Half-body single photon emission computed tomography with resolution recovery for the evaluation of metastatic bone disease: implementation into routine clinical service

OBJECTIVESTypically, scintigraphic evaluation of metastatic bone disease uses planar imaging. Although single photon emission computed tomography (SPECT) offers increased clinical utility, the acquisition time necessary to cover the required scan range (at our centre, skull vertex to mid-femur) has made its use in place of planar imaging impracticable. Recently, reconstruction with resolution recovery (RR) has allowed SPECT acquisition times to be shortened while maintaining acceptable image quality. This study was carried out to establish whether half-body SPECT with RR could replace planar scintigraphy in routine practice. METHODSA series of reduced acquisition time SPECT scans were reconstructed retrospectively and reviewed to establish optimal reconstruction parameters. Twenty patients referred for evaluation of bone metastases underwent planar imaging, followed by half-body SPECT, reconstructed using the optimized parameters. SPECT and planar images were reported by an experienced radiologist, who reviewed image quality and recorded the number of lesions observed, their location, clinical significance and reporter confidence. RESULTSSPECT images of acceptable quality and covering the range from skull vertex to mid-femur were acquired in 33 min. Audit indicated that SPECT identified clinically significant lesions not reported from planar views and improved lesion localization and reporter confidence. CONCLUSIONReduced acquisition times together with RR allowed half-body SPECT for the evaluation of bone metastases to be accommodated within our department’s schedule. Audit indicated that SPECT delivered the expected clinical advantages. Half-body SPECT has replaced planar imaging for the routine evaluation of metastatic bone disease at our centre, with ∼2500 studies carried out to date.