Uporaba SPECT in PET v nuklearnomedicinski kardiologiji - pregled literature : diplomsko delo

Knez, Sabina (author), Sember, Tara (author), Rep, Sebastijan (mentor), Ležaič, Luka (comentor), Matjašič, Alenka (reviewer)

Uvod: Nuklearna medicina je slikovna diagnostika, ki uporablja radiofarmake za prikaz telesnih funkcij za potrebe slikovne diagnostike in zdravljenja. Uporabljamo posebne kamere (SPECT in PET), ki prikažejo razporeditev in kopičenje radiofarmaka po telesu. Perfuzija miokarda je slikovni postopek v nuklearni medicini, ki simbolizira delovanje srčne mišice. V nuklearnomedicinski kardiologiji pri SPECT preiskavah se uporablja s tehnecijem-99m označen sestaMIBI ([99mTc]Tc-sestaMIBI). Pri PET preiskavah prevladuje uporaba radiofarmaka rubidij-82 (82Rb), medtem ko je v tujini v porastu uporaba s fluorom-18 (18F) označenih radiofarmakov. Namen: Namen diplomske naloge je s pregledom literature predstaviti uporabo SPECT-a in PET-a v nuklearno medicinski kardiologiji ter med seboj primerjati različne radiofarmake. Metode dela: Za diplomsko delo smo uporabili deskriptivno metodo s sistematičnim pregledom literature. Strokovne in znanstvene članke smo iskali na različnih podatkovnih bazah. Osredotočili smo se predvsem na angleške in slovenske vire. Rezultati: Postopek pridobitve virov je prikazan s shematskim prikazom po metodi PRISMA. Članki, ki ustrezajo kriterijem so predstavljeni v tabeli. Analiza člankov je pokazala, da ima PET več boljših lastnosti kot SPECT. Med primerjanjem člankov o radiofarmakih, so se najbolje izkazali 18F označeni radiofarmaki. Razprava in zaključek: Ugotovili smo, da je za prikaz perfuzije miokarda boljši PET v primerjavi s SPECT. PET je superioren zaradi natančnejše korekcije atenuacije, boljše resolucije, nižje dozne obremenitve in krajšega trajanja preiskave. Kljub temu ima tudi SPECT določene prednosti zaradi katerih je še vedno pogosteje v uporabi. PET radiofarmak 82Rb se je tudi izkazal za boljšega v primerjavi s [99mTc]Tc-sestaMIBI SPECT radiofarmakom kar se tiče dozne obremenitve za pacienta in osebje zaradi svoje kratke razpolovne dobe ter hitrejše izvedbe preiskave. Čeprav se 82Rb najpogosteje uporablja v nuklearnomedicinskih kardioloških preiskavah ni najbolj idealen PET radiofarmak. Potrebno se je tudi zavedati, da imajo pozitroni, ki nastanejo pri razpadu višjo energijo, kar pomeni daljši domet in posledično slabšo resolucijo. Le-teh pomanjkljivosti pa 18F nima. Zaradi njegovih dobrih lastnosti se je tako izkazal za superiornega ob [99mTc]Tc-sestaMIBI in 82Rb radiofarmakov. Kratek domet pozitrona in posledično dobre resolucije, nam s tem tako omogočata večjo diagnostično natančnost. Prav tako ima boljšo vezavo na celice miokarda od predhodno omenjenih radiofarmakov, kar rezultira v večji senzitivnosti in specifičnosti.

• Language: Slovenian
• Keywords: diplomska dela radiološka tehnologija SPECT, PET, nuklearna medicina, kardiologija, perfuzija miokarda, fluor-18, [$^{99m}Tc$]Tc-sestaMIBI, rubidij-82
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [S. Knez : T. Sember]
• Year: 2025
• Number of pages: 24 str.
• PID: 20.500.12556/RUL-172949
• UDC: 616-07
• COBISS.SI-ID: 248699907
• Publication date in RUL: 12.09.2025

Secondary language

• Language: English
• Title: The use of SPECT and PET in nuclear cardiology - overview of literature : diploma work

Abstract

Introduction: Nuclear medicine is a diagnostic imaging that uses radiopharmaceuticals to visualize bodily functions for diagnostic imaging and treatment purposes. Special cameras (SPECT and PET) are used to show the distribution and accumulation of radiopharmaceuticals in the body. Myocardial perfusion is an imaging procedure in nuclear medicine that symbolizes the functioning of the heart muscle. In nuclear cardiology, the radioisotope [99mTc]Tc-sestaMIBI is used in SPECT scans. In PET scans, the use of rubidium-82 (82Rb) is dominant, meanwhile the use of flurpiridaz-18 (18F) is growing abroad. Purpose: The purpose of this diploma work is to present the use of SPECT and PET in nuclear cardiology with the systematic review of literature and compare different radiopharmaceuticals. Methods: For this diploma work we used the descriptive method with the systematic review of literature. We searched for scientific articles on different databases. We focused mainly on english and slovenian resources. Results: The procedure of acquiring resources is presented schematically with PRISMA method. Articles that fit the criteria are presented in the table. Article analyse showed that PET has more good properties compared to SPECT. When comparing the articles regarding radiopharmaceuticals, 18F presented itself as the most ideal. Discussion and conclusion: We have determined that PET is superior to SPECT for visualizing myocardial perfusion. PET is superior due to its more accurate attenuation correction, better resolution, lower radiation dose, and shorter examination time. Despite this, SPECT still has certain advantages, which is why it remains more commonly used. The PET radiopharmaceutical 82Rb has also proven to be better than the [99mTc]Tc-sestaMIBI SPECT radiopharmaceutical in terms of radiation dose burden for both the patient and staff, due to its short half-life and faster procedure time. Although 82Rb is most commonly used in nuclear medicine cardiology, it is not the ideal PET radiopharmaceutical. It is important to note that positrons generated during decay have higher energy, which means a longer range and consequently poorer resolution. This drawback is not present with 18F. Due to its favorable properties, 18F has proven superior to [99mTc]Tc-sestaMIBI and 82Rb radiopharmaceuticals. The short range of positrons and the resulting good resolution allow for greater diagnostic accuracy. Additionally, 18F has a better binding affinity to myocardial cells than the previously mentioned radiopharmaceuticals, resulting in higher sensitivity and specificity.

• Keywords: diploma theses, radiologic technology, SPECT, PET, nuclear medicine, cardiology, myocardial perfusion, flurpiridaz-18, [$^{99m}Tc$]Tc-sestaMIBI, rubidium-82