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Nuclear medicine departments may wish to evaluate the feasibility of undertaking education of the hybrid imaging workforce is crucial to the future utilisation of this
CT examinations during periods where access to radiopharmaceuticals is limited important area of clinical practice.
(eg early morning/late afternoon), or utilising the CT component of the hybrid
unit for out-of-hours work to alleviate some of the demands on the radiology
References
department’s main CT unit. This may require some degree of cross pollination of
1. Schillaci O, Danieli R, Manni C, Simonetti G. (2004) Is SPECT/CT with a hybrid
training requirements
26
and the development of appropriate educational curriculum
camera useful to improve scintigraphic imaging interpretation? Nuclear Medicine
Communications, Volume 25, pp 705-710.
within the workplace and at academic institutions. Educational programmes for
2. Department of Health (1999) Ionising Radiation (Medical Exposure) Regulations
nuclear medicine technologists in North America and Australia provide focused
2000, London, Department of Health.
academic and clinical training specifically related to the utilisation of CT within the
3. Bateman TM, Cullom SJ. (2005) Attenuation correction Single Photon Emission
nuclear medicine environment.
Computed Tomography Myocardial Perfusion Imaging, Seminars in Nuclear Medicine,
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In the USA, working relationships between the Society of Nuclear Medicine 4. Sorenson SA, Phelps ME. (2003) Physics in Nuclear Medicine, 3rd Edition,
Technologists and the American Society for Radiologic Technologists are considered
There is
Philadelphia, Saunders.
to be a good example of a synergistic approach to the training requirements
5. Ficaro EP, Fessler JA, Ackermann RJ. (1995) Simultaneous transmission-emission
between professions. The University of Sydney in Australia also offers a dedicated
a debate
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distribution, Journal of Nuclear Medicine, Volume 36, pp 921.
distance based CT module aimed at nuclear medicine technologists who are
6. Ficaro EP. (2002) Controversies – Should SPET attenuation correction be more widely
involved in using CT within a nuclear medicine environment. In the UK, there
about the employed in routine clinical practice? – For, European Journal of Nuclear Medicine, Vol
is limited scope for the provision of a dedicated hybrid imaging programme. 29, 3, pp 409-411.
However, short courses for technologists related to the safe use of CT, and hybrid
appropriate
7. Prvulovich EM, Lonn AHR, Bomanji JB. (1997) Effect of attenuation correction on
imaging modules of study have emerged from two academic institutes over the
myocardial thallium-201 distribution in patients with a low likelihood of coronary
last couple of years. Currently, it is unclear what CT training requirements are
use of low
artery disease, European Journal of Nuclear Medicine, pp 266-275.
needed officially by a technologist working within the hybrid nuclear medicine
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the efficacy of correction for photon attenuation and scatter in SPECT myocardial
field, especially if the CT unit has a multislice configuration and the imaging
dose CT
perfusion imaging, Circulation, Volume 99, pp 2742-2749.
parameters are interchangeable. A clear educational strategy is required for
9. Duvernoy CS, Ficaro EP, Karabajakian MZ. (2000) Improved detection of left main
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SPECT/CT, Seminars in Nuclear Medicine, Volume 38, pp 177-198.
Conclusion
11. Koral KF, Dewaraja Y. (2000) Initial results for hybrid SPECT – conjugate-view tumor
Following the inception of SPECT-CT hybrid technology, there appears to be an
dosimetry in I-131 anti-B1 antibody therapy of previously untreated patients with
lymphoma, Journal of Nuclear Medicine, Volume 41, pp 1579-1586.
evolution in the useful applications associated with this modality. Initial ‘low-
12. Koral KF, Dewaraja Y. (2003) Update on hybrid conjugate view SPECT tumour
end’ systems introduced over a decade ago provided a platform for improved
dosimetry and response in I-131 tositumomab therapy of previously untreated
anatomical localisation and high photon-flux attenuation co-efficient data, lymphoma patients, Journal of Nuclear Medicine, Volume 44, pp 457-464.
potentially improving the sensitivity and specificity of existing imaging techniques. 13. Van der Ploeg I, Renato A, Valdés Olmos B, Kroon R, Emiel J, Rutgers T, Omgo N,
Beyond the existing techniques, SPECT-CT has the potential for mirroring the
(2009) The hidden sentinel node and SPECT/CT in breast cancer patients, European
success of PET-CT in terms of radiotherapy planning, dosimetry calculations and
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multi-imaging approaches, which include coronary artery calcium scoring and
14. Schillaci O, Filippi L, Manni C, Santoni R, (2007) Single-Photon Emission Computed
Tomography / Computed Tomography in Brain Tumours, Seminars in Nuclear
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Medicine, Volume 37, pp 34-47.
15. Krausz Y, Israel O, (2006) SPECT/CT in Endocrinology, Seminars in Nuclear Medicine,
As detector technology also continues to evolve, the overall design and utilisation
Volume 36, pp 267-274.
of future SPECT/CT units may further develop. The use of solid state materials such
16. Schillaci O, (2006) SPECT/CT in lung cancer and malignant lymphoma, Seminars in
as cadmium-zinc-telluride will provide a single detector interface and, potentially, Nuclear Medicine, Volume 36, pp 275-285.
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