Enhanced diagnostic value of 99Tcm-MDP SPECT/CT in patients with spinal bone malignancy
10.3760/cma.j.issn.0253-9780.2011.03.005
- VernacularTitle:99Tcm-MDP SPECT/CT骨显像对脊柱良恶性病变的鉴别诊断
- Author:
Yi-qiu, ZHANG
;
Hong-cheng, SHI
;
Yu-shen, GU
;
Yan, XIU
;
Bei-lei, LI
;
Wei-min, ZHU
;
Shu-guang, CHEN
;
Hao-jun, YU
- Publication Type:Journal Article
- Keywords:
Spinal diseases;
Diagnosis,differential;
Tomography,emission-computed,single-photon;
Tomography,X-ray computed;
MDP
- From:Chinese Journal of Nuclear Medicine
2011;31(3):164-168
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the additional diagnostic value of 99Tcm-MDP SPECT/CT over conventional SPECT scan in patients with spinal bone malignancy. Methods Fifty-two patients (mean age (56±14) years) with suspicious spinal bone diseases underwent both bone SPECT and SPECT/CT imaging right after 99Tcm-MDP whole-body planar bone scintigraphy. All patients were pathologically diagnosed by either spine operation or trans-spinal biopsy. The images were evaluated by two independent reviewers; inter-reviewer agreement was evaluated using a weighted Kappa score. Each focus of abnormality was recorded using a 4-point diagnostic confidence scale: benign (B), possibly benign (PB), possibly malignant (PM) or malignant (M). Results Accord to the pathological results, 36 patients had bone malignancy (19 with metastatic tumors and 17 with non-metastatic tumors) and 16 had benign lesions. Over SPECT images, two reviewers rated 73.1% (38/52) and 67.3% (35/52) the lesions as the equivocal (PB or PM) respectively. Over SPECT/CT images, they rated only 25.0% (13/52) and 13.5% (7/52) lesions as the equivocal. Inter-reviewer agreement was 63.5% (weighted Kappa score=0.62) for SPECT and 78.9% (weighted Kappa score=0.81) for SPECT/CT. Conclusions Compared with99Tcm-MDP SPECT, 99Tcm-MDP SPECT/CT results in a significant reduction of equivocal diagnoses for the spinal bone malignancy.
