NM – SPECT & PET

NM – Nuclear Medicine
• Nuclear medicine - medical specialty that uses radioactive tracers
(radiopharmaceuticals) to assess bodily functions and to diagnose and
treat disease.

• Radioactive tracers are made up of carrier molecules that are bonded

tightly to a radioactive atom. These carrier molecules vary greatly
depending on the purpose of the scan. Some tracers employ molecules
that interact with a specific protein or sugar in the body and can even
employ the patient’s own cells.
• The most commonly used radiotracer is F-18 fluorodeoxyglucose, or FDG, a
molecule similar to glucose. Cancer cells may absorb glucose at a higher
rate, being more metabolically active.
Effective dose of NM procedures
Process
• Administer radiopharmaceutical (a radionuclide labeled to a
pharmaceutical)
• The radiopharmaceutical concentrates in the desired locations
• Nucleus of the radionuclide decays to emit photons (g , x-ray)
• Detect the photons using a “gamma camera”
Single Photon Emission Computed
Tomography (SPECT)
• SPECT imaging - provide three-dimensional (tomographic) images of the
distribution of radioactive tracer molecules that have been introduced into
the patient’s body.
• The 3D images are computer generated from a large number of projection
images of the body recorded at different angles.
• SPECT imagers have gamma camera detectors that can detect the gamma
ray emissions from the tracers that have been injected into the patient.
• Gamma rays are a form of light that moves at a different wavelength than
visible light.
• The cameras are mounted on a rotating gantry that allows the detectors to
be moved in a tight circle around a patient who is lying motionless on a
pallet.
Positron Emission Tomography (PET)
• PET scans also use radiopharmaceuticals to create three-dimensional
images.
• While SPECT scans measure gamma rays, the decay of the radiotracers
used with PET scans produce small particles called positrons.
• A positron is a particle with roughly the same mass as an electron but
oppositely charged. These react with electrons in the body and when these
two particles combine they annihilate each other. This annihilation
produces a small amount of energy in the form of two photons that shoot
off in opposite directions. The detectors in the PET scanner measure
these photons and use this information to create images of internal organs.
• https://www.youtube.com/watch?v=GHLBcCv4rqk
 SPECT vs PET

SPECT PET
(Step-and-shoot acquisition) (Simultaneous acquisition)
2015 Nuclear Medicine Physics for Radiology Residents Sameer Tipnis, PhD, DABR
 SPECT & PET
• SPECT – 2 views from opposite sides
• Res. ~ collimator res., which degrades rapidly with increasing
distance from collimator face
• PET – Simultaneous acquisition
• Res. ~ detector width; is max in center of ring
• SPECT sensitivity ~ 0.02%
• Huge losses due to absorptive collimators
• PET sensitivity- 2D ~ 0.2%; 3D ~ 2% or higher
• High sensitivity due to ACD (electronic collimation)
• Allows higher frequency filters / higher spatial resolution

2015 Nuclear Medicine Physics for Radiology Residents Sameer Tipnis, PhD, DABR
PET/CT
• In many centers, nuclear medicine images can be superimposed with
computed tomography (CT) or magnetic resonance imaging (MRI) to
produce special views, a practice known as image fusion or co-registration.
• These views allow the information from two different exams to be
correlated and interpreted on one image, leading to more precise
information and accurate diagnoses. In addition, manufacturers are now
making single photon emission computed tomography/computed
tomography (SPECT/CT) and positron emission tomography/computed
tomography (PET/CT) units that are able to perform both imaging exams at
the same time.
• An emerging imaging technology, but not readily available at this time is
PET/MRI.
• https://www.radiologyinfo.org/en/info.cfm?pg=gennuclear

• https://www.nibib.nih.gov/science-education/science-topics/nuclear-
medicine