Document Detail


Clinical Utility of SPECT-(Low-Dose)CT Versus SPECT Alone in Patients Presenting for Bone Scintigraphy.
MedLine Citation:
PMID:  22157024     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: : This prospective study evaluated the contribution of single-photon emission computed tomography (SPECT)-(low-dose)CT (SPECT-ldCT) over SPECT alone in all-comers referred for bone scintigraphy for any indication.
METHODS: : In this prospective study, imaging was performed on 100 consecutive patients who presented for bone scintigraphy using a combined SPECT-ldCT single-gantry system (Brightview XCT, Philips Medical Systems Inc., Cleveland, OH). SPECT images were reconstructed with (AC