Hybrid spect-CT for characterization of isolated vertebral lesions seen on bone scintigraphy: comparison with planar scintigraphy, spect and CT

Abstract

RESULTSAmong the 108 lesions, 49 were indeterminate on planar scintigraphy, 16 on SPECT, and one each on SPECT-CT and CT. SPECT-CT was superior to both planar scintigraphy (P < 0.001) and SPECT alone (P = 0.014), but not to CT (P = 0.302). CT was superior to planar scintigraphy (P < 0.001) but only slightly superior to SPECT (P = 0.063). SPECT-CT correctly characterized 96% of the indeterminate lesions observed by planar scintigraphy. SPECT-CT had an impact on the clinical management of 60.6% patients compared to planar scintigraphy and 18.1% compared to SPECT. CONCLUSION SPECT-CT is better than planar scintigraphy and SPECT alone, but not CT alone, for characterizing equivocal vertebral lesions that are observed by bone scintigraphy, thus SPECT-CT can have a significant impact on patient management.

Pitfalls and Limitations of Radionuclide Planar and Hybrid Bone Imaging

“…SPECT/CT provides a unique opportunity to correlate the scintigraphic findings with their morphologic counterpart. The current evidence shows that SPECT/CT reduces the number of equivocal findings on the planar scan, increases the diagnostic confidence, and improves accuracy and specificity [41][42][43] (Fig. 26).…”

The usefulness of SPECT/CT in characterization of skeletal and soft tissue lesions — report of two cases

“…For characterizing vertebral lesion 99m Tc-MDP SPECT/CT is superior to planar bone scan and SPECT alone, but not to CT alone [4]. SPECT/CT also significantly reduces number of spinal lesion judged equivocal in SPECT alone [5].…”

SPECT/CT imaging in breast cancer - current status and challenges

“…Some authors observed poorer detection of metastases particularly in the pelvis, spine and sacrum with the planar scintigraphy 38 . The greatest benefit of SPECT/CT is reported, however, for these localizations 24 . The authors drew attention to the lower availability and higher cost of PET/CT versus SPECT/CT for a routine check-up 34 .…”

“…This resulted in a change in treatment of patients in 61% compared to a planar scintigraphy and in 18% compared to SPECT (ref. 24 ). Concerning the examination of patients with back pain, there was a threefold improvement of the characteristics of indeterminate lesions by SPECT/CT versus SPECT (ref.…”