David Wolinsky, M.D., director of nuclear cardiology at Cleveland Clinic Florida and past-president of the American Society of Nuclear Cardiology (ASNC), discusses advancements in nuclear imaging and some of the issues facing the subspecialty.

At SNMMI, Siemens introduced innovative new technologies for both PET and SPECT.  The vendor introduced what it calls xSPECT on its 510(k)-pending Symbia Intevo SPECT/CT. In traditional SPECT/CT imaging, the SPECT image has always been reconstructed at a low-resolution matrix — much lower than the CT portion of the exam. As a result, the CT resolution must be downgraded dramatically to the level of SPECT to enable mechanical fusion of the two modalities. xSPECT combines the images into a new, completely integrated single dataset for vastly  higher resolution and quantitative images. 

Aimed at the oncology market to start, an example displayed at SNMMI showed a traditional SPECT/CT spinal image with hot spots, but the low resolution makes it unclear if the areas of enhancement are tumors or inflamation. The combined xSPECT image greatly enhanced resolution to show the hot spots were actually inflammation caused by clearly defined spinal compression fractures.  The clear, fused image also eliminates the alignment artifacts common with hybrid imaging, where the SPECT and CT images do not exactly match anatomical boundaries. The vendor says centers using the system in trials are reading the xSPECT image rather than going back and forth between the usual collage of three images showing the SPECT, CT and combined overlay image.

SPECT has traditionally been dubbed “unclear” instead of “nuclear” imaging due to its low image quality, said Mike Rittman, senior manager, product marketing, Siemens molecular imaging. He explained xSPECT offers a way to greatly clarify the image with CT-like quality. Instead of an increamental technology advance, Rittman said this is a major step forward for SPECT, involving 10 years of development and 32 pounds worth of paperwork submitted to the U.S. Food and Drug Adminitsration (FDA) for the approval process.