The basis of SPECT imaging is same for all nuclear medicine procedures.
The commonly performed SPECT procedures are

1. Bone SPECT
2. Liver SPECT
3. DMSA SPECT

BONE SPECT PROCEDURE :
Common indications are :
1. Evaluation of focal hot spot or spots in vertebrae.
2. Avascular necrosis of Femoral head (can also involve other long bones).
3. Osteoid osteoma

Protocols for SPECT bone scan
1.Adult dose: 25mci
2. Acquisition 3-4 hours later , 128 X 128 matrix
3.LEHR, if not available then LEAP collimator is used, 25-30 seconds per projection, 64 projections over 360 degrees. Step & Shoot

Processing
Uniformity correction
Hanning filter (frequency cutoff = 0.8 cycles/cm pre-processing)
Even butterworth is preferred
Filters are to be decided with consultation of doctor
Reconstruct by filtered back projection with Ramp filter
No attenuation correction
6mm (one pixel) thick transaxial, sagittal & coronal images

DMSA SPECT PROCEDURE: For cortical scar evaluation.

Adult dose: 4 - 6 mCi
Acquisition 2-3 hours later, 64 X 64 or 128 X 128 matrix, LEHR is preferred over LEAP collimator, 20seconds/projection, 64 projections over 360 degrees. Step & Shoot

It is to be noted that a pinhole imaging is preferred over DMSA SPECT in assessing renal cortical scars.

Reconstruction parameters are to be standardized, as improper reconstruction can lead to over & under diagnosis of cortical scars.

LIVER SPECT:
Most of the time this is done in evaluation of a space-occupying lesion in liver suspected to be a hemangioma where a combined colloid & RBC blood pool imaging is performed.

RBC Bloodpool Liver SPECT:
Perform InVivo labeling of RBCs with 20-25mCi
Acquisition parameters: 128 X 128 matrix, LEHR if not available then LEAP collimator, 64 views over 360 deg., 20 sec per view

Liver colloid SPECT:
Dose : 7-8 mCi Tc S.colloid or Phytate
Acquisition parameters: 128 X 128 matrix, LEHR if not available then LEAP collimator, 64 views over 360 deg., 25-30 sec per view

Colloid liver SPECT is done normally before RBC Blood pool SPECT & blood pool SPECT has to be performed 10 – 15 min & 2-3 hours post injection

Reconstruction Parameters:
For both, Butter worth filter is preferred.
Back projection is done with Ramp filter.
Images are to be displayed in the standard format of transaxial, sagittal & coronal sections.
If S.colloid & RBC blood pool SPECTs are performed, they should be displayed so that the congruency of the images is maintained.