The AAPM/RSNA physics tutorial for residents - Physics of SPECT

Single-photon emission computed tomography (SPECT) provides three-dimensional (3D) image information about the distribution of a radiopharmaceutical injected into the patient for diagnostic purposes. By combining conventional scintigraphic and computed tomographic methods, SPECT images present 3D functional information about the patient in more detail and higher contrast than found in planar scintigrams. A typical SPECT system consists of one or more scintillation cameras that acquire multiple two-dimensional planar projection images around the patient. The projection data are reconstructed into 3D images. The collimator of the scintillation camera has substantial effects on the spatial resolution and detection efficiency of the SPECT system. Physical factors such as photon attenuation and scatter affect the quantitative accuracy and quality of SPECT images, and various methods have been developed to compensate for these image-degrading effects. In myocardial SPECT, an important application of SPECT, recent use of attenuation compensation methods has provided images with reduced artifacts and distortions caused by the nonuniform attenuation in the chest region and by the diaphragmatic and breast attenuation. Attenuation-compensated myocardial SPECT images have the potential to improve clinical diagnosis by reducing the false-positive and false-negative detection of myocardial defects. In the future, further improvement in SPECT images will be realized from the continuous development of new radiopharmaceuticals for new clinical applications, instrumentation with high spatial resolution and detection efficiency, and image reconstruction algorithms and compensation methods that reduce the image-degrading effects of the collimator-detector, attenuation, and scatter.