Comparison of reprojected bone SPECT/CT and planar bone scintigraphy for the detection of bone metastases in breast and prostate cancer

Abstract

Objective The aim of this study was to compare reprojected bone SPECT/CT (RBS) against planar bone scintigraphy (BS) in the detection of bone metastases in breast and prostate cancer patients. Methods Twenty-six breast and 105 prostate cancer patients with high risk for bone metastases underwent 99mTc-HMDP BS and whole-body SPECT/CT, 1.5-T whole-body diffusion-weighted MRI and 18F-NaF or 18F-PSMA-1007 PET/CT within two prospective clinical trials (NCT01339780 and NCT03537391). Consensus reading of all imaging modalities and follow-up data were used to define the reference standard diagnosis. The SPECT/CT data were reprojected into anterior and posterior views to produce RBS images. Both BS and RBS images were independently double read by two pairs of experienced nuclear medicine physicians. The findings were validated against the reference standard diagnosis and compared between BS and RBS on the patient, region and lesion levels. Results All metastatic patients detected by BS were also detected by RBS. In addition, three metastatic patients were missed by BS but detected by RBS. The average patient-level sensitivity of two readers for metastases was 75% for BS and 87% for RBS, and the corresponding specificity was 79% for BS and 39% for RBS. The average region-level sensitivity of two readers was 64% for BS and 69% for RBS, and the corresponding specificity was 96% for BS and 87% for RBS. Conclusion Whole-body bone SPECT/CT can be reprojected into more familiar anterior and posterior planar images with excellent sensitivity for bone metastases, making additional acquisition of planar BS unnecessary.

Incremental diagnostic value of SPECT/CT to post-radioiodine therapy planar whole-body scan in patients with papillary thyroid cancer

“…The application of additional SPECT/CT to planar gamma camera images has become feasible in recent years with the increased availability of hybrid cameras. Both functional and structural imaging can be obtained together with the SPECT/CT, which gives better diagnostic accuracy than planar image (25)(26)(27).…”

Detection of prostate cancer bone metastases with fast whole-body 99mTc-HMDP SPECT/CT using a general-purpose CZT system

“…In this study, we have shown that the acquisition time of whole-body SPECT can be lowered from 50 to 16 min without losing diagnostic performance for lesion detection. To smoothen the transition from planar bone scintigraphy to whole-body SPECT/CT, we have validated reprojected bone SPECT/CT as a method to facilitate the reading of SPECT images [ 30 ].…”

Diagnostic Utility of 99mTc-MDP Bone Scintigraphy for Nivolumab-Induced Inflammatory Arthritis

“…7 The symmetrical moderate uptake at the metacarpophalangeal joints and the wrist joints was detected on 99m Tc-MDP bone scintigraphy (G), which was not consistent with metastatic bone lesions or rheumatoid joint destruction. [8][9][10][11] Pembrolizumab-induced inflammatory arthritis has already been described to have symmetrically strong uptake in the major distal joints of the extremities on 99m Tc-MDP bone scintigraphy. 5 To our knowledge, 99m Tc-MDP bone scintigraphy in nivolumab-induced inflammatory arthritis has not yet been described; however, similar symmetrical uptake patterns could also be detected in cases with nivolumab-induced inflammatory arthritis.…”

“…The 8 affected joints (bilateral second to fourth metacarpophalangeal joints and bilateral wrist joints) were sites that are susceptible to rheumatoid arthritis; however, the diagnostic criteria of rheumatoid arthritis were not fulfilled 7 . The symmetrical moderate uptake at the metacarpophalangeal joints and the wrist joints was detected on 99m Tc-MDP bone scintigraphy ( G ), which was not consistent with metastatic bone lesions or rheumatoid joint destruction 8–11 . Pembrolizumab-induced inflammatory arthritis has already been described to have symmetrically strong uptake in the major distal joints of the extremities on 99m Tc-MDP bone scintigraphy 5 .…”