SPECT/CT fusion imaging analysis of costal single hot spots in patients with lung cancer

Abstract

Objective To analyze the imaging features and clinical significance of solitary costal hot spots in patient with lung cancer on SPECT/CT fusion imaging and the value of low-dose CT for diagnosis.Methods SPECT/CT scan was performed on 68 patients with lung cancer and costal single hot spots using whole body bone imaging.The sites of lesions were classified into four types:junction between costal cartilage and rib,frontal rib,lateral rib,posterior rib.The shapes of lesions were classified into two forms:punctiform and strip shapes,and were analyzed and classified.The differences of the diagnosis of whole body bone imaging and SPECT/CT scan were analyzed.Results Punctiform spots were mainly due to costal fractures(36/68,52.94％).The majority of spots in strip shape were costal metastases (21/23,91.30％).The lesions of junction between costal cartilage and rib were punctiform shape and benign.Hot spots in posterior ribs were mainly costal metastases (18/22,81.82％).Sensitivity of diagnosis of the metastatic bone tumor with whole body bone imaging and SPECT/CT in single hot spot of spine and rib was 69.23％ (18/26) and 92.31％(24/26),specificity 59.52％(25/42) and 85.71％(36/42),accuracy 63.24％(43/68) and 88.24％ (60/68),positive predictive value 51.43％ (18/35) and 80.00％ (24/30),negative predictive value 75.76％ (25/33) and 94.74％ (36/38).SPECT/CT scan had differences with whole body bone imaging in sensitivity (P ＜ 0.05),SPECT/CT scan had significant differences with whole body bone imaging in coincidence and specificity (P ＜ 0.01).Conclusions Useful imaging features can be obtained from SPECT/CT fusion imaging with single costal hot spots,being helpful to differential diagnosis of benign and malignant lesions.SPECT/CT fusion imaging may improve the accuracy to diagnose the rib disease. Key words: Pulmonary neoplasm; Ribs ; Tomography; Emission-computed ; Single-photon