Endocrinología, Terapia y Miscelánea
Article N°AJ31-21

Clinical usefulness of SPECT/CT fusion with external markers in oncology pathology.

Background: Fusion imaging between functional and morphological studies such as Single Photon Emission Computed Tomography (SPECT) and Computed Tomography (CT) is a new format which shows complementary data. Abnormal uptake foci in functional studies may require morphological correlation for its interpretation. Wide clinical applications have been described using hybrid equipment, but they lack of availability. Aim: To demonstrate that SPECT/CT fusion images, acquired separately with external markers, are useful in clinical practice clarifying pathological meaning of abnormal and hard to localize areas. Patients and Methods:  Thirty-four patients (21 female), who presented abnormal foci on scintigraphy were selected. SPECT and CT acquisition in different equipment were done, the same day, fused using 3D software and manually corrected based on external markers. Interpretation was performed by independent specialists. Planar and fused scans were classified in 2 groups: probably malignant (PM) and probably benign (PB.Comparison using Fisher Test. Results: Forty-nine foci were analyzed in 28 patients. Mean age was 39,5 ±16,3 year-old (range 5 - 68). Most of referral diagnoses were oncological (93%), with 23/34 corresponding to Differentiated Thyroid Carcinoma. Initial conclusion was PM in 88% and PB in 12%. Post-fusion they changed to 68% and 32% respectively, reaching significant statistic difference (p=0,028), which had direct influence in the management of 12 patients. Conclusions: SPECT/CT fusion with external markers through a standard methodology of acquisition and processing, is useful mainly in Iodine I¹³¹ studies. In the absence of hybrid equipment external-marker fusion technique is feasible and easy to set up in conjunction with radiologists.

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