BM6711

HOSPITAL TRAINING
Single Positron Emission Computed Tomography

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 CONTENTS
• Introduction
• Principle
• Why spect?
• Components
• Procedure
• Advantages
• Risk and complications
• Result
• References
 SPECT
• A single-photon emission computerized tomography
(SPECT) scans and analyzes the function of some of
your internal organs.
• SPECT/ SPET is a nuclear medicine tomographic
imaging technique using gamma rays

• While imaging tests such as X-rays can show what the

structures inside your body look like, a SPECT scan
produces images that show how your organs work. A
SPECT scan can show how blood flows to your heart or
what areas of your brain are more active or less active.

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 Principle
• SPECT imaging is performed by using a gamma camera
to acquire multiple 2-D images from multiple angles.

• A computer is then used to apply a tomographic

reconstruction algorithm to the multiple projections,
yielding a 3-D data set.

• This data set may then be manipulated to show thin

slices along any chosen axis of the body, similar to those
obtained from other tomographic techniques, such as
MRI, X-ray CT, and PET.
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A Siemens brand SPECT scanner, consisting of two gamma
cameras.

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 Why it's done
• The most common uses of SPECT are to help diagnose
or monitor brain disorders, heart problems and bone
disorders.
• Brain disorders such as dementia and clogged blood
vessels can easily be imaged with SPECT
• SPECT scans can also diagnose and track the
progression of cancer that has spread to the bones.
• SPECT can also check for clogged coronary arteries
in which a portion of the heart muscle served by these
arteries can become damaged or even die.

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https://en.wikipedia.org/wiki/Single-photon_emission_computed_tomography

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 Components
Single head gamma camera
• Rotated around the patient during image acquisition
• Long image acquisition times
• No longer commonly used
Multiple head gamma camera
• Dual head, large field of view camera
• Housed on a gantry with slip ring technology that can
rotate the cameras around the H-configuration or an L-
configuration relative to each other.

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https://www.radiologycafe.com/radiology-trainees/frcr-physics-notes/spect-imaging

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Gantry
Needs to have:
• Accurately aligned centre of rotation
• Constant rotational speed
• Detectors aligned parallel to axis of rotation
Collimator
• Important to use high resolution collimator
• Maximise spatial resolution throughout depth of the
patient
• Reduce image distortion during reconstruction

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• Ensure smallest camera-patient distance but maintain
safe distance
• Infra-red beams fitted to collimator face that enable
automatic body contouring to minimise the detector-
patient distance and optimise image quality
• Fitted with pressure sensitive safety devices to prevent
any contact between the collimators and the patient
Patient table
• Low attenuation of gamma photons to allow photons to
pass through and enable 360 degree acquisition

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https://www.slideshare.net/ssuser4b0a90/spect-with-clinical-application

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 Imaging
Matrix
• Determines maximum resolution and image noise
(counts per pixel)
• Modern dual headed system = 128 x 128 matrix
• To reduce image noise (at expense of resolution):
– Increase slice thickness
– Smoother reconstruction filters
– Display slice data in 64 x 64 pixel matrix

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Minimising artefacts
• Minimise patient movement
• Injection site (very high count density) should be kept out
of the field of view
• Arms above heads for chest and abdominal imaging to
remove radiation attenuation and minimise patient-
detector distance

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 Reconstruction
• Reconstructed images typically have resolutions of
64×64 or 128×128 pixels, with the pixel sizes ranging
from 3–6 mm.

• The number of projections acquired is chosen to be

approximately equal to the width of the resulting images.

• In general, the resulting reconstructed images will be of

lower resolution, have increased noise than planar
images, and be susceptible to artifacts.

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• A very intense area of activity (e.g., the bladder) can
cause extensive streaking of the images and obscure
neighboring areas of activity.

• This is a limitation of the filtered back projection

reconstruction algorithm.

• Iterative reconstruction is an algorithm, as it is less

sensitive to artifacts and can so correct for attenuation
and depth dependent blurring.

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 http://www.owlnet.rice.edu/~elec539/Projects97/cult/
node2.html
http://www.people.vcu.edu/~mhcrosthwait/clrs322/Iterativerec
onstructionrev.html

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 Procedure
• SPECT scans involve two steps: receiving a radioactive
injection (called a tracer) and using a SPECT machine to
scan a specific area of your body.
• To acquire SPECT images, the gamma camera is
rotated around the patient. Projections are acquired at
defined points during the rotation, typically every 3–6
degrees.
• In most cases, a full 360-degree rotation is used to
obtain an optimal reconstruction. The time taken to
obtain each projection is also variable, but 15–20
seconds is typical. This gives a total scan time of 15–20
minutes.
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• Multi-headed gamma cameras can provide accelerated
acquisition.
• For example, a dual-headed camera can be used with
heads spaced 180 degrees apart, allowing two
projections to be acquired simultaneously, with each
head requiring 180 degrees of rotation.
• Triple-head cameras with 120-degree spacing are also
used.

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SPECT machine performing a total body bone scan. The patient lies on
a table that slides through the machine, while a pair of gamma
cameras rotate around her.
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 Advantages
• A SPECT scan is similar to an MRI study in that both can
show 3D images and “slices” of the brain. However,
whereas MRI shows the physical anatomy or structure of
the brain, SPECT shows how the brain works.

• MRI does not give any information on function. A newer

version of MRI, functional MRI or “fMRI” is also capable
of showing brain activity and is used extensively in
scientific research on brain function.

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• fMRI shows instantaneous neural activity to see how the
brain responds to a specific stimulus. With SPECT we
see brain activity averaged over a few minutes so it is
better at showing the brain doing everyday activities
such concentrating, meditating, reading, etc.

• For both fMRI and PET, the images actually occur when
a patient lies in the camera, which can be uncomfortable,
noisy, and anxiety provoking. For SPECT, the image
occurs when a patient is in the injection room, making
the procedure more reliable and easier to do.

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 Risks
• For most people, SPECT scans are safe. If you receive
an injection or infusion of radioactive tracer, you may
experience:
• Bleeding, pain or swelling where the needle was inserted
in your arm
• Rarely, an allergic reaction to the radioactive tracer
• SPECT scans aren't safe for women who are pregnant
because the radioactive tracer may be passed to the
developing fetus or the nursing baby.

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 Result

• For instance, a brain SPECT image might show a lighter

color where brain cells are less active and darker colors
where brains cells are more active.
• Some SPECT images show shades of gray, rather than
colors.

https://www.amenclinics.com/the-science/why-spect/
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