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Added value of SPECT/spiral CT versus SPECT in diagnosing solitary spinal lesions in patients with extraskeletal malignancies.
MedLine Citation:
PMID:  23442544     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The aim of this study was to investigate the added value of single-photon emission computed tomography (SPECT)/spiral computed tomography (CT) versus SPECT alone in the differential diagnosis of solitary spinal lesions in patients with extraskeletal malignancies. MATERIALS AND METHODS: A total of 90 patients who had a solitary spine 'hot spot' that could not be definitively diagnosed using planar scintigraphy were enrolled in the study. SPECT/spiral CT was performed on the indeterminate lesions in the spine. Images were independently interpreted by two experienced nuclear medicine physicians. Each spinal lesion was graded on a four-point diagnostic scale (1, benign; 2, likely benign; 3, likely bone metastasis; 4, bone metastasis). The final diagnosis of each lesion was based on pathological confirmation or follow-up. κ scores were used to evaluate inter-reviewer agreement and agreement of the SPECT and SPECT/spiral CT diagnoses with the final diagnosis. RESULTS: Final diagnoses revealed 25 bone metastases and 65 benign lesions. Forty percent (36/90) of the solitary spinal lesions were diagnosed as equivocal (likely benign or likely bone metastasis) according to SPECT, whereas only 5.6% (5/90) were diagnosed as equivocal according to SPECT/spiral CT. For SPECT/spiral CT-based and SPECT-based diagnoses, the κ scores for inter-reviewer agreement were 0.889 (P<0.001, 95% confidence interval 0.824-0.954) and 0.504 (P<0.001, 95% confidence interval 0.401-0.607). The diagnostic accuracies of SPECT/spiral CT and SPECT images were 91.1% (82/90) and 58.9% (53/90), respectively (χ=24.919, P<0.001). CONCLUSION: Compared with SPECT imaging alone, SPECT/spiral CT imaging was more accurate and valuable in the differential diagnosis of solitary spinal lesions in patients with extraskeletal malignancies.
Authors:
Yiqiu Zhang; Hongcheng Shi; Dengfeng Cheng; Lei Jiang; Yan Xiu; Beilei Li; Yushen Gu; Shuguang Chen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-25
Journal Detail:
Title:  Nuclear medicine communications     Volume:  -     ISSN:  1473-5628     ISO Abbreviation:  Nucl Med Commun     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aDepartment of Nuclear Medicine, Zhongshan Hospital bNuclear Medicine Institute, Fudan University cShanghai Institute of Medical Imaging, Shanghai, China.
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