Added Value of SPECT/CT Fusion in Assessing Suspected Bone Metastasis: Comparison with Scintigraphy Alone and Nonfused Scintigraphy and CT

Utsunomiya, Daisuke; Shiraishi, Shinya; Imuta, Masanori; Tomiguchi, Seiji; Kawanaka, Koichi; Morishita, Shoji; Awai, Kazuo; Yamashita, Yasuyuki

doi:10.1148/radiol.2373041358

Cited by 226 publications

(134 citation statements)

References 29 publications

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“…In the absence of other pathology the foci of increased osteoblastic activity reflect areas of mechanical stress and degenerative change in the skeleton [9][10][11]. SPECT has been widely used to evaluate patients with spinal pain and facet joint arthropathy [12,13].…”

Section: Introductionmentioning

confidence: 99%

Is hybrid imaging (SPECT/CT) a useful adjunct in the management of suspected facet joints arthropathy?

Matar

Navalkissoor

Berovic

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to assess the value of SPECT/CT imaging in patients with chronic spinal pain. Methods This was a retrospective consecutive study. Patients with chronic neck or back pain from outpatient spinal clinics with clinical features raising the possibility of a facetogenic pain generator and non-conclusive MRI/CT findings were included. Imaging was performed on a dual-headed, hybrid SPECT/CT γ-camera with a low-dose CT transmission scan acquired after the SPECT study. SPECT/CT studies were viewed in the coronal, axial, and sagittal planes and in 3-dimensional mode. Descriptive statistical analysis was performed.Results Seventy-two patients were included (37 females, 35 males, mean age of 53.9 years). There were 25 cervical spine scans and 49 lumbar spine scans. In the cervical spine group, 13 (52 %) patients had scintigraphically active cervical facet joint arthropathy and ten (36 %) had other pathology identified. Two thirds of patients diagnosed with facet joint arthropathy received steroid guided injections following their scans. In the lumbar spine group 34 (69.4 %) patients had scintigraphically active lumbar facet joint arthropathy and eight had other pathology identified. Twenty patients (58.8 %) diagnosed with facet joint arthropathy subsequently received steroid guided injections. Conclusions Hybrid SPECT/CT imaging identified potential pain generators in 92 % of cervical spine scans and 86 % of lumbar spine scans. The scan precisely localised SPECT positive facet joint targets in 65 % of the referral population and a clinical decision to inject was made in 60 % of these cases.

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Section: Introductionmentioning

confidence: 99%

Is hybrid imaging (SPECT/CT) a useful adjunct in the management of suspected facet joints arthropathy?

Matar

Navalkissoor

Berovic

et al. 2013

International Orthopaedics (SICOT)

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“…This inevitably leads to extra cost, heightened concern and frequent delays in management. Where available, specificity (and to a lesser extent sensitivity) has been greatly improved with the use of single photon emission computed tomography (SPECT)/CT [1][2][3], but can be further significantly improved with the use of 18 F-fluoride positron emission tomography (PET)/CT [4][5][6]. Further, 18 F-fluoride can on occasion identify early metastatic lesions at a time when the bone scan is normal [7][8][9][10].…”

mentioning

confidence: 99%

The isotope bone scan: we can do better

Fogelman

Blake

Cook

2013

Eur J Nucl Med Mol Imaging

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“…26,27 Bone scintigraphy is not routinely necessary in investigating Pancoast tumors. Bone pain is the most common reason for performing WBBS, 28,29 which may precede the diagnosis of metastasis.…”

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confidence: 99%

Bone single photon emission computed tomography (SPECT) in a patient with Pancoast tumor: a case report

et al. 2010

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CONTEXT: Non-small cell lung carcinomas (NSCLCs) of the superior sulcus are considered to be the most challenging type of malignant thoracic disease. In this disease, neoplasms originating mostly from the extreme apex of the lung expand to the chest wall and thoracic inlet structures.Multiple imaging procedures have been applied to identify tumors and to stage and predict tumor resectability in surgical operations. Clinical examinations to localize pain complaints in shoulders and down the arms, and to screen for Horner's syndrome and abnormalities seen in paraclinical assessments, have been applied extensively for differential diagnosis of superior sulcus tumors. Although several types of imaging have been utilized for diagnosing and staging Pancoast tumors, there have been almost no reports on the efficiency of whole-body bone scans (WBBS) for detecting the level of abnormality in cases of superior sulcus tumors. CASE REPORT:We describe a case of Pancoast tumor in which technetium-99m methylene diphosphonate (Tc-99m MDP) bone single-photon emission-computed tomography (SPECT) was able to accurately detect multiple areas of abnormality in the vertebrae and ribs. In describing this case, we stress the clinical and diagnostic points, in the hope of stimulating a higher degree of suspicion and thereby facilitating appropriate diagnosis and treatment. From the results of this study, further clinical trials to evaluate the potential of SPECT as an efficient imaging tool for the work-up on cases of Pancoast tumor are recommended. RESUMOCONTEXTO: Carcinomas pulmonares de células não pequenas (NSCLCs) do sulco superior são considerados como o maior desafio nos tumores malignos torácicos. Nesta doença, as neoplasias se originam principalmente do ápice do pulmão e se expandem pela parede e pelas estruturas torácicas. Diversas técnicas de imagem têm sido utilizadas para identificar e estagiar os tumores, permitindo um prognóstico para a sua ressecção em procedimentos cirúrgicos. O exame clínico tem sido bastante usado para diagnóstico diferencial de tumores do sulco superior nas queixas de dores no ombro, síndrome de Horner e anormalidades observadas em exames paraclínicos. Embora diversos tipos de exames de imagem sejam utilizados para diagnóstico e estadiamento de tumores de Pancoast, praticamente não existem relatos sobre a eficácia do exame ósseo do corpo todo (WBBS) na detecção do nível de anormalidade em casos de tumores do sulco superior. RELATO DE CASO:Descrevemos um caso de tumor de Pancoast, em que foi realizada a tomografia computadorizada óssea por emissão de fóton único (SPECT) com metileno difosfonato de tecnécio-99 (Tc-99m MDP). Este exame foi capaz de detectar com acurácia as múltiplas áreas de anormalidade em vértebras e costelas. Ao descrever este caso, os autores ressaltam os pontos clínicos e diagnósticos, esperando estimular maior grau de suspeita, facilitando assim o diagnóstico e tratamento apropriados. A partir dos resultados deste trabalho, outros estudos clínicos podem avaliar o potencial...

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Added Value of SPECT/CT Fusion in Assessing Suspected Bone Metastasis: Comparison with Scintigraphy Alone and Nonfused Scintigraphy and CT

Abstract: Results demonstrate the increased diagnostic confidence obtained with fused SPECT/CT images compared with separate sets of scintigraphic and CT images in differentiating malignant from benign bone lesions.

Cited by 226 publications

References 29 publications

Is hybrid imaging (SPECT/CT) a useful adjunct in the management of suspected facet joints arthropathy?

Is hybrid imaging (SPECT/CT) a useful adjunct in the management of suspected facet joints arthropathy?

The isotope bone scan: we can do better

Bone single photon emission computed tomography (SPECT) in a patient with Pancoast tumor: a case report

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