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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

医学 核医学 单光子发射计算机断层摄影术 乳腺癌 骨闪烁照相术 放射科 发射计算机断层扫描 Spect成像 断层摄影术 正电子发射断层摄影术 癌症 内科学
作者
Ate Haraldsen,Henrik Bluhme,Lisbeth Røhl,Erik Morre Pedersen,Anders Bonde Jensen,Eva Boysen Hansen,Hanne Nellemann,Finn Rasmussen,Anni Morsing
出处
期刊:Clinical Physiology and Functional Imaging [Wiley]
卷期号:36 (1): 40-46 被引量:12
标识
DOI:10.1111/cpf.12191
摘要

To evaluate and compare the diagnostic performance of whole-body planar bone scintigraphy (WBS), single photon emission computed tomography (SPECT), SPECT/low-dose computerized tomography (SPECT/ldCT) and SPECT/contrast enhanced diagnostic CT (SPECT/cdCT) in the staging of patients with advanced breast cancer.Seventy-eight patients with recurrence of biopsy-proven breast cancer and suspicion of disseminated disease were investigated with WBS, SPECT, SPECT/ldCT, SPECT/cdCT and MRI performed on the same day in this prospective study. Images were separately analysed in a blinded fashion by radiologists and nuclear medicine physicians regarding the presence of pathological findings. MRI served as reference standard.According to reference standard, 38 of 73 patients had bone metastases. The sensitivity was 87%, 87%, 79%, and 84% and specificity 63%, 71%, 63% and 83% for WBS, SPECT, SPECT/ldCT and SPECT/cdCT. A significantly increased specificity of SPECT/cdCT compared to WBS and SPECT/ldCT was found, and other parameters did not differ significantly between modalities. Additional two patients had bone metastases solely located outside the MRI scan field and seven patients had soft tissue metastases, but no skeletal changes on MRI.WBS, SPECT and SPECT/ldCT were less sensitive than MRI and equally specific for the detection of bone metastases in patients with advanced breast cancer. Based on our findings, we suggest that initial staging include WBS, MRI of the spine and CT for soft tissue evaluation. Further studies may clarify the potential benefits of whole-body MRI and 18F-NaF PET/CT or 18F-FDG PET/CT.
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