Is there Still Enough Diagnostic Confidence with Bone Spect Scintigraphy Alone: A Retrospective Evaluation and Extended Review of the Literature

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

“…Most of the previous studies evaluating the additional value of SPECT, however, showed a significantly higher increase in lesion detection rates by SPECT compared to planar imaging [2,3,5,6,8,10]. Han et al [6] compared Looking at the impact of SPECT, SPECT-based patient staging differed from the planar staging in 26.6% of all our 271 patients.…”

“…The results from prospective trials might not be applicable to clinical routine, because these trials included highly selected patient collectives which are not representative for everyday clinical routine. Only few studies have evaluated the value of additional SPECT in unselected patients from clinical routine [3][4][5][6][7][8][9][10][11], all of them with rather small sample sizes. Some of these studies reported the fraction of lesions missed in planar images but detected by SPECT to be significant (20.1-25.6%) [5,6], while other authors found this fraction to be rather small (4.3%) [7].…”

“…Only few studies have evaluated the value of additional SPECT in unselected patients from clinical routine [3][4][5][6][7][8][9][10][11], all of them with rather small sample sizes. Some of these studies reported the fraction of lesions missed in planar images but detected by SPECT to be significant (20.1-25.6%) [5,6], while other authors found this fraction to be rather small (4.3%) [7]. Commenting on the available literature, therefore, Ignac Fogelman, pointed out: ''To our knowledge, SPECT has not convincingly identified cases of malignancy that were not identified on planar images, although this is implied in reports'' [12].…”