Value of CT thallium-201 SPECT fusion imaging over SPECT alone for detection and localization of nasopharyngeal and maxillary cancers

Tadaki Nakahara, Naoyuki Shigematsu, Masato Fujii, Etsuo Kunieda, Takayuki Suzuki, Chikako Tanaka, Jun Hashimoto, Atsushi Kubo

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


OBJECTIVE. The purpose of this study was to investigate the incremental clinical utility of CT and high-resolution SPECT fusion imaging. MATERIALS AND METHODS. Eighteen patients with nasopharyngeal cancer or cancers around the maxilla were scanned with high-resolution SPECT at the time of initial diagnosis (18 studies) and during follow-up after chemoradiotherapy (23 studies). SPECT results were compared with histologic findings or the findings of other imaging techniques. In addition, automatic image registration without fiducial markers was performed from CT and SPECT data, and the effect of fusion imaging on the localization of abnormalities was evaluated. RESULTS. All of the original 18 untreated lesions showed high uptake. Recurrent tumors had a tendency to show high uptake (seven of nine patients), whereas little or no uptake generally represented no recurrence (12 of 14 patients) (chi-square test with Yates correction: χ2 = 6.80, p < 0.01). In two patients, physiologic uptake in the unilateral prevertebral muscle was revealed on image fusion. In four of the nine recurrent nasopharyngeal cancers (44%), SPECT alone could not determine abnormalities in uptake sites, whereas CT/SPECT fusion imaging clearly localized the sites and was helpful for treatment strategy. CONCLUSION. High-resolution thallium-201 (201Tl) SPECT has a very high detection rate in patients with nasopharyngeal cancer and cancers around the maxilla. However, the anatomic identification or localization of the uptake sites is sometimes difficult without CT/SPECT fusion imaging. This technique without external markers is practically feasible to generate clinically valid fusion images.

Original languageEnglish
Pages (from-to)825-829
Number of pages5
JournalAmerican Journal of Roentgenology
Issue number3
Publication statusPublished - 2006 Sept


  • CT
  • Head and neck imaging
  • Image fusion
  • Maxillary cancer
  • Nasopharyngeal cancer
  • Nuclear imaging
  • Thallium-201

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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