Whole-Body SPECT/CT versus Planar Bone Scan with Targeted SPECT/CT for Metastatic Workup. (24th July 2017)

• Record Type: Journal Article
• Authors: Rager, Olivier; Nkoulou, René; Exquis, Nadia; Garibotto, Valentina; Tabouret-Viaud, Claire; Zaidi, Habib; Amzalag, Gaël; Lee-Felker, Stephanie Anne; Zilli, Thomas; Ratib, Osman
• Other Names: Ogawa Kazuma Academic Editor.
• Is Part Of: BioMed research international. Volume 2017(2017)
• Publication Date: 2017-07-24
• Subjects: Medicine -- Periodicals; Biology -- Periodicals; Biotechnology -- Periodicals; Life sciences -- Periodicals; 610.5
• DOI: 10.1155/2017/7039406
• Languages: English
• ISSNs: 2314-6133

Abstract

Abstract : Purpose . The use of SPECT/CT in bone scans has been widespread in recent years, but there are no specific guidelines concerning the optimal acquisition protocol. Two strategies have been proposed: targeted SPECT/CT for equivocal lesions detected on planar images or systematic whole-body SPECT/CT. Our aim was to compare the diagnostic accuracy of the two approaches. Methods . 212 consecutive patients with a history of cancer were referred for bone scans to detect bone metastases. Two experienced readers randomly evaluated for each patient either planar images with one-field SPECT/CT targeted on equivocal focal uptakes (targeted SPECT/CT) or a whole-body (two-field) SPECT/CT acquisition from the base of the skull to the proximal femurs (whole-body SPECT/CT). The exams were categorized as "nonmetastatic, " "equivocal, " or "metastatic" on both protocols. The presence or absence of any extra-axial skeletal lesions was also assessed. The sensitivity and specificity of both strategies were measured using the results of subsequent imaging follow-up as the reference standard. Results . Whole-body SPECT/CT had a significantly higher sensitivity than targeted SPECT/CT to detect bone metastases ( p = 0.0297 ) and to detect extra-axial metastases ( p = 0.0266 ) . There was no significant difference in specificity among the two approaches. Conclusion . Whole-body SPECT/CT is the optimal modality of choice for metastatic workup, including detection of extra-axial lesions, with improved sensitivity and similar specificity compared to targeted SPECT/CT.