For years, new cardiovascular imaging technologies have generated buzz, but how does SPECT MPI imaging compare to these newer modalities, and which is better? The answer may surprise you.

While newer technologies may offer improvements to image quality, you have to consider the whole picture when it comes to cardiac imaging. Image quality is one component, but many factors shape how to serve patients best.

Digirad recently spoke with Dr. Saurabh Malhotra, the Director of Advanced Cardiac Imaging at Cook County Health, Chicago, Illinois, and ASNC Chief Executive Officer, Kathleen Flood to hear their thoughts on where SPECT in the cardiovascular imaging space. In the discussion, they laid out five unique ways why SPECT remains the go-to study for most cardiologists.

1. SPECT Leverages a Large and Growing Infrastructure

One of the most overlooked advantages of SPECT imaging is the infrastructure that has been created around the modality. There is a global network in place to support SPECT MPI that includes everything from repair and support to the production of radiopharmaceuticals.

Due to the ubiquitous nature of SPECT, hospitals and clinics have protocols, labs, and radiation safety programs set up and maintained. The sheer size of the SPECT market gives it a more dynamic and active pool of options and development. Software developers continue to improve on and roll out new imaging packages that are improving image quality.

The advantages of SPECT MPI also reach into the staffing side of clinics. A large number of technologists and stress techs are trained in delivering SPECT MPI studies, and there is a broad, experienced, growing pool of talent who can perform these studies.

2. Unbeatable Access and Effectiveness of Radiopharmaceuticals

The availability and real-world usability of radiopharmaceuticals is a vital piece of the puzzle when evaluating which modality should be the dominant force in cardiovascular imaging.

Technetium-99 has a diverse and established supply chain within the industry, minimizing the risk of shortages or breakage. The product is more affordable than other radiopharmaceuticals requiring a generator, and Tc-99 saves the healthcare system money by enhancing value-based care.

Additionally, with a six-hour half-life, Tc-99 gives labs more flexibility in imaging patients and results in less waste.

3. New, Innovative, and High-Performance SPECT MPI Cameras are Available

SPECT MPI cameras have significantly evolved over the last 20 years and continue to see generational leaps in performance and image quality. The shift from cameras with large photomultiplier tubes to solid-state cameras that use CZT or CsI was the beginning of a new era in nuclear medicine. Although that innovation was developed in the year 2000, shockingly, many of the older style Photomultiplier Tube based cameras are still in use today.

As solid-state imaging has become the dominant form of nuclear imaging, cameras have improved and added new features and capabilities. Technologies such as Fluorescence Attenuation Correction (FAC), SPECT/CT, and point-of-care nuclear imaging have been introduced and adopted into the market.

When it comes to cardiovascular imaging, SPECT MPI cameras have the widest availability, are continually improving, and are the most flexible type of camera available. Practices who have held onto their equipment for 15+ years are not experiencing the innovations and may have an outdated view of what SPECT can do.

4. SPECT is More Flexible When Compared to Other Cardiac Imaging Modalities

The sheer flexibility of SPECT plays a significant role in making it the go-to test for cardiologists. It’s a very flexible study that can be adjusted to the needs of the patients.

With SPECT, you can perform both stress and rest studies, and the modality allows you to physically stress the heart vs. only relying on vasodilators.

The extendable nature of SPECT allows you to perform low dose imaging, and when combined with CT, allows for true Attenuation Correction, and more. A broad and dynamic range of cameras is also available, which adds to the flexibility of SPECT that accommodates a wide variety of patient needs and imaging spaces.

5. SPECT Technology is Supported by a Vibrant and Innovative Market

Since its initial introduction in the 1950s, SPECT MPI imaging has been on a constant path of innovation and improvement. Both the hardware and software sides of this modality have developed at a significant pace and show no signs of stopping.

SPECT is now being used in previously unheard-of ways, and new areas of medicine are beginning to see the value and potential of SPECT. Manufacturers, software companies, research centers, and educational facilities are all seeing the value and potential of SPECT MPI.

The Future of SPECT – What’s Next

SPECT is not slowing down. The pace of innovation around SPECT is faster than it’s ever been, and this modality is building on a platform that spans the globe.

Innovations and new modalities are vital to improving patient care, but SPECT remains the most available, most affordable, highest value, most reliable study on the market.

Undoubtedly, the cardiac imaging space will evolve and grow, but SPECT MPI looks to play the leading role for a long time to come.