Impact of additional SPECT in bone scanning in tumor patients with suspected metastatic bone disease

Apostolova, Ivayla; Gölcük, Elif; Bohuslavizki, K. H.; Buchert, Ralph; Brenner, Winfried

doi:10.1007/s12149-009-0317-6

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…Owing to the retrospective nature of the study, we are not able to provide a facit for lesions deemed metastatic or nonmetastatic to support, but this reflects the everyday clinical situation. Finally, not all patients received a SPECT/CT in addition to BS either, the addition of SPECT/CT in all patients might have decreased the number of equivocal findings on BS [33].…”

Section: Discussionmentioning

confidence: 99%

The value of 68Ga-PSMA-11 PET/CT in patients with prostate cancer and inconclusive standard imaging at primary staging

Nalliah

2022

Nuclear Medicine Communications

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Objective The current standard imaging recommended for primary staging of intermediate-and high-risk prostate cancer (PCa) consists of bone scintigraphy (BS) and computed tomography (CT). Some patients will have equivocal lesions or divergent findings on BS and CT, leading to inconclusive disease staging. Our aim was to investigate the value of 68 Ga-PSMA-11 PET/CT in PCa with inconclusive disease stage based on standard imaging. MethodsWe made a single-center study of patients with newly diagnosed PCa who underwent a 68 Ga-PSMA-11 PET/CT due to equivocal findings or discrepancies between BS and CT from 1 January 2017 to 31 December 2020. The value of 68 Ga-PSMA-11 PET/ CT was evaluated for each location of equivocal findings (regional lymphnode, nonregional lymphnodes, bones and other metastases) and on a patient level. ResultsSeventy-six patients were included in the study (62 patients with 72 equivocal lesions, 14 with discrepancy between BS and CT). Equivocal lesions were predominately in the bones (61%, 44/72), or in the regional lymph nodes (17%, 12/72). 68 Ga-PSMA-11 PET/ CT provided a conclusive diagnosis in 90% (65/72) of the equivocal lesions. All patients with discrepancies between BS and CT had definite answers after 68 Ga-PSMA-11 PET/ CT. 68 Ga-PSMA-11 PET/CT also uncovered 32 additional sites of metastasis in 25 patients not visible by standard imaging. Conclusion 68 Ga-PSMA-11 PET/CT provides a definite disease stage in more than 90% of newly diagnosed patients with inconclusive standard imaging. Furthermore, it revealed additional sites of metastasis in 25 patients not detected by standard imaging. Nucl Med Commun 43: 1092

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Section: Discussionmentioning

confidence: 99%

The value of 68Ga-PSMA-11 PET/CT in patients with prostate cancer and inconclusive standard imaging at primary staging

Nalliah

2022

Nuclear Medicine Communications

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“…Some of the planar bone scintigraphies are inconclusive [8,23,31] thus potentially both misclassifies patients and/or delay treatment. The proportion of equivocal scans is markedly decreased if supplemental SPECT/CT is done and comparable to 18 F-NaF PET/CT [8,32]. Yet, a small number of scans remain inconclusive.…”

Section: Discussionmentioning

confidence: 99%

The Value of 68Ga-PSMA PET/CT Following Equivocal 18F-NaF PET/CT in Prostate Cancer Patients

2020

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Background: Inconclusive bone scans are a challenge but there is no consensus about follow-up imaging. We evaluated the use of 68gallium-labelled prostate-specific membrane antigen (68Ga-PSMA) PET/CT if 18F-sodium fluoride (18F-NaF) PET/CT was inconclusive. Methods: This retrospective study included patients with no previously known bone metastases who had one or more equivocal bone lesions on 18F-NaF PET/CT and underwent additional 68Ga-PSMA PET/CT. The bone lesions were deemed as true metastases or not based on follow-up by surveying supplemental imaging modalities and hospital records. A subgroup of patients with “most valid follow-up” was created, which included patients with unmeasurable PSA after prostatectomy or subsequent imaging (additional 18F-NaF PET/CT, 68Ga-PSMA PET/CT, CT, or MRI). Results: Of the 2918 patients referred for 18F-NaF PET/CT from the department of urology in the inclusion period, 51 (1.7%) were inconclusive regarding bone metastases and underwent additional 68Ga-PSMA PET/CT. Thirteen of these patients (25%) were ultimately diagnosed with bone metastases. Patient-based sensitivity, specificity, and accuracy of additional 68Ga-PSMA PET/CT were 100%, 95%, and 96%, respectively. In patients with “most valid follow-up”, the same parameters were 100%, 93%, and 94%, respectively. Conclusion: 68Ga-PSMA PET/CT is an excellent complementary modality in when 18F-NaF PET/CT is equivocal.

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“…However, the lack of anatomical markers on radionuclide imaging and the low spatial resolution make this imaging modality challenging. Moreover, combining images from different techniques could lead to errors due to different patient positions and variable acquisition time acquisition [5,6].…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of targeted single-photon emission computed tomography/computed tomography (SPECT/CT) bone scintigraphy on the assessment of bone metastasis in cancer patients

Kapsoritakis

Stathaki

Bourogianni

et al. 2021

Nuclear Medicine Communications

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Objectives We investigated the clinical impact of single-photon emission computed tomography/computed tomography (SPECT/CT) bone scintigraphy combined with 16-slice CT on metastatic workup and treatment planning in a large cancer patient series. Methods Between January 2019 and January 2020, a total of 600 cancer patients were prospectively evaluated with whole-body planar bone scan (wbPBS) for staging or restaging purposes. 272/600 had equivocal lesions on wbPBS and 265/272 underwent additionally a targeted SPECT/CT bone scintigraphy on designated regions. Findings were classified as benign (score 1), metastatic (score 2) and inconclusive (score 3). Findings from SPECT/CT bone scintigraphy were compared with the results of wbPBS. Results A total of 668 lesions were considered as unclear οn wbPBS and were re-evaluated through targeted SPECT/CT bone scintigraphy. Definite diagnostic findings on SPECT/CT bone scintigraphy were obtained in 227/265 (85.7%) patients and in 592/668 (88.6%) lesions vs. 15.4% of wbPBS alone. On per-patient analyses, 38.9% of patients were considered definitely nonmetastatic and 46.8% as definitely metastatic. On per lesion analyses using SPECT/CT bone scintigraphy, corresponding diagnostic rates were 47.5 and 41.2%. Although the addition of SPECT/CT bone scintigraphy significantly reduced the rate of equivocal wbPBS results (83.1%), it failed to provide a conclusive diagnosis in a relatively small proportion of lesions 76/668 (11.4%) in 38 patients. Conclusions SPECT/CT bone scintigraphy afforded a significant reduction of the number of patients with equivocal findings who needed further evaluation with other imaging modalities, preventing unnecessary delays in diagnosis and potential changes in disease staging and treatment planning. Moreover, SPECT/CT bone scintigraphy slightly increased diagnostic sensitivity.

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Impact of additional SPECT in bone scanning in tumor patients with suspected metastatic bone disease

Cited by 8 publications

References 14 publications

The value of 68Ga-PSMA-11 PET/CT in patients with prostate cancer and inconclusive standard imaging at primary staging

The value of 68Ga-PSMA-11 PET/CT in patients with prostate cancer and inconclusive standard imaging at primary staging

The Value of 68Ga-PSMA PET/CT Following Equivocal 18F-NaF PET/CT in Prostate Cancer Patients

Clinical impact of targeted single-photon emission computed tomography/computed tomography (SPECT/CT) bone scintigraphy on the assessment of bone metastasis in cancer patients

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