Utility of SPECT imaging for determination of vertebral metastases in patients with known primary tumors

Bushnell, David; Kahn, Daniel; Huston, B.; Bevering, C. G.

doi:10.1007/bf02425938

Cited by 37 publications

(14 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several studies have reported improved diagnostic accuracy with the addition of SPECT, particularly in the vertebral column through improved tracer localisation [20][21][22]. As a general rule, uptake in the vertebral body or the pedicle alone is more likely to represent malignant disease than a pattern of uptake isolated to the vertebral body periphery or at the facet joints [23,24]. However, even with SPECT, spatial resolution is often insufficient for precise localisation of bone lesions, and correlation with anatomical imaging is often required.…”

Section: Applications In Musculoskeletal Radiologymentioning

confidence: 99%

SPECT-CT: applications in musculoskeletal radiology

Saha

Burke²,

Desai³

et al. 2013

BJR

View full text Add to dashboard Cite

This article reviews the technique, basic science principles and applications of integrated single photon emission CT (SPECT)-CT in musculoskeletal radiology. A review of the current evidence on the topic was undertaken, and selected clinical cases from the authors' institution have been used for illustration. SPECT-CT is a technology with emerging applications that offers technical advantages to image fusion of separately acquired SPECT and CT studies. The prevailing evidence indicates that there may be benefit in adding SPECT-CT to conventional imaging algorithms during the evaluation of some malignant and benign musculoskeletal conditions. SPECT-CT can improve both sensitivity and specificity by reducing equivocal interpretation in comparison to planar scintigraphy or SPECT alone. The evidence base for SPECT-CT in musculoskeletal radiology is still evolving. There is a lack of evidence comparing SPECT-CT with MRI in many key indications, and further research is required in these areas.A wide range of pathological conditions may affect the musculoskeletal system, including infection, trauma and malignant disease. Advances in MRI, multidetector CT (MDCT) and high-frequency ultrasound have provided considerable improvements in imaging musculoskeletal disease over the past decade. There are, however, limitations associated with each of these techniques. MRI image acquisition remains relatively time consuming and, particularly in musculoskeletal radiology, image quality can be degraded significantly by metal artefact from internal fixation and prostheses. MDCT offers exquisite characterisation of bone and can rapidly generate highquality three-dimensional reconstructions; however, the contrast resolution for soft tissues is limited and the modality can also suffer metal-related artefact, although like MRI, imaging parameters can be adjusted to reduce this artefact. High-frequency ultrasound, although operator dependent, provides excellent spatial and contrast resolution for superficial structures but is suboptimal for deeper structures and is unable to penetrate cortical bone.Bone scintigraphy remains an important and highly sensitive tool to the musculoskeletal radiologist but this is frequently criticized for its lack of specificity. Radionuclide imaging, however, may be the only modality to demonstrate pathology before it becomes evident on anatomical imaging. Developments in gamma camera technology now allow high-resolution imaging with shortened scan times, and single photon emission CT (SPECT) imaging has become commonplace in the UK. SPECT is able to increase sensitivity further and improves lesion localisation, but the paucity of anatomical markers on radionuclide imaging remains a constant challenge. Thus, the importance of correlating anatomical and functional imaging has become increasingly recognised [1].Use of a combined SPECT/CT system allows for sequential acquisition of both anatomical and functional information with a high degree of image fusion accuracy.

show abstract

Section: Applications In Musculoskeletal Radiologymentioning

confidence: 99%

SPECT-CT: applications in musculoskeletal radiology

Saha

Burke²,

Desai³

et al. 2013

BJR

View full text Add to dashboard Cite

show abstract

“…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.…”

Section: Discussionmentioning

confidence: 90%

“…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].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Spinal abnormalities involving the vertebral body or the pedicle alone are more likely to represent malignant disease compared with abnormalities confined to the periphery of the body or facet joint (30)(31)(32). Although the majority of bone metastases appear as hot spots, some appear as cold lesions.…”

Section: Musculoskeletal Imagingmentioning

confidence: 98%

Multimodality imaging techniques

Martí‐Bonmatí¹,

Sopena²,

Bartumeus³

et al. 2010

Contrast Media & Molecular

128

View full text Add to dashboard Cite

In multimodality imaging, the need to combine morphofunctional information can be approached by either acquiring images at different times (asynchronous), and fused them through digital image manipulation techniques or simultaneously acquiring images (synchronous) and merging them automatically. The asynchronous post-processing solution presents various constraints, mainly conditioned by the different positioning of the patient in the two scans acquired at different times in separated machines. The best solution to achieve consistency in time and space is obtained by the synchronous image acquisition. There are many multimodal technologies in molecular imaging. In this review we will focus on those multimodality image techniques more commonly used in the field of diagnostic imaging (SPECT-CT, PET-CT) and new developments (as PET-MR). The technological innovations and development of new tracers and smart probes are the main key points that will condition multimodality image and diagnostic imaging professionals' future. Although SPECT-CT and PET-CT are standard in most clinical scenarios, MR imaging has some advantages, providing excellent soft-tissue contrast and multidimensional functional, structural and morphological information. The next frontier is to develop efficient detectors and electronics systems capable of detecting two modality signals at the same time. Not only PET-MR but also MR-US or optic-PET will be introduced in clinical scenarios. Even more, MR diffusion-weighted, pharmacokinetic imaging, spectroscopy or functional BOLD imaging will merge with PET tracers to further increase molecular imaging as a relevant medical discipline. Multimodality imaging techniques will play a leading role in relevant clinical applications. The development of new diagnostic imaging research areas, mainly in the field of oncology, cardiology and neuropsychiatry, will impact the way medicine is performed today. Both clinical and experimental multimodality studies, in humans and animals, will have to demonstrate an efficient use of the imaging information provided by the modalities to affect the future of medical imaging.

show abstract

Utility of SPECT imaging for determination of vertebral metastases in patients with known primary tumors

Cited by 37 publications

References 9 publications

SPECT-CT: applications in musculoskeletal radiology

SPECT-CT: applications in musculoskeletal radiology

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

Multimodality imaging techniques

Contact Info

Product

Resources

About