Clinical Utility of SPECT-(Low-Dose)CT Versus SPECT Alone in Patients Presenting for Bone Scintigraphy

Abstract

Bone SPECT-ldCT provides interpreting physicians a significantly greater level of diagnostic confidence and reduces additional diagnostic imaging studies, but the overall diagnostic accuracy of SPECT-ldCT was not affected when compared with SPECT alone, suggesting that SPECT-ldCT should be used on a patient-by-patient basis.

Single photon emission computed tomography (SPECT) and SPECT/low‐dose computerized tomography did not increase sensitivity or specificity compared to planar bone scintigraphy for detection of bone metastases in advanced breast cancer

“…However, in the present study, SPECT/ld CT did not increase specificity demonstrating that improving the anatomical localization of scintigraphic findings was insufficient to distinguish benign from malignant bone changes in this population. Our findings are in accordance with results from a prospective study including 100 oncologic and non-oncologic patients where SPECT/ldCT did not increase specificity compared to SPECT alone (Franc et al, 2012), but contrary to studies on mixed populations (Gates, 1998;Costelloe et al, 2009;Palmedo et al, 2014). The discrepancy between our data and the other studies may be explained by significant differences in study design.…”

“…Nevertheless, we found that SPECT and SPECT/ldCT reduced the number of reader defined inconclusive studies compared to WBS. This is in line with results from previous retrospective and prospective studies in mixed patient populations suggesting that the improved focal visualization and anatomical localization in SPECT and SPECT/ldCT leads to a greater level of observer confidence (Romer et al ., ; Franc et al ., ) .…”

Extraosseous Findings on Bone Scintigraphy Using Fusion SPECT/CT and Correlative Imaging

“…There is growing evidence in the literature that SPECT/CT applied to bone scintigraphy improves diagnostic performance, primarily by increasing specificity by better distinguishing between benign and malignant processes [38][39][40][41][42][43][44]. Jiang and colleagues [45] independently reviewed SPECT and SPECT/CT images obtained of 48 patients with indeterminate spinal lesions without a history of malignancy and reported that SPECT/CT had better diagnostic accuracy (79.2% vs 70.8%), specificity (50.0% vs 33.3%), positive predictive value (76.3% vs 70.0%), and negative predictive value (90.0% vs 75.0%) than did SPECT.…”

Novel SPECT Technologies and Approaches in Cardiac Imaging

“…An integrated attenuation correction system with an effective dose of 5 μSv has been implemented, in which photons from an X-ray source are detected by solid-state detectors with a fan beam collimator operating in high counting rate mode [9]. Another example of new attenuation correction technology is a flat panel X-ray detector system that provides low-dose (0.12 mSv) CT images that can be used for attenuation correction of SPECT images [10]. Although, not geared exclusively toward nuclear cardiology, this system can be used for low-dose attenuation correction in myocardial perfusion studies.…”