Journal Reading

Hybird SPECT/CT
Imaging in the
Evaluation of Coronary
Stenosis : Role in
Diabetic Patients
Rahmandra 1102010228

Kepanitraan Klinik Bagian Radiologi

Fakultas Kedokteran Universitas YARSI
Rumah Sakit Bhayangkata Tk.I Raden
Said Sukanto

Introduction
1.

CT-SCAN
Computer Tomography (CT) biasa
juga disebut Computed axial
tomography (CAT), computerassisted tomography, atau (body
section roentgenography) yang
merupakan suatu proses yang
menggunakan digital processing
untuk menghasilkan suatu
gambaran internal tiga dimensi
suatu obyek dari satu rangkaian
sinar x yang menghasilkan
gambar dua dimensi

APLIKASI CT
SCAN

CT Scanner memiliki kemampuan yang unik

untuk memperhatikan suatu kombinasi dari
jaringan, pembuluh darah dan tulang secara
bersamaan. CT Scanner dapat digunakan untuk
mendiagnose permasalahan berbeda seperti :
Adanya gumpalan darah di dalam paru-paru
(pulmonary emboli)
Pendarahan di dalam otak (cerebral vascular
accident)
Batu ginjal
Inflamed appendix
Kanker otak, hati, pankreas, tulang, dll.
Tulang yang retak

SPECT SCAN
What is SPECT?
SPECT is short for single
photon emission computed tomography.
As its name suggests (single photon
emission) gamma rays are the sources of
the information rather than X-ray
emission in the conventional CT scan.
Why SPECT?
Similar to X-ray, CT, MRI, etc
SPECT allows us to visualize functional
information about patients specific
organ or body system.

THEORY AND
INSTRUMENTATION
SPECT is a technology used in
nuclear medicine where the patient is
injected with a radiopharmaceutical
which will emit gamma rays.
We seek the position and
concentration of radionuclide
distribution by the rotation of a
photon detector array around the
body which acquires data from
multiple angles.

ADVANTAGES

Localization of defects
is more precise and
more clearly seen by
the inexperienced eye.

SPECT
APPLICATIONS
Heart imaging
Brain Imaging

Extend and size of

defects is better
defined.

SPECT imaging

Images free of
background.

Bone Scans

Tumor detection

Anatomi
Jantung

Arteri Koronaria
Arteri koronaria adalah cabang
pertama dari sirkulasi
sitemik.Muara arterikoronaria
ini terdapat di dalam sinus
valsava dalam aorta, tepat di
ataskatup aorta.Sirkulasi
koroner memiliki dua cabang
besar, arteri koronerkanan dan
arteri koroner kiri. Arteri
koroner kiri mempunyai dua
cabangbesar, arteri desendens
anterior kiri (LAD), dan arteria

Gambaran Normal CT
Arteri Koronaria

Method and Material

1. Population

3. SPECT Scan

Result

Discussion

However, the perfusion images obtained with

SPECT show a good sensitivity and a low
specificity in the detection of patients with
CAD.
Furthermore SPECT reported some false
positives when a patient cannot reach 85%
of the theoretical maximum heart rate during
the exercise testing; this event occurs in
obese patients, in older patients, in patients
with arterial disease of the lower limbs, and
in subjects treated with beta-blockers.

Discussion
In our experience, hybrid SPECT/CT images
provide help in the evaluation and grading of
calcied stenoses in CT and overcome the
problem of the abnormal uptake of the
radiopharmaceutical by the breast tissue in
SPECT.
Therefore, the usefulness of the fusion between
CT and SPECT images is to overcome the limits
of CT and the limits of SPECT with a high
diagnostic accuracy, especially in patients with
high cardiovascular risk and high presence of
physical limitations, like the diabetic patients.

Terima Kasih