Bedside tomographic scintigraphy: a diagnostic tool in intensive care and the emergency room

Scintigraphic tomography (SPECT) with a gamma camera is an established tool for the diagnosis of disturbances in perfusion of the myocardium. The tech nique has been shown to be useful in the management of patients with acute myocardial infarction. However, SPECT is not widely used for seriously ill patients due to the need to transport the patient to the gamma camera syste m. In order to make tomography. available by the bedside, a form of limited vi ew angle tomography, Ectomography, has been implemented on a mobile gamma c amera system. Projection data are acquired by rotating a slant hole collima tor simple and easily transported. The mobile system is in front of the sta tionary detector and therefore, the head gantry is completely self-containe d providing acquisition, reconstruction and bedside display. System sensiti vity can be increased by using a segmented collimator, making it possible t o present reconstructed sections for diagnosis less than 10 min after the s tart of acquisition. At present, reconstruction is performed with 2D filter ed back projection, A comparative study of patients with suspected coronary artery disease has shown that Ectomography and SPECT yield similar diagnostic information. In an experimental study, in which a coronary artery was occluded, it has been possible to use Ectomography to define myocardial area at risk and final i nfarct size. Myocardial imaging has been performed in the intensive care un it and a pilot study has demonstrated that brain scans can also be performe d. Bedside tomographic scintigraphy has been shown to be feasible and studi es can be performed without moving the patient. The method should provide, therefore, an alternative to SPECT in intensive care and the emergency room . (C) 2001 Elsevier Science B.V. All rights reserved.