Advancements in Diagnostic Imaging: SPECT/CT and PET/CT in Thyroid and Breast Cancer

In the evolving landscape of cancer care, the integration of advanced imaging techniques plays a pivotal role in refining diagnostic accuracy and treatment strategies. SPECT/CT and 18F-FDG PET/CT continue to transform understandings within thyroid and breast cancer domains, driving a new era of precision medicine. Within guideline-aligned pathways, SPECT/CT is used in select thyroid evaluations and PET/CT is primarily applied in metastatic or restaging breast cancer scenarios.

By merging SPECT with CT, clinicians can improve lesion localization and characterization in thyroid nodule evaluation; a recent study demonstrates better inter-reader agreement, and management impact remains context-dependent.

Radiomics-derived risk scores based on metabolic and textural features from 18F-FDG PET/CT have been explored to predict treatment response in breast cancer, with reported high AUC in internal validation and generalizability still to be established.

Metabolic imaging can help assess chemotherapy response, but major guidelines place PET/CT primarily in metastatic or restaging breast cancer contexts, with early-stage response assessment remaining investigational.

It may help gauge the likelihood of treatment response and support clinical decision-making; effects on outcomes remain to be established.

Hybrid imaging techniques such as SPECT/CT can add diagnostic value in select contexts, for example when clarifying indeterminate thyroid nodules, and—consistent with the inter-reader agreement study noted above—may refine characterization that informs staging and risk discussions without duplicating sources.

Building on earlier discussion that early metabolic response assessment may support therapy adjustments, PET/CT's practical application offers a patient-centered lens, as faster visualization can facilitate timely clinical decisions.

SPECT/CT integrates anatomical detail with functional insights, enhancing thyroid nodule evaluation and supporting more precise clinical decision-making.

Comprehensive imaging approaches can inform patient management and care planning, while considerations of cost, access, radiation exposure, and validation remain.

Key Takeaways:

• SPECT/CT integrates anatomical detail with functional insights, enhancing thyroid nodule evaluation and supporting more precise clinical decision-making.
• 18F-FDG PET/CT radiomics-derived risk scores show promise for predicting therapy response in breast cancer but require broader validation.
• PET/CT is mainly applied in metastatic/restaging breast cancer contexts; early-stage response assessment remains investigational.
• Comprehensive imaging can inform management, alongside considerations of cost, access, radiation exposure, and validation.