Should SPECT-CT replace SPECT for the evaluation of equivocal bone scan lesions in patients with underlying malignancies?

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dc.contributor.authorNdlovu X.
dc.contributor.authorGeorge R.
dc.contributor.authorEllmann A.
dc.contributor.authorWarwick, James M.en_ZA
dc.date.accessioned2011-05-15T16:17:31Z
dc.date.available2011-05-15T16:17:31Z
dc.date.issued2010
dc.description.abstractINTRODUCTION: Bone scintigraphy is used extensively in evaluating metastatic disease. There are currently no clear recommendations for the use of single photon emission computed tomography (SPECT)/CT in metastatic bone disease. Given its limited availability there is a need to identify the clinical indications for which SPECT/CT is clearly beneficial in influencing patient care and outcome. METHODS: Forty-two patients with equivocal lesions on planar scintigraphy were recruited and underwent SPECT/CT imaging. On reading of SPECT alone and then SPECT/CT, lesions were classified as malignant, benign or equivocal. Follow-up clinical information, radiological studies and/or bone scans were used as a gold standard. SPECT and SPECT/CT were compared in terms of the number of equivocal findings and accuracy on a patient-wise and lesion-wise basis. RESULTS: Forty-two patients with 189 skeletal lesions were examined. There was a diverse variety of primary tumours, with the majority being breast (n=22) and prostate cancer (n=8). SPECT/CT resulted in a significant reduction in the proportion of patients (48-14%, P=0.0015) and lesions (31-9%, P<0.0001) with equivocal findings. The overall accuracy of SPECT/CT was significantly higher on both a patient-wise (52-79%, P=0.0026) and lesion-wise basis (67-92%, P<0.0001). CONCLUSION: SPECT/CT significantly outperforms SPECT alone for the interpretation of skeletal lesions in patients undergoing bone scanning for metastases. When available SPECT/CT is indicated in patients in whom correct classification of equivocal lesions is expected to alter the patient's management. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
dc.description.versionArticle
dc.identifier.citationNuclear Medicine Communications
dc.identifier.citation31
dc.identifier.citation7
dc.identifier.issn01433636
dc.identifier.other10.1097/MNM.0b013e3283399107
dc.identifier.urihttp://hdl.handle.net/10019.1/14251
dc.subjectmedronate technetium tc 99m
dc.subjectadult
dc.subjectaged
dc.subjectarticle
dc.subjectbenign tumor
dc.subjectbone disease
dc.subjectbone metastasis
dc.subjectbone scintiscanning
dc.subjectbreast cancer
dc.subjectclinical article
dc.subjectclinical trial
dc.subjectcomputer assisted tomography
dc.subjectcontrolled study
dc.subjectdiagnostic accuracy
dc.subjectfemale
dc.subjectfollow up
dc.subjecthuman
dc.subjectimage analysis
dc.subjectintermethod comparison
dc.subjectmale
dc.subjectmalignant neoplastic disease
dc.subjectmedical information
dc.subjectprimary tumor
dc.subjectprostate cancer
dc.subjectradiodiagnosis
dc.subjectsingle photon emission computer tomography
dc.subjecttumor classification
dc.subjectAdult
dc.subjectAged
dc.subjectBone and Bones
dc.subjectBone Neoplasms
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectProspective Studies
dc.subjectTomography, Emission-Computed, Single-Photon
dc.subjectTomography, X-Ray Computed
dc.titleShould SPECT-CT replace SPECT for the evaluation of equivocal bone scan lesions in patients with underlying malignancies?
dc.typeArticle
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