Endocrine radionuclide scintigraphy with fusion single photon emission computed tomography/computed tomography

Table 1 Advantages of single photon emission computed tomography/computed tomography for endocrine scintigraphy

Reported benefits of hybrid SPECT/CT imaging	99mTc-sestamibi parathyroid scan	99mTc-pertechnetate or 123I-thyroid scan	131I- or 123I-thyroid cancer scan	111In-DTPA octreotide scan	131I-NP-59 adrenal cortical scan	131I- or 123I-MIBG scan
Precise localization of the radioactivity	+ + + +	+ +	+ + + +	+ + + +	+ + +	+ + + +
Characterization of the radioactivity	+ + + +	+ +	+ + + +	+ + + +	+ + +	+ + + +
Clarification of equivocal radiotracer uptake	+ +	NA	+ + + +	+ + + +	+ +	+ + +
Incremental sensitivity over planar/SPECT	+ +	NA	+	+ +	+	+
Incremental specificity over planar/SPECT	+ + + +	NA	+ + + +	+ + + +	+ + +	+ + +
Additional information on the non-diagnostic CT	+ + +	NA	+ + +	+ + +	+ +	+ + +
Improved interobserver agreement	+ + +	NA	+ +	+ + + +	NA	+ + +
Improved reader confidence	+ + +	NA	+ + + +	+ + + +	NA	+ + +
Attenuation correction	+	NA	+	+ +	NA	+ +
Staging (TNM) of tumor	NA	NA	+ + + +	+ +	NA	+
Surveillance and detection of recurrent tumor	NA	NA	+ + + +	+ + + +	NA	+ +
Preoperative localization of target for resection	+ + + +	NA	+	+	+ + +	+ + +
Confirming of radiotracer avidity as a prerequisite to radionuclide based therapy1	NA	NA	+ + + +	+ + + +	NA	+ + +
Exclusion of radiotracer avidity to recommend alternative imaging2	NA	NA	+ + +	+ + +	NA	+ + +
Correlation to outcomes and prognosis	+ + +	NA	+ + +	+ +	+ + + +	+ +
Radiation dosimetry (tumor- or organ-specific)	NA	NA	+ + +	+ + +	NA	NA
Radionuclide imaging times reduced	NA	NA	+ +	+ + +	NA	NA
Ordering of additional CT/MRI imaging reduced	NA	NA	+ + +	+ + +	+	+
Change in management	+ + + +	NA	+ + + +	+ + + +	+ + + +	+ + + +
Surgical times reduced	+ + + +	NA	NA	NA	NA	NA
Cost-effectiveness	+ +	NA	NA	NA	NA	NA

¹e.g., MIBG avidity prior to ¹³¹I-MIBG therapy of metastatic pheochromocytoma, paraganglioma and neuroblastoma;

²e.g., selection of non-iodine-avid thyroid cancer for ¹⁸F-fluorodeoxyglucose PET imaging. SPECT/CT: Single photon emission computed tomography/computed tomography; MRI: Magnetic resonance imaging; ^99mTc-: ^99mtechnetium; ¹²³I-: ¹²³I-radioiodine; ¹³¹I-: ¹³¹I-radioiodine; ¹¹¹In-DTPA Octreotide: ¹¹¹In-diethylene triamine penta-acetic acid-pentetreotide (Octreoscan^®); ¹³¹I-norcholesterol (NP-59): ¹³¹I-6-beta-iodomethyl-19-norcholesterol; ¹²³I- or ¹³¹I-MIBG: ¹²³I- or ¹³¹I-metaiodobenzylguanidine; NA: Not applicable or not available; TNM: Tumor node metastasis.