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Is there still a role for SPECT–CT in oncology in the PET–CT era?


For the evaluation of biological processes using radioisotopes, there are two competing technologies: single-photon emission computed tomography (SPECT) and positron emission tomography (PET). Both are tomographic techniques that enable 3D localization and can be combined with CT for hybrid imaging. PET–CT has clear technical superiority including superior resolution, speed and quantitative capability. SPECT–CT currently has greater accessibility, lower cost and availability of a wider range of approved radiotracers. However, the past decade has seen dramatic growth in PET–CT with decreasing costs and development of an increasing array of PET tracers that can substitute existing SPECT applications. PET–CT is also changing the paradigm of imaging from lesion measurement to lesion characterization and target quantification, supporting a new era of personalized cancer therapy. The efficiency and cost savings associated with improved diagnosis and clinical decision-making provided by PET–CT make a cogent argument for it becoming the dominant molecular technique in oncology.

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Figure 1: The physics principles of SPECT and PET.
Figure 2: Brain imaging with 201Tl, FDG and FET.
Figure 3: Bone imaging with 18F-fluoride and 99mTc-MDP.


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Both authors researched the data for the article, discussed its content, wrote the manuscript and edited it before submission.

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Correspondence to Rodney J. Hicks.

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Hicks, R., Hofman, M. Is there still a role for SPECT–CT in oncology in the PET–CT era?. Nat Rev Clin Oncol 9, 712–720 (2012).

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