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June Anita Ejlersen

Three-minute SPECT/CT is sufficient for the assessment of bone metastasis as add-on to planar bone scintigraphy: prospective head-to-head comparison to 11-min SPECT/CT

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  • Helle Damgaard Zacho, Aalborg University, Denmark
  • José A Biurrun Manresa, Centro de Investigaciones y Transferencia de Entre Ríos, CONICET-UNER, Entre Ríos, Argentina.
  • ,
  • Ramune Aleksyniene, Aalborg University
  • ,
  • June A Ejlersen
  • Joan Fledelius
  • Henrik Bertelsen, Aalborg University
  • ,
  • Lars J Petersen, Aalborg University, Department of Nuclear Medicine, Aalborg University Hospital, Hobrovej 18-22, Postboks 365, 9100, Aalborg, Denmark.

BACKGROUND: 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. 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.

RESULTS: Among 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.

CONCLUSIONS: To 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.

Original languageEnglish
JournalEJNMMI research
Pages (from-to)1
Publication statusPublished - Dec 2017

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