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Der Nuklearmediziner 2016; 39(01): 8-21
DOI: 10.1055/s-0042-100693
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© Georg Thieme Verlag KG Stuttgart · New York

Wertigkeit der SPECT/CT in der skelettszintigrafischen Diagnostik

Bone imaging with SPECT/CT
M. Beck
1   Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Erlangen
,
T. Kuwert
1   Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Erlangen
› Author Affiliations
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Publication History

Publication Date:
22 March 2016 (online)

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Zusammenfassung

Seit Einführung in die klinische Routine in den 70er Jahren stellt die Skelettszintigrafie eines der häufigsten nuklearmediznischen Untersuchungsverfahren dar. Ihre Sensitivität bei der Detektion skelettaler Läsionen ist sehr hoch, Spezifität als auch räumliche Auflösung sind hingegen limitiert. Dies gilt auch, wenn die Skelettszintigrafie durch eine Einzelphotonenemissionscomputertomografie (SPECT) ergänzt wird. Hybridkameras, welche die Akquisition eines SPECT und einer Röntgencomputertomografie (CT) in einem Untersuchungsgang erlauben, stehen seit ca. 10 Jahren kommerziell zur Verfügung. Die SPECT/CT verbessert die Genauigkeit der Knochenszintigrafie beim Staging von Tumorerkrankungen erheblich. Auch bei der Diagnostik gutartiger Veränderungen des Skeletts ergeben sich gegenüber der konventionellen nuklearmedizinischen Bildgebung deutliche Vorteile der Hybriddiagnostik. Die Möglichkeit der Quantifizierung des regionalen Traceruptakes in absoluten Einheiten und sog. multimodale Rekonstruktionstechniken stellen jüngste methodische Fortschritte dar.

Abstract

Skeletal scintigraphy is one of the most frequent in-vivo procedures in the field of nuclear medicine. By visualizing bone metabolism, it exhibits a very high sensitivity for detecting skeletal lesions, but has limitations with regard to specificity and spatial resolution, even when single-photon emission computed tomography (SPECT) is used. Combining SPECT with X-ray computed tomography (CT) helps overcome these limitations. This has, in particular, been shown when diagnosing bone involvement in malignant tumors. Emerging evidence indicates the benefit of hybrid imaging for bone scintigraphy during the workup of painful conditions affecting the back and the extremities. Methodological advances holding considerable promise for further improving its value are the quantitation of skeletal tracer uptake in absolute units, as well as multimodal image reconstruction techniques that have recently become available for use in the clinical routine.

Schlüsselwörter

SPECT/CT - Knochenszintigrafie - Skelett

Key words

SPECT/CT - bone scintigraphy - skeleton
 

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