The added value of multislice SPECT/CT in patients with equivocal bony metastasis from carcinoma of the prostate

Helyar, Vincent; Mohan, Hosahalli; Barwick, Tara; Livieratos, Lefteris; Gnanasegaran, Gopinath; Clarke, S. E.M.; Fogelman, Ignac

doi:10.1007/s00259-009-1334-3

Cited by 163 publications

(118 citation statements)

References 13 publications

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“…Conventional planar bone scintigraphy (pBS) with 99m Tc-labeled radiopharmaceuticals, such as hydroxyethylene-diphosphonate ( 99m Tc-HDP), is still the most frequently used modality for diagnosing bone metastases (3). Studies have shown that adding SPECT/CT to pBS improves the specificity and positive predictive value (PPV) as well as the diagnostic confidence of the reader, thereby reducing the number of equivocal study reports (4,5). 18 F-sodium fluoride ( 18 F-NaF) was introduced in 1962 by Blau et al (6).…”

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A Prospective Study Comparing ^99mTc-Hydroxyethylene-Diphosphonate Planar Bone Scintigraphy and Whole-Body SPECT/CT with ¹⁸F-Fluoride PET/CT and ¹⁸F-Fluoride PET/MRI for Diagnosing Bone Metastases

et al. 2017

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See an invited perspective on this article on page 1776.We prospectively evaluated and compared the diagnostic performance of 99m Tc-hydroxyethylene-diphosphonate ( 99m Tc-HDP) planar bone scintigraphy (pBS), 99m Tc-HDP SPECT/CT, 18 F-NaF PET/CT, and 18 F-NaF PET/MRI for the detection of bone metastases. Methods: One hundred seventeen patients with histologically proven malignancy referred for clinical pBS were prospectively enrolled. pBS and whole-body SPECT/CT were performed followed by 18 F-NaF PET/CT within 9 d. 18 F-NaF PET/MRI was also performed in 46 patients. Results: Bone metastases were confirmed in 16 patients and excluded in 101, which was lower than expected. The number of equivocal scans was significantly higher for pBS than for SPECT/CT and PET/CT (18 vs. 5 and 6, respectively; P 5 0.004 and 0.01, respectively). When equivocal readings were excluded, no statistically significant difference in sensitivity, specificity, positive predictive value, negative predictive value, or overall accuracy were found when comparing the different imaging techniques. In the per-patient analysis, equivocal scans were either assumed positive for metastases ("pessimistic analysis") or assumed negative for metastases ("optimistic analysis"). The percentages of misdiagnosed patients for the pessimistic analysis were 21%, 15%, 9%, and 7% for pBS, SPECT/CT, PET/CT, and PET/MRI, respectively. Corresponding figures for the optimistic analysis were 9%, 12%, 5%, and 7%. In those patients identified as having bone metastases according to the reference standard, SPECT/CT, 18 F-NaF PET/CT, and PET/MRI detected additional lesions compared with pBS in 31%, 63%, and 71%, respectively. Conclusion: 18 F-NaF PET/CT and whole-body SPECT/CT resulted in a significant reduction of equivocal readings compared with pBS, which implies an improved diagnostic confidence. However, the clinical benefit of using, for example, 18 F-NaF PET/CT or PET/MRI as compared with SPECT/CT and pBS in this patient population with a relatively low prevalence of bone metastases (14%) is likely limited. This conclusion is influenced by the low prevalence of patients with osseous metastases. There may well be significant differences in the sensitivity of SPECT/CT, PET/CT, and PET/MRI compared with pBS, but a larger patient population or a patient population with a higher prevalence of bone metastases would have to be studied to demonstrate this.

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A Prospective Study Comparing ^99mTc-Hydroxyethylene-Diphosphonate Planar Bone Scintigraphy and Whole-Body SPECT/CT with ¹⁸F-Fluoride PET/CT and ¹⁸F-Fluoride PET/MRI for Diagnosing Bone Metastases

et al. 2017

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“…Una de las mayores ventajas del gammagrama óseo es que requiere un mínimo del 5% de tasa de recambio óseo para poder detectar una lesión, mientras que los estudios anatómicos como la radiografía requieren un mínimo del 40-50% de dicho recambio para la visualización. Tiene una elevada sensibilidad para la detección de metástasis óseas (llega a ser hasta del 96.9%) 10 ; la mayor desventaja de dicho estudio es su baja especificidad, que puede variar del 41 al 57% 10,11 . Por tal motivo, los equipos híbridos (tomografía por emisión de fotón simple con tomografía computarizada [SPECT/CT]) permiten mejorar dicha especificidad, al fusionar los hallazgos con un estudio tomográfico, logrando una especificidad de hasta el 82%11 (Fig.…”

Section: Metilendifosfonatounclassified

Radiotrazadores empleados en medicina nuclear para el diagnóstico y seguimiento del cáncer de próstata

