Objective To systematically review the current research status of cadmium zinc telluride (CZT) detector-based SPECT using bibliometric methods and to explore its future development trends.

Methods Studies related to CZT-SPECT published in the Web of Science Core Collection from January 1, 2005 to May 2, 2026 were retrieved, and 431 articles were included after screening. CiteSpace and VOSviewer together with descriptive statistical methods were applied to analyze the annual number of publications, countries or regions, institutional collaboration networks, author distribution, and keywords (frequency, clustering, and burst detection). An exponential fitting model was applied to fit the annual number of publications against the publication year, and the research landscape of this field was interpreted in combination with knowledge maps.

Results The annual number of publications showed an increasing trend (exponential fitting, R²=0.829). The top five countries by number of publications were France (91), the United States (76), China (61), Italy (57), and Japan (45). The United Kingdom, Italy, and the United States (betweenness centrality of 0.45, 0.22, and 0.21, respectively) played key bridging roles in the collaboration network. Although China ranked third in publication volume, its betweenness centrality was only 0.10, indicating that its bridging role in the international collaboration network requires further strengthening. Highly productive institutions were mainly from Europe. The University of Lorraine (France) and the National Research Council of Italy were tied for first place with 27 publications each. University Hospital Zurich achieved the highest total citations (772). Author cocitation analysis showed that Gimelli A, Duvall WL, and Sharir T were the top cocited authors. Keyword map analysis revealed that research hotspots have long focused on myocardial perfusion imaging, CZT detector performance optimization, and gated SPECT. Dosimetry has emerged as a new research hotspot.

Conclusions Research hotspots in CZT-SPECT have evolved from "hardware performance validation" toward "precision quantification and algorithm-enabled applications". Future efforts should focus on multicenter collaboration and standardization, artificial intelligence development, and whole-body clinical validation across multiple diseases.