From the June 2012 issue of HealthCare Business News magazine


“There will always be those types of exams where I need to do traditional nuclear medicine imaging,” he says. “Let’s say I want to look at how well my liver or kidneys are functioning; I do not necessarily want to look at slices in an instance, but rather function across time.”

Even so, if an end user needs to replace SPECT equipment, Misra advises to go straight to SPECT/CT.


“There isn’t much value in replacing a 10-year-old gamma camera with new SPECT equipment,” Misra says. “You want to make a paradigm shift to SPECT/CT if you’re going to replace the gamma camera anyway. In order to get the most out of your existing gamma camera, invest in new informatics, like software and applications.”

DeGraaff predicts the full-fledged adoption of SPECT/CT is another three to five years away.

“Eventually, you will see SPECT cameras fade away, with only SPECT/CT cameras remaining,” he says.

PET peeve
Procedure migration has placed SPECT on thin ice – especially cardiac procedures and bone scans shifting from SPECT to PET, which together comprise almost 80 percent of procedures, says Misra.

“PET cardiac is clinically better than SPECT in many ways,” he explains. “It is lower dose, better image quality and a much faster workflow: 45 minutes, as opposed to six hour protocols.”

Although physicians have a glowing appreciation for PET, an end user’s final decision often comes down to the total cost of investment. The equipment and pharmaceuticals for PET cost a lot more than for SPECT. Most radiopharmaceuticals used in SPECT come from reactor-created products, whereas most of the radiopharmaceuticals used in PET come from cyclotrons.

“The distribution for PET and SPECT radiopharmaceuticals is different and based upon economics,” says Don Bogutski, president of Diagnostix Plus Inc., a supplier of new and refurbished nuclear medicine equipment and services. “Distribution of technetium-99m with a half-life of seven hours can cover a much larger area than distribution of fluorodeoxyglucose with a half-life of 109 minutes. Therefore, the customer base is far larger with technetium and the individual doses can be distributed at a much lower cost while maintaining a reasonable profit margin.”


While the migration of SPECT procedures to PET is inevitable, according to Misra, he adds that there will always be a need for SPECT/CT imaging, and good SPECT imaging in general.

“The trick – especially for cardiac and bone imaging — is working out the best strategy to balance between SPECT and PET imaging to manage your hospital’s workflow,” he says.

June 2012 Magazine

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