A NEW CONCEPT IN THE DETECTION OF PELVIC RECURRENCES AFTER CURATIVELYOPERATED RECTAL-CANCER - IMAGE FUSION OF MAGNETIC-RESONANCE TOMOGRAPHY AND ANTI-CEA IMMUNOSCINTIGRAPHY (SPECT) - TECHNIQUE AND CLINICAL EXAMPLE

We present a new technique of image fusion (IF) of magnetic resonance imaging (MRT) and anti-CEA-immunoscintigraphy (Behring 431/26) and sin gle photon emission computed tomography (SPECT). We performed SPECT an d MRT within 8 hours on the same day. Glucagon intravenously was used to reduce artefacts due to intestinal motility. Before image fusion we analysed the SPECT and MRT images independently of each other. The MR T and SPECT were connected by a local area network (LAN) to a Gateway computer, which is also used as a picture archive. There a program aut omatically starts, translates the MRT data from the ACR/NEMA format to the Elscint one and these data are sent for image fusion to the nucle ar medicine computer Elscint SP1. By means of a clinical example we pr esent anatomic concordant superimposition and explain the findings and the clinical value of our technique. This system and technique are eq ually applicable to other digital imaging investigations. By IF, on th e basis of the certain evidence of the tracer depot of a pathological lesion diagnosed by MRT and the reliability of the anatomical assignme nt of a focal lesion diagnosed by SPECT, early detection of local recu rrence after surgical treatment of rectal cancer, the correct localisa tion of recurrent disease and its distinction from non-malignant tissu e becomes possible. This enables planning of further therapeutical str ategies.