Abstract
BackgroundxSPECT Bone® (xB) is a new reconstruction algorithm developed by Siemens® in bone hybrid imaging (SPECT/CT). A CT-based tissue segmentation is incorporated into SPECT reconstruction to provide SPECT images with bone anatomy appearance. The objectives of this study were to assess xB/CT reconstruction diagnostic reliability and accuracy in comparison with Flash 3D® (F3D)/CT in clinical routine. Two hundred thirteen consecutive patients referred to the Brest Nuclear Medicine Department for non-oncological bone diseases were evaluated retrospectively. Two hundred seven SPECT/CT were included. All SPECT/CT were independently interpreted by two nuclear medicine physicians (a junior and a senior expert) with xB/CT then with F3D/CT three months later. Inter-observer agreement (IOA) and diagnostic confidence were determined using McNemar test, and unweighted Kappa coefficient. The study objectives were then re-assessed for validation through > 18 months of clinical and paraclinical follow-up.ResultsNo statistically significant differences between IOA xB and IOA F3D were found (p = 0.532). Agreement for xB after categorical classification of the diagnoses was high (κxB = 0.89 [95% CI 0.84 –0.93]) but without statistically significant difference F3D (κ F3D = 0.90 [95% CI 0.86 – 0.94]). Thirty-one (14.9%) inter-reconstruction diagnostic discrepancies were observed of which 21 (10.1%) were classified as major. The follow-up confirmed the diagnosis of F3D in 10 cases, xB in 6 cases and was non-contributory in 5 cases.ConclusionsxB reconstruction algorithm was found reliable, providing high interobserver agreement and similar diagnostic confidence to F3D reconstruction in clinical routine.
Highlights
XSPECT Bone® is a new reconstruction algorithm developed by Siemens® in bone hybrid imaging (SPECT/computed tomography (CT))
Background xSPECT Bone® is a new iterative reconstruction algorithm developed by Siemens® for bone single photon emission computed tomography (SPECT)
Seven patients were excluded (four due to a poor image fusion between SPECT and CT related to important movements, one for whom the SPECT/CT was not retrieved from PACS, another for whom the field of view of the CT was too small, and one who declined to participate in the study)
Summary
XSPECT Bone® (xB) is a new reconstruction algorithm developed by Siemens® in bone hybrid imaging (SPECT/CT). Its originality consists of constraining counts in computed tomography (CT) based on bone segmentation (Fig. 1) and providing a quantitative reconstruction [1, 2]. This innovation, like the progress of image acquisition and reconstruction, could convey a higher diagnostic confidence through an enhanced bone uptake location. Studies have reported early planar images with good sensitivity yet poor specificity The latter was improved when using SPECT reconstructions with negative predictive value while maintaining an excellent sensitivity [3,4,5].
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