Abstract
BackgroundThe aim of this study is to assess whether ultra-fast acquisition SPECT/CT (UF-SPECT/CT) can replace standard SPECT/CT (std-SPECT/CT) as “add-on” to whole-body bone scintigraphy (WB-BS) for the investigation of bone metastases.Consecutive cancer patients referred for WB-BS who underwent SPECT/CT in addition to WB-BS were included. Std-SPECT, UF-SPECT, and low-dose CT were performed (std-SPECT: matrix 128 × 128, zoom factor 1, 20 s/view, 32 views; UF-SPECT: identical parameters except for 10 s/view and 16 views, reducing the acquisition time from 11 to 3 min). A consensus diagnosis was reached by two observers for each set of images (WB-BS + standard SPECT/CT or WB-BS + UF-SPECT/CT) using a three-category evaluation scale: M0: no bone metastases; M1: bone metastases; and Me: equivocal findings.ResultsAmong the 104 included patients, most presented with prostate cancer (n = 71) or breast cancer (n = 28). Using WB-BS + std-SPECT/CT, 71 (68%) patients were classified as M0, 19 (18%) as M1, and 14 (14%) as Me. Excellent agreement was observed between WB-BS + std-SPECT/CT and WB-BS + UF-SPECT/CT using the three-category scale: kappa = 0.91 (95% CI 0.84–0.97). No difference in observer agreement between cancer types was detected. SPECT/CT provided a definitive classification in 90 of 104 cases in which WB-BS was not entirely diagnostic.ConclusionsTo investigate potential bone metastases, UF-SPECT/CT can be conducted as add-on to WB-BS to notably reduce the SPECT acquisition time without compromising diagnostic confidence.
Highlights
The aim of this study is to assess whether ultra-fast acquisition single-photon emission computed tomography (SPECT)/CT (UF-SPECT/CT) can replace standard SPECT/CT as “add-on” to whole-body bone scintigraphy (WB-BS) for the investigation of bone metastases
A total of 48 patients were referred for staging, 26 patients were referred due to bone-related pain, 18 patients were referred because biomarker (PSA or alkaline phosphate) findings indicated bone metastases, and 12 patients were referred for various other reasons
We investigated the use of UF-SPECT/CT as add-on to WBBS for confirming or excluding the presence of bone metastases in cancer patients, and we found excellent agreement between UF-SPECT/CT and std-SPECT/CT for this task
Summary
The aim of this study is to assess whether ultra-fast acquisition SPECT/CT (UF-SPECT/CT) can replace standard SPECT/CT (std-SPECT/CT) as “add-on” to whole-body bone scintigraphy (WB-BS) for the investigation of bone metastases. Several studies have reported improved diagnostic confidence when using SPECT/CT as an “add-on” to WB-BS in cases of equivocal or suspicious lesions, due to the increased specificity of SPECT/CT [4, 7,8,9,10]. SPECT/CT may improve diagnostic sensitivity [4]. A long acquisition time may be a challenge in terms of patient capacity and patient compliance; many patients with pain may find it difficult to lie still for 30– 40 min for two-bed SPECT/CT. A short acquisition time is technically attainable; the acquisition time should not be reduced at the cost of compromised diagnostic confidence
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