Specification of Equivocal Lesions in Planar Whole Body Bone Scintigraphy with SPECT/CT in Oncological Patients
Authors:
Ladislav Zadražil () 1,2,3; Petr Libus () 1
Authors‘ workplace:
Oddělení nukleární medicíny, Nemocnice Havlíčkův Brod, p. o.
1; Radiodiagnostické oddělení, Nemocnice Havlíčkův Brod, p. o.
2; Radiologická klinika, LF MU Brno
3
Published in:
NuklMed 2013;2:25-30
Category:
Original Article
Overview
Aim:
To determine how often SPECT/CT is needed to specify the abnormal finding in a planar WB bone scan, whether comparison with the previous scan is useful, in how many cases SPECT/CT gives a definitive diagnosis, and how many foci are found in bone scan in benign and malignant affections.
Patients and method:
We studied retrospectively 471 WB scans in 450 patients with breast, lung and prostate cancers, who underwent bone scintigraphy in 2008. SPECT/CT or CT was used in 11,9 % examinations of 12,4 % patients. Repeated scintigraphy (319 patients after bone scintigraphy and 36 patients after SPECT/CT) were used as a reference examination.
Results:
Comparison with previous scintigraphy was useful in patients with breast cancer before SPECT/CT was indicated. SPECT/CT could specify equivocal lesions in 90,9 % cases. The sensitivity, specificity, positive and negative predictive values of the CT in SPECT/CT for detection of bone metastases were 72,8 %, 96 %, 88,9 % and 88,9 %, respectively. No significant difference between the group with one and without any suspected lesions in WB scan in the development of metastatic disease in 2 years was proven (p = 0,4272), but if more uncertain foci in the bones were detected, the malignant origin should be taken into consideration (p ≤ 0,0001).
Conclusion:
SPECT/CT improves specificity of bone scintigraphy. It seems to be reasonable to consider SPECT/CT in 10-20 % of all cases after comparison with previous bone scan. The CT guided by WB scan adds a relatively small radiation dose to that from scintigraphy, 13 % in a collective effective dose in our study.
Key Words:
bone scintigraphy, bone metastases, SPECT/CT
Sources
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Nuclear Medicine
2013 Issue 2
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