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The clinical impact of multidetector SPET technology

Mahmood, Shahid; (1994) The clinical impact of multidetector SPET technology. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Introduction: Single photon emission tomography (SPET) is an established technique in Nuclear Medicine. Recent advances in SPET technology have now permitted the development of multidetector gamma cameras. This thesis evaluates some of these new gamma cameras and their impact on clinical practice. Aim: (a) To assess four new multidetector SPET gamma cameras (IGE Neurocam, Toshiba GCA-9300A, IGE Optima and Sopha DST). (b) To establish appropriate acquisition and analytical clinical protocols. Methodology: For each instrument, the tomographic spatial resolution, contrast and sensitivity were measured. The capability of a new slant hole collimator (IGE Optima) to perform radionuclide ventriculography (RNV) was assessed. To evaluate the utility of these systems, a total of 1215 patient studies were performed (1007 cardiac, 85 skeletal, 73 renal and 50 brain studies). The effect of 8, 16 and 32 minutes data acquisition on image quality and clinical relevance was evaluated. In addition, a new cardiac SPET protocol for rest/stress myocardial perfusion scintigraphy (thallium-201/Tc-99m tetrofosmin) was tested. Results: Tomographic spatial resolution of the order of 10 mm FWHM was achieved by all four systems. System sensitivity was related to the number of detectors and ranged between 9.2–11.2 Kcps/(MBq/ml)/cm per detector. The slant hole collimator with cephalic tilt gave highly reproducible results (r=0.98,SEE=+2) for ejection fraction measurements in 75 patients. There was no significant difference in the clinical information obtained using 8 min, 16 min and 32 min acquisitions. Based on patient studies and experience with these multidetector SPET systems, optimum acquisition and analysis protocols for commonly performed SPET studies were documented for routine clinical use. Artefacts due to patient movement during Tl-201 myocardial SPET studies were less frequent on a dual-detector system compared with a single detector system (0.7% and 4% respectively); while artefacts due to poor positioning or shift in centre of rotation were more. The rest/stress thallium-201/Tc-99m tetrofosmin study protocol (acquisition and analysis) was completed in 90 min. This protocol gave a sensitivity of 80% and specificity of 70% for the detection of coronary artery disease. Conclusion: For the first time a comprehensive comparison of multidetector SPET systems has been documented. Optimum acquisition and analysis protocols have been identified. The study also shows that the new generation of multidetector SPET systems offer adequate resolution and sensitivity for routine clinical imaging. Increased sensitivity can be translated into an increased patient throughput. This can increase the cost-effectiveness of this new technology.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: The clinical impact of multidetector SPET technology
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
Keywords: Health and environmental sciences; SPET
URI: https://discovery.ucl.ac.uk/id/eprint/10102623
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