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1 Department of Anesthesiology and Intensive Care, Karolinska University Hospital, Solna, Stockholm, Sweden; Department of Physiology and Pharmacology, Section of Anaesthesiology and Intensive Care, Karolinska Institutet, Stockholm, Sweden
2 Department of Hospital Physics, Section of Nuclear Medicine, Karolinska University Hospital, Solna, Stockholm, Sweden; Medical Radiation Physics, Department of Oncology-Pathology, Stockholm University and Karolinska Institutet, Stockholm, Sweden
* To whom correspondence should be addressed. E-mail: johan.petersson{at}karolinska.se.
Emission tomography provides three-dimensional, quantitative images of the distribution of radiotracers used to mark physiologic, metabolic or pathologic processes. Quantitative SPECT requires correction for the image degrading effects due to photon attenuation and scatter. Phantom experiments have shown that radioactive concentrations can be assessed within some percent of the true value when relevant corrections are applied. SPECT is widely spread and radiotracers are available that are easy to use and comparably inexpensive. When compared to other methods, SPECT suffers from a lower spatial resolution and the time required for image acquisition is longer than for some alternative methods. In contrast to some other methods, SPECT allows simultaneous imaging of more than one process, e.g. both regional blood flow and ventilation, for the whole lung. SPECT has been used to explore the influence of posture and clinical interventions on the spatial distribution of lung blood flow and ventilation. Lung blood flow is typically imaged using macroaggregates of albumin. Both radioactive gases and particulate aerosols labeled with radioactivity have been used for imaging of regional ventilation. However, all radiotracers are not equally suited for quantitative measurements, all have specific advantages and limitations. With SPECT both blood flow and ventilation can be marked with radiotracers that remain fixed in the lung tissue, which allows tracer administration during different conditions than at image registration. All SPECT methods have specific features that results from the used radiotracer, the manner in which it is administered and how images are registered and analyzed.
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