Hybrid nuclear imaging takes the guesswork out of diagnostics

Monday, 9 November 2015 by Kelsey Fletcher


Hybrid SPECT-CT imaging has put radiology providers in a position to make more accurate diagnoses for certain patients.

Scintigraphy (nuclear imaging) uses very small amounts of radioactivity in order to provide functional information at a molecular level. Hybrid SPECT-CT imaging adds to the sensitivity of traditional nuclear imaging techniques and provides much greater specificity and accuracy.

By fusing a 3D SPECT scan and CT, staff are able to view images across multiple planes.

Dr Hament Pandya self-funded Accuron Radiology in Auckland in 2013 in order to facilitate the provision of high quality nuclear imaging in New Zealand.

“With nuclear imaging, we’re fundamentally taking the energy source and putting it inside the patient,” he says. “Rather than giving you an ‘outside-in’ picture, it’s giving you an ‘inside-out’ picture.”

SPECT-CT scanning involves tagging a wide variety of biochemical markers with radioactive isotopes to demonstrate numerous physiological processes, such as increased bone turnover (bone scan) or gallbladder contractility (‘HIDA’ scan).

During the scanning process, crystals within the gamma camera part of the scanner glow, or ‘scintillate’ when the tagged markers emit energy.

“SPECT CT represents a significant leap forward in the sensitivity and accuracy of finding abnormal molecular function,” Dr Pandya says. “The value that modern hybrid imaging can add to current diagnostic imaging is now substantial.”

Affiliated Provider programme

Dr Pandya says Southern Cross has been great to work with while he raises awareness of what nuclear imaging can do for clinicians and patients in New Zealand.

“Southern Cross were brilliant. They were the first group that allowed funding to enable the public to get access to the service,” he says. “The Affiliated Provider programme is extremely useful and helpful in facilitating prompt access and prompt payment.”

“The biggest barrier to a clinician accessing new technology is often funding, but with Southern Cross the barrier was gone. So, effectively, the main barrier to utility of the service became a barrier of knowledge and awareness.”

Nuclear imaging is reimbursed under all Southern Cross policies.

Nuclear Medicine Referrals

Dr Pandya says clinicians should be considering whether functional imaging might paint a clearer picture of their patient’s healthcare problem, in situations where traditional imaging have not elucidated a clear diagnosis.

“Nuclear imaging often provides further information which can guide the clinician in choosing the optimal approach, such as minimally invasive treatment or surgical intervention,” he says.

For example, a clinician may be faced with a patient with a persistent sore back and who MRI (or CT) scanning has failed to delineate a specific likely cause.

“In this situation, SPECT-CT will often demonstrate abnormal bone uptake in a particular area of the spine,” explains Dr Pandya.

“Or the patient might have right upper quadrant abdominal pain and a normal ultrasound. A HIDA scan can demonstrate whether the gallbladder is contracting properly or not (chronic cholecystitis).”