A multicentre simulation study of planar whole-body bone scintigraphy in Sweden

Abstract

Background Whole-body bone scintigraphy is a clinically useful non-invasive and highly sensitive imaging method enabling detection of metabolic changes at an early stage of disease, often earlier than with conventional radiologic procedures. Bone scintigraphy is one of the most common nuclear medicine methods used worldwide. Therefore, it is important that the examination is implemented and performed in an optimal manner giving the patient added value in the subsequent care process. The aim of this national multicentre survey was to investigate Swedish nuclear medicine departments compliance with European practice guidelines for bone scintigraphy. In addition, the effect of image acquisition parameters on the ability to detect metabolic lesions was investigated. Methods Twenty-five hospital sites participated in the study. The SIMIND Monte Carlo (MC) simulation and the XCAT phantom were used to simulate ten fictive patient cases with increased metabolic activity distributed at ten different locations in the skeleton. The intensity of the metabolic activity was set into six different levels. Individual simulations were performed for each site, corresponding to their specific camera system and acquisition parameters. Simulated image data sets were then sent to each site and were visually evaluated in terms of if there was one or several locations with increased metabolic activity relative to normal activity. Result There is a high compliance in Sweden with the EANM guidelines regarding image acquisition parameters for whole-body bone scintigraphy. However, up to 40% of the participating sites acquire lower count density in the images than recommended. Despite this, the image quality was adequate to maintain a stable detection level. None of the hospital sites or individual responders deviated according to the statistical analysis. There is a need for at least 2.5 times metabolic activity compared to normal for a lesion to be detected. Conclusion The imaging process is well harmonized throughout the country and there is a high compliance with the EANM guidelines. There is a need for at least 2.5 times the normal metabolic activity for a lesion to be detected as abnormal.

Evaluation of radiomics in improving the diagnostic efficacy of whole body 99m Tc-MDP bone scintigraphy

“…99m Tc methylene diphosphonate ( 99m Tc-MDP) bone scintigraphy has been widely used to detect bone metastases (BMS) of malignant tumors, and can evaluate the therapeutic effect. With the increasing incidence of breast cancer, prostate cancer, lung cancer and other tumors in China year by year, the demand for bone imaging has also increased [4] . According to the national census report of nuclear medicine in China, bone imaging ranked rst in the total number of single photon examinations in 2019, accounting for 63.1%.…”