García-Pérez¹,

Medina-Ornelas²

2022

GAMO

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Resumen El cáncer de próstata (CP) es la causa más común de cáncer en hombres a nivel mundial. Actualmente, la imagen en el CP ha tomado una gran importancia para la estadificación, reestadificación, selección del tratamiento y evaluación de la recurrencia. La imagen molecular con tomografía por emisión de positrones (PET) ha permitido un enfoque personalizado para estos propósitos. Además de estas necesidades clínicas, existe una creciente visión y reto para las nuevas técnicas de imagen molecular, no sólo para detectar la enfermedad metastásica, sino también para proporcionar información importante acerca de la biología tumoral, el pronóstico y, uno de los retos más grandes de las técnicas de imagen no radioisotópicas, la detección de recurrencia en pacientes con niveles bajos de antígeno prostático específico (APE). (creativecommons.org/licenses/by-nc-nd/4.0/). ARTÍCULO DE REVISIÓNRadiotrazadores empleados en medicina nuclear para el diagnóstico y seguimiento del cáncer de próstata

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“…This feature provides elevated sensitivity for the detection of bone metastases, which can be as high as 96.9% 10 . However, the greatest disadvantage of this study is its low specificity, which can range from 41 to 57% 10,11 . For this reason, hybrid equipment (SPECT/CT) allows for such specificity to be improved by merging the findings with a CT study, with up to 82% specificity being attained (Fig.…”

Section: Radiotracers Used For Scintigraphy Plus Spect/ct 99mtc-mdpmentioning

confidence: 99%

Radiotracers Used in Nuclear Medicine for Prostate Cancer Diagnosis and Follow-Up

García-Pérez¹,

Medina-Ornelas²

2022

GAMO

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Prostate cancer is the most common cause of cancer in males worldwide. Currently, imaging in prostate cancer has acquired great importance in staging, re-staging, treatment selection, and recurrence assessment. Molecular imaging with positron-emission tomography has enabled a personalized approach for these purposes. In addition to these clinical needs, there are growing perspectives and a challenge for new molecular imaging techniques, not only to detect metastatic disease, but also to provide relevant information on tumor biology and prognosis, and one of the greatest challenges for non-radioisotope imaging techniques is the ability to detect recurrence in patients with low levels of prostate-specific antigen. (creativecommons.org/licenses/by-nc-nd/4.0/).

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The added value of multislice SPECT/CT in patients with equivocal bony metastasis from carcinoma of the prostate

Cited by 163 publications

References 13 publications

A Prospective Study Comparing ^99mTc-Hydroxyethylene-Diphosphonate Planar Bone Scintigraphy and Whole-Body SPECT/CT with ¹⁸F-Fluoride PET/CT and ¹⁸F-Fluoride PET/MRI for Diagnosing Bone Metastases

A Prospective Study Comparing ^99mTc-Hydroxyethylene-Diphosphonate Planar Bone Scintigraphy and Whole-Body SPECT/CT with ¹⁸F-Fluoride PET/CT and ¹⁸F-Fluoride PET/MRI for Diagnosing Bone Metastases

Radiotrazadores empleados en medicina nuclear para el diagnóstico y seguimiento del cáncer de próstata

Radiotracers Used in Nuclear Medicine for Prostate Cancer Diagnosis and Follow-Up

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The added value of multislice SPECT/CT in patients with equivocal bony metastasis from carcinoma of the prostate

Cited by 163 publications

References 13 publications

A Prospective Study Comparing 99mTc-Hydroxyethylene-Diphosphonate Planar Bone Scintigraphy and Whole-Body SPECT/CT with 18F-Fluoride PET/CT and 18F-Fluoride PET/MRI for Diagnosing Bone Metastases

A Prospective Study Comparing 99mTc-Hydroxyethylene-Diphosphonate Planar Bone Scintigraphy and Whole-Body SPECT/CT with 18F-Fluoride PET/CT and 18F-Fluoride PET/MRI for Diagnosing Bone Metastases

Radiotrazadores empleados en medicina nuclear para el diagnóstico y seguimiento del cáncer de próstata

Radiotracers Used in Nuclear Medicine for Prostate Cancer Diagnosis and Follow-Up

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A Prospective Study Comparing ^99mTc-Hydroxyethylene-Diphosphonate Planar Bone Scintigraphy and Whole-Body SPECT/CT with ¹⁸F-Fluoride PET/CT and ¹⁸F-Fluoride PET/MRI for Diagnosing Bone Metastases

A Prospective Study Comparing ^99mTc-Hydroxyethylene-Diphosphonate Planar Bone Scintigraphy and Whole-Body SPECT/CT with ¹⁸F-Fluoride PET/CT and ¹⁸F-Fluoride PET/MRI for Diagnosing Bone Metastases