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    ABSTRACT: Background Since its introduction a decade ago, “hybrid” or dual modality imaging combining emission tomography and X-ray computed tomography has become widely accepted and acclaimed as one of the most powerful diagnostic tools in oncology. The key feature of these dual modality systems is the presentation of nuclear imaging information in the well-known anatomical format of a CT scan. Cancer has been a primary target for the application these multimodality devices.The current report focuses on the clinical utility in cancer of one of these systems, SPECT-CT. SPECT-CT systems Commercial dual modality SPECT-CT hardware systems have only been in operation since 1999. The first commercially available dual modality SPECT-CT system was the “Hawkeye”, produced by GE Healthcare, UK. There are currently three systems available: the Hawkeye (GE Healthcare), the “Symbia” (Siemens molecular Imaging) and the “Precedence” (Philips Medical Solutions). In contrast with other methods of image registration, the images are acquired in the same scanning session with a consistent body position and geometry, minimal delay between the two studies and without the need for markers. The basic design of these dual modality systems includes a radionuclide detector, e.g. a PET or SPECT scanner, and an X-ray tube and detector (CT scanner), mounted on a gantry with a patient table suitable for nuclear medicine and x-ray imaging. The images are not acquired simultaneously but are sequentially acquired in the combined device and fused. Market penetration Over the last few years there has been an expansion of SPECT-CT technology worldwide. As of June 2007 there were approximately 600 SPECT-CT installations worldwide, over 200 of these were located across the USA. The majority of these systems were equipped with low definition or low dose CT scanners. Intended use Both PET-CT and SPECT-CT integrated systems are commercially available from several manufactures and are in clinical use for a variety of purposes and indications. These include tumour imaging, cardiac imaging, and neurological and psychiatric diagnoses. Combined imaging systems are reported to have a number of advantages over stand alone imaging systems in oncology including: • early disease diagnosis leading to better prognosis • accurate staging of disease leading to better therapeutic choices • monitoring the effectiveness of treatment potential • surgical procedures under real-time imaging guidance • minimally invasive surgery at the desired spot.
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    ABSTRACT: The purpose of this study was to assess the relationship between (99m)Tc-MIBI and (99m)Tc-MDP bone scintigraphy and clinical or pathological variables, including preoperative serum PTH levels and tumor diameter, in patients with newly diagnosed PHPT.
    Annals of Nuclear Medicine 08/2014; 28(8). DOI:10.1007/s12149-014-0876-z · 1.51 Impact Factor
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    ABSTRACT: Osteosarcoma is the most common primary osseous malignancy excluding malignant neoplasms of marrow origin (myeloma, lymphoma and leukemia) and accounts for approximately 20% of bone cancers. It predominantly affects patients younger than 20 years and mainly occurs in the long bones of the extremities, the most common being the metaphyseal area around the knee. These are classified as primary (central or surface) and secondary osteosarcomas arising in preexisting conditions. The conventional plain radiograph is the best for probable diagnosis as it describes features like sun burst appearance, Codman's triangle, new bone formation in soft tissues along with permeative pattern of destruction of the bone and other characteristics for specific subtypes of osteosarcomas. X-ray chest can detect metastasis in the lungs, but computerized tomography (CT) scan of the thorax is more helpful. Magnetic resonance imaging (MRI) of the lesion delineates its extent into the soft tissues, the medullary canal, the joint, skip lesions and the proximity of the tumor to the neurovascular structures. Tc99 bone scan detects the osseous metastases. Positron Emission Tomography (PET) is used for metastatic workup and/or local recurrence after resection. The role of biochemical markers like alkaline phosphatase and lactate dehydrogenase is pertinent for prognosis and treatment response. The biopsy confirms the diagnosis and reveals the grade of the tumor. Enneking system for staging malignant musculoskeletal tumors and American Joint Committee on Cancer (AJCC) staging systems are most commonly used for extremity sarcomas.
    Indian Journal of Orthopaedics 05/2014; 48(3):238-46. DOI:10.4103/0019-5413.132491 · 0.62 Impact Factor