Protocol-driven multidetector SPECT/CT: integration of hybrid imaging into the routine workflow of whole-body bone scintigraphy in oncology patients.

Published on Jan 1, 2020in Clinical Radiology2.118
· DOI :10.1016/J.CRAD.2019.09.128
Pratik Adusumilli3
Estimated H-index: 3
(Leeds Teaching Hospitals NHS Trust),
P. Adusumilli (Leeds Teaching Hospitals NHS Trust)+ 5 AuthorsFahmid U. Chowdhury18
Estimated H-index: 18
(Leeds Teaching Hospitals NHS Trust)
AIM To analyse the additional clinical value of protocol-driven and selective use of multidetector single-photon-emission tomography/computed tomography (SPECT/CT) in oncology patients undergoing whole-body bone scintigraphy (BS) and to analyse reporter confidence in diagnosis with and without SPECT/CT. MATERIALS AND METHODS During a 1-year period, 2,954 whole-body BS examinations were performed in oncology patients, with 444 (15%) undergoing additional protocol-driven SPECT/CT. Retrospective evaluation of planar BS and SPECT/CT images was performed by two experienced dual-trained nuclear medicine radiologists. The BS and SPECT/CT images were graded blindly using a five-point scale designed to evaluate the likelihood of a lesion being benign or malignant. Interpretation was applied on a per-patient basis. RESULTS There was a 74.5% increase in definitive diagnostic classification and a 26.6% reduction in equivocal findings with SPECT/CT when compared to BS alone (p CONCLUSION Protocol-driven, selective use of SPECT/CT imaging to augment planar BS reduces equivocal findings and improves reporter confidence whilst minimising the impact on patient and reporting workflows.
📖 Papers frequently viewed together
6 Citations
17 Citations
The aim of this study was to evaluate the additive value of 99mtechnetium methylene diphosphonate (99mTc-MDP) hybrid single-photon emission computed tomography/computed tomography (SPECT-CT) in the diagnosis of skull base osteomyelitis (SBO) compared to planar bone scintigraphy (PBS). This was a single institution; prospective study included 23 patients with otitis externa, clinically suspected of SBO, all of them were diabetic. Three-phase bone scintigraphy and SPECT/CT were performed to all pa...
4 CitationsSource
#1Andrei Iagaru (Stanford University)H-Index: 37
#2Ryogo MinamimotoH-Index: 24
: Bone is the most common site of metastases from advanced breast cancer. Whole-body bone scintigraphy has been most frequently used in the process of managing cancer patients; its advantage is that it provides rapid whole-body imaging for screening of osteoblastic or sclerotic/mixed bone metastases at reasonable cost. Recent advanced techniques, such as single-photon emission computed tomography (SPECT)/CT, quantitative analysis, and bone scan index, contribute to better understanding of the di...
5 CitationsSource
#1Eleni MavriopoulouH-Index: 4
#2Petros Zampakis (University of Patras)H-Index: 9
Last. Dimitrios J. Apostolopoulos (Heidelberg University)H-Index: 2
view all 8 authors...
OBJECTIVE: Single photon emission tomography/computed tomography (SPET/CT) is usually recommended after ambiguous whole body bone scan (WBS) findings. We investigated the value of routine 2-field ("near" whole-body) SPET/CT application in breast cancer (BC) patients. SUBJECTS AND METHODS: In this prospective study planar WBS and 2-field SPET/CT was performed in 257 consecutive BC patients referred for a bone scan. Whole body scan and SPET/CT were interpreted separately. Additional imaging studie...
3 Citations
#1Olivier Rager (University of Geneva)H-Index: 15
#2Rene Nkoulou (University of Geneva)H-Index: 25
Last. Osman Ratib (University of Geneva)H-Index: 57
view all 10 authors...
Purpose. The use of SPECT/CT in bone scans has been widespread in recent years, but there are no specific guidelines concerning the optimal acquisition protocol. Two strategies have been proposed: targeted SPECT/CT for equivocal lesions detected on planar images or systematic whole-body SPECT/CT. Our aim was to compare the diagnostic accuracy of the two approaches. Methods. 212 consecutive patients with a history of cancer were referred for bone scans to detect bone metastases. Two experienced r...
18 CitationsSource
#1M. L. Waller (Leeds Teaching Hospitals NHS Trust)H-Index: 5
#2Fahmid U. Chowdhury (Leeds Teaching Hospitals NHS Trust)H-Index: 18
Abstract In the era of increasing utilization of cross-sectional imaging in orthopaedic patients with computed tomography (CT) and magnetic resonance imaging (MRI), nuclear medicine (NM) techniques continue to occupy a valuable role in the investigation of these patients. It can provide crucial functional information in a variety of clinical settings that are encountered regularly in orthopaedic practice. It is important that the orthopaedic surgeon is aware of the modalities on offer and apprec...
2 CitationsSource
#1Gerard J O’Sullivan (Mater Misericordiae University Hospital)H-Index: 1
#2Fiona L Carty (Mater Misericordiae University Hospital)H-Index: 1
Last. Carmel G. Cronin (Mater Misericordiae University Hospital)H-Index: 2
view all 3 authors...
Early detection of skeletal metastasis is critical for accurate staging and optimal treatment. This paper briefly reviews our current understanding of the biological mechanisms through which tumours metastasise to bone and describes the available imaging methods to diagnose bone metastasis and monitor response to treatment. Among the various imaging modalities currently available for imaging skeletal metastasis, hybrid techniques which fuse morphological and functional data are the most sensitiv...
104 CitationsSource
Today, SPECT/CT is increasingly used and available in the majority of larger nuclear medicine departments. Several applications of SPECT/CT as a supplement to or replacement for traditional conventional bone scintigraphy have been established in recent years. SPECT/CT of the upper and lower extremities is valuable in many conditions with abnormal bone turnover due to trauma, inflammation, infection, degeneration or tumour. SPECT/CT is often used in patients if conventional radiographs are insuff...
52 CitationsSource
#1Shouvik Saha (St Thomas' Hospital)H-Index: 3
Last. Gopinath GnanasegaranH-Index: 19
view all 5 authors...
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 the...
36 CitationsSource
#1Yiqiu ZhangH-Index: 10
#1Zhang Yiqiu (Ruijin Hospital)H-Index: 1
Last. Shu-guang ChenH-Index: 3
view all 8 authors...
PurposeThe aim of this study was to investigate the added value of single-photon emission computed tomography (SPECT)/spiral computed tomography (CT) versus SPECT alone in the differential diagnosis of solitary spinal lesions in patients with extraskeletal malignancies.Materials and methodsA total o
17 CitationsSource
#1Lei Jiang (Fudan University)H-Index: 180
#2Lei Han (Fudan University)H-Index: 3
Last. Hongcheng Shi (Fudan University)H-Index: 16
view all 6 authors...
Objective Metastases and benign conditions of spine are common, however, the diagnoses of imaging modalities in the nature of spinal lesions are difficult, especially for the solitary lesions in spine. This study aims to retrospectively evaluate the diagnostic value of single photon emission computed tomography (SPECT)/spiral computed tomography (CT) in assessing indeterminate spinal solitary lesion of patients without certain medical history of malignancies.
10 CitationsSource
Cited By0