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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

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@article{a6c9922201514c27a71c382339f33399,
title = "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",
abstract = "PURPOSE: 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.METHODS: 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.RESULTS: 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.CONCLUSION: 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.",
author = "Ate Haraldsen and Henrik Bluhme and Lisbeth R{\o}hl and Pedersen, {Erik Morre} and Jensen, {Anders Bonde} and Hansen, {Eva Boysen} and Hanne Nellemann and Finn Rasmussen and Anni Morsing",
note = "{\textcopyright} 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.",
year = "2016",
month = jan,
doi = "10.1111/cpf.12191",
language = "English",
journal = "Clinical Physiology and Functional Imaging",
issn = "1475-0961",
publisher = "Wiley-Blackwell Publishing Ltd.",

}

RIS

TY - JOUR

T1 - 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

AU - Haraldsen, Ate

AU - Bluhme, Henrik

AU - Røhl, Lisbeth

AU - Pedersen, Erik Morre

AU - Jensen, Anders Bonde

AU - Hansen, Eva Boysen

AU - Nellemann, Hanne

AU - Rasmussen, Finn

AU - Morsing, Anni

N1 - © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

PY - 2016/1

Y1 - 2016/1

N2 - PURPOSE: 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.METHODS: 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.RESULTS: 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.CONCLUSION: 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.

AB - PURPOSE: 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.METHODS: 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.RESULTS: 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.CONCLUSION: 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.

U2 - 10.1111/cpf.12191

DO - 10.1111/cpf.12191

M3 - Journal article

C2 - 25257661

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

SN - 1475-0961

ER -