ACR 2017 The Crossroads of Radiology

ACR2017VM55 - SPECT, SPECT-CT and PET-MR: Game Changers for Your Nuclear Medicine Practice

May 24, 2017 1:30pm ‐ May 24, 2017 3:00pm


Description

The purpose of this session is to discuss the current status of bone and lung scintigraphy. Bone scintigraphy has been a mainstay of MSK imaging for over four decades. While predominately used for evaluating bone metastases, there is also great utility in the assessment of MSK injuries. The recent introduction of hybrid imaging has further enhanced the diagnostic value of bone scintigraphy. Therefore, the diagnostic role of SPECT and SPECT-CT in the many athletic related injuries will be reviewed to include concordant correlation with MRI. PET/MRI is the newest hybrid modality combining the most advanced functional and anatomic imaging technologies. However, PET/MRI scanners are expensive and the process of ordering, protocoling, scanning, and interpretation is complicated. Nonetheless, the capability of simultaneously acquiring PET and MR information can provide important unique clinical information. Challenges and approaches to providing a clinical PET/MRI service will be presented, as well as potential target clinical applications that will most benefit from this new technology. Lung scintigraphy and probabilistic reporting have traditionally been used in the evaluation of pulmonary embolism (PE), this practice however, changed with the introduction of CT pulmonary angiography (CTPA). CTPA is now the procedure of choice in pulmonary embolism evaluation. To address this shift, lung scintigraphy evolved to include improved scan techniques, tomographic acquisition and a definitive reporting style (PE or no PE). This improved technology, however, created the concerns of overdiagnosis and overtreatment of the small PE. Developed in conjunction with Society of Nuclear Medicine and Molecular Imaging.

Learning Objectives:

  1. Discuss the pros and cons of planar, SPECT and SPECT-CT bone scintigraphy in musculoskeletal (MSK) injuries and infection, and describe the value of scintigraphic and hybrid imaging that best identifies MSK disease, particularly in the athlete.
  2. Identify the challenges for bringing PET/MRI into routine clinical practice and describe clinical applications where PET/MRI is preferable to PET/CT.
  3. Explain the transition from probabilistic to definitive pulmonary embolism (PE) reporting for V/Q scans.
  4. Discuss the pros and cons of V/Q planar versus tomographic and hybrid imaging and understand the concerns of overdiagnosis and overtreatment of the small PE.

Speaker(s):

Disclosures

  • Darlene Metter, MD, FACR - This speaker has nothing to disclose

  • Bennett Greenspan, MD, MS, FACR, FACNM - This speaker has nothing to disclose

  • Kevin Banks, MD - This speaker has nothing to disclose

  • Terence Wong, MD, PhD - This speaker has nothing to disclose

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