E. Gordon Depuey MD, Presenter: Consultant, BioClinica, Inc Consultant, ICON plc Steering Committee, Adenosine Therapeutics, LLC

1) Understand software methods to cope with lower SPECT counting statistics in order to reduce scan acquisition time and/or radiopharmaceutical injected activity and their clinical impact. 2) Understand instrumentation advances that allow new cameras to perform SPECT with markedly reduced acquisition times and/or less radiopharmaceutical activity and their clinical impact. 3) Implement protocols that facilitate patient-centered imaging and that reduce patient radiation exposure. 4) Recognize new software methods to select appropriate patients for cardiac resynchronization therapy (CRT).

 New software methods and new innovative hardware now allow for significantly shortened SPECT acquisition times without a decrease in image quality. Advancements include iterative reconstruction, resolution recovery, and noise reduction software, and focused collimation and solid state detectors incorporated into new camera designs. Attenuation correction increases diagnostic specificity and facilitates stress-only protocols. Software advancements such such as high resolution imaging, scatter correction, and respiratory gating increase diagnostic sensitivity.     There has been an intersocietal effort to promote patient-centered imaging with a focus on appropriateness guidelines, cost-containment, radiation dose reduction, and the selection of the most appropriate imaging test and protocol to suit particular patient needs. The technical advancements described above facilitate implementation of patient-centered imaging. Even with such technical advancements, however, attention to technical detail is essential to assure optimal image quality. Camera and radiopharmaceutical quality control deserve the highest priority. A systematic review of myocardial perfusion SPECT images is essential to recognize artifacts and optimize diagnostic accuracy. Case examples will be presented to reinforce this approach.  

Depuey, E, Advances in Cardiac SPECT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/11001973.html