Diagnostic impact of SPECT-CT in the assessment of endocrine tumors

Image fusion using single photon emission computed tomography - computed tomography (SPECT - CT) associates functional and morphological images. This study evaluates the added value of SPECT- CT, obtained with a hybrid SPECT- CT gamma camera, on anatomic localization and diagnostic impact in assessment of endocrine tumours and pheochromocytomas. Method: Six months prospective study was undertaken including 33 consecutive exams encompassing 20 Somatostatin Receptor Scintigraphies (S.R.S.) and 13 123I-meta-iodo-benzyl-guanidine (Mibg) scans. Two experienced nuclear medicine physicians independently analysed independently planar and SPECT images in a first time, then, SPECT- CT fused images in a second time. They evaluated two parameters: SPECT- CT impact on anatomic localization (L.A.) and its diagnostic impact (I.D.). Each parameter was scored according three levels of evaluation. Results: An added value of SPECT- CT images was evidenced in 55% of cases on the anatomic localization and in 41% of the patients on the diagnostic impact. Therefore, a more important benefit was noted when SPECT was positive (L.A.: 90%; I.D.: 70%) than when it was negative (L.A.: 15%; I.D.: 8%). Furthermore, the added value proved higher for the S;R.S. compared to Mibg scans. Conclusion: SPECT- CT fusion images obtained by a hybrid system is more relevant to determine anatomic localization and more accurate than SPECT alone, particularly in the assessment of endocrine tumours. The added value of SPECT- CT seems to be lower for Mibg scans in the assessment of pheochromocytomas. (authors)