Hybrid SPECT-CT for characterizing isolated vertebral lesions observed by bone scintigraphy: comparison with planar scintigraphy, SPECT, and CT

作者：Sharma Punit; Dhull Varun Singh; Reddy Rama Mohan; Bal Chandrasekhar; Thulkar Sanjay; Malhotra Arun; Kumar Rakesh^*

来源：Diagnostic and Interventional Radiology, 2013, 19(1): 33-40.

DOI：10.4261/1305-3825.DIR.5790-12.1

PURPOSE
We aimed to assess the-role of single photon emission computed tomography-computed tomography (SPEC-CT) for characterizing isolated vertebral lesions observed by tine scintigraphy compared to Planar scintigraphy, SPECT, and CT, and to evaluate the impact of SPECT-CT on patient management
MATERIALS AND METHODS
Data from 99 patients (mean age, 52.4+/-18.9 years; females, 58.5%)with 108 isolated vertebral lesions visible on planar bone scintigraphy, who had undergone SPECT-CT of a:selected volume, were retrospectively analyzed:Planar scintigraphy, SPECT, CT, and SPECT-CT images were independently evaluated in-separate sessions to minimize recall bias. A storing scale of 1,to 5 was used, with 1 being definitely metastatic, 2 most likely metastatic, <= 3 indeterminate, 4 most likely benign, and 5 definitely benign. Sensitivity, specificity, and predittive values Were calculated;:a score 3 was-defined as metastatic. The areas under the receiver operating characteristic:Curve were calculated and compared. Clinical and imaging follow-up with or without histopathology we-re used as a reference standard.
RESULTS
Among 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.

• 出版日期2013-2
• 单位河北医科大学