Letter from the Editors

Article Outline

• Copyright

This issue of Seminars in Nuclear Medicine continues the discussion of the various clinical areas where relatively new single-photon emission computed tomography/computed tomography (SPECT/CT) technology is beginning to have a clinical impact. Perhaps the area of greatest interest for utilization of this modality is cardiology. The introduction of 64-slice CT has provided the speed and resolution to compete diagnostically with cardiac catheterization. Coronary artery visualization with this new modality can be quite spectacular. Some cardiologists have predicted that 64-slice CT coronary angiography may replace radionuclide myocardial perfusion imaging as the primary screening procedure for coronary artery disease. This is obviously short sighted in that a functional assessment of blood flow remains a key determinant in assessing therapeutic options. In their superb introductory article, Dan Berman and his associates at Cedars-Sinai place these two powerful tools in perspective. In most instances, particularly surveillance, a combination of calcium score obtained from a simple noncontrast CT exam and a radionuclide myocardial perfusion study will provide the appropriate screening information to guide subsequent management decisions.

The CT portion of these hybrid instruments requires a choice. The simplest would have nondiagnostic, low-energy capability that provides attenuation correction and co-registration for the fusion image. The other end of the spectrum offers fully diagnostic CT capability with the potential of up to 64 slices. Decisions regarding these choices should be made after assessing the need at a specific site with a specific patient population.

Other areas discussed in this issue include the brain, abdomen, breast sentinel node imaging, and prostate immunoscintigraphy. It is clear that single-photon imaging is here to stay and the addition of SPECT/CT will provide a powerful complement to the exciting advances already made by positron emission tomography (PET)/CT.