the SPECT and CT
images, then you are allowed to leave.
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After you have left the hospital department or
radiology practice a nuclear medicine technologist
will process the images and accurately fuse (merge)
the SPECT and CT images. The time taken for this
will depend on the computer software used and the
workload but may take up to 1-2 hours.
What are the risks of a SPECT-CT
scan?
There are no risks involved in the nuclear medicine
SPECT scan or the CT scan procedures. The test
involves a small dose of ionising radiation from the
radiopharmaceutical injected into your vein, and
also from the CT scan. (See Radiation Risk of
Medical Imaging for Adults and Children)
Importantly, the SPECT component of the test
requires no additional injection of
radiopharmaceutical beyond what you would have
been given for the nuclear medicine test without the
SPECT part. The CT is usually done using a low-dose
radiation technique which is around 20-25% the
radiation exposure of a normal CT scan.
Your doctor has weighed up the benefit versus risk
for having a SPECT-CT scan and has decided that
the benefit of having the information gained from
the scan outweighs any risk.
What are the benefits of a SPECT-CT
scan?
SPECT-CT provides the ability to merge or combine
the images often allowing the nuclear medicine
specialist to more accurately pinpoint the site of any
abnormality on your nuclear medicine scan. This
may be of particular importance in certain clinical
situations, when the interpretation of an area of
interest may change depending on its location. For
example, in small areas like the spine or feet, it is
sometimes hard to determine from the nuclear
medicine imaging alone whether the abnormality lies
in the bone or the adjacent joints – fusing a SPECT
with CT provides added confidence in identifying
where the abnormality is.
Who does the SPECT-CT scan?
Nuclear medicine technologists perform the scans
which are then analysed and interpreted by nuclear
medicine specialist who also provide a report of the
scan to your referring doctor. See Nuclear Medicine
for more information about these health
professionals.
Where is a SPECT-CT scan done?
A SPECT-CT scan is done at a nuclear medicine
facility with a dedicated SPECT-CT machine. Many
large public and private hospitals as well as some
private radiology practices now have SPECT-CT
scanners
©RANZCR® 2009 A Quality Use of Diagnostic Imaging (QUDI) Initiative
SPECT-CT
When can I expect the results of my
SPECT-CT scan?
The time that it takes your doctor to receive a
written report on the test or procedure you have had
will vary, depending on:
• the urgency with which the result is needed
• the complexity of the examination
• whether more information is needed from
your doctor before the examination can be
interpreted by the radiologist
• whether you have had previous X-rays or
other medical imaging that needs to be
compared with this new test or procedure
(this is commonly the case if you have a
disease or condition that is being followed to
assess your progress)
• how the report is conveyed from the practice
or hospital to your doctor (in other words,
email, fax or mail)
Please feel free to ask the private practice, clinic, or
hospital where you are having your test or
procedure when your doctor is likely to have the
written report.
It is important that you discuss the results with the
doctor who referred you, either in person or on the
telephone, so that they can explain what the results
mean for you.
Please note:
This information is of a general nature only and is
not intended as a substitute for medical advice. It is
designed to support, not replace, the relationship
that exists between a patient and his/her doctor. It
is recommended that any specific questions
regarding your procedure be discussed with your
family doctor or medical specialist
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www.insideradiology.com.au SPECT-CT

Additional Information for Health Care
Professionals
What are the prerequisites for having a
SPECT-CT scan done?
Referral for a SPECT-CT scan is usually done after
consultation between the nuclear medicine specialist
and the referrer. The nuclear medicine specialist
may consider the SPECT-CT to be helpful in
delineating pathology when standard planar gamma
camera imaging is difficult to interpret.
What are the absolute
contraindications for a SPECT-CT
scan?
This study may not be suitable for pregnant women.
The benefit versus risk should be discussed with the
nuclear medicine specialist.
Women who are breastfeeding and people who are
the primary or sole carer for small children may
need to make special preparations after the test to
stop breastfeeding for a short time and to avoid
close contact with young children due to the small
amount of radioactivity released for a while after the
test. Patients should discuss this with their referring
doctor or the nuclear medicine practice where they
will have the test for details. See Nuclear Medicine
for further information about the precautions to take
with nuclear medicine studies for breastfeeding
patients and those in close contact with children.
What are the relative contraindications
for a SPECT-CT scan?
Relative contraindications include patients who
exceed the weight limit for the SPECT or CT scanner
table (this varies depending on the machine but
usually at least 150 kilograms). It is best to check
with the technologist staff at your nuclear medicine
department first. Patients must be capable of
voluntarily staying still.
specialist and the referrer. The nuclear medicine
specialist may consider the SPECT-CT to be helpful
in delineating pathology when standard planar
gamma camera imaging is difficult to interpret.
Further information about SPECT-CT
scan not covered under Section 2
SPECT-CT imaging involves the acquisition of a low
dose, non-contrast, non-diagnostic CT (computed
tomography) scan immediately prior to SPECT
(single photon emission computed tomography)
imaging, which uses a rotating gamma camera. It is
usually performed in nuclear medicine as an adjunct
to standard single plane, gamma camera imaging as
a useful problem solving tool for interpretation of
difficult imaging.
Post-acquisition fusion of the CT component of the
study with SPECT enables more precise anatomical
localisation of radiopharmaceutical uptake. The CT
also enables correction for artefact which results
from some of the emitted ionising radiation
travelling through and being attenuated in the
patient’s body tissues prior to being detected on the
rotating gamma camera.
To enable accurate image fusion, patients must be
able to stay still for the duration of the imaging
(usually 30-40 minutes). Risks from the additional
radiation required from the low dose CT scan are
very minimal, notably the dosage using standard
low dose CT technique is around 20-25% that of a
comparable standard radiology diagnostic CT scan.
The low dose CT is usually accurate enough to
detect gross structural abnormalities such as
degenerative arthropathy of the joints or spine,
large, multi centimetre soft tissue masses, and
viscera. Given the lower radiation dose and absence
of IV contrast it is not diagnostic for more subtle
pathology such as small metastases, non-displaced
fractures or intra-abdominal lymph nodes. Notably,
whilst anatomic localisation is improved with SPECT-
CT fusion, the inherent resolution of the nuclear
medicine component of the imaging is not changed.

What are the adverse effects of a

SPECT-CT scan?
The QUDI Program is managed by the Royal
None
Australian and New Zealand College of Radiologists
and funded by the Australian Commonwealth
Are there alternative imaging tests, Department of Health and Ageing.
interventions or surgical procedures Publication Date: July 15 2009
to a SPECT-CT scan?
Referral for SPECT-CT is usually done after
consultation between the reporting nuclear medicine

The RANZCR is not aware that any person intends to act or rely upon the opinions, advices or information contained in this publication or of the manner in which it might
be possible to do so. It issues no invitation to any person to act or rely upon such opinions, advices or information or any of them and it accepts no responsibility for any
of them.
The RANZCR intends by this statement to exclude liability for any such opinions, advices or information. The content of this publication is not intended as a substitute for
medical advice. It is designed to support, not replace, the relationship that exists between a patient and his/her doctor. Some of the tests and procedures included in this
publication may not be available at all radiology providers.
The RANZCR recommends that any specific questions regarding any procedure be discussed with a person's family doctor or medical specialist. Whilst every effort is
made to ensure the accuracy of the information contained in this publication, The RANZCR, its officers, councillors and employees assume no responsibility for its
content, use, or interpretation. Each person should rely on their own inquires before making decisions that touch their own interests.

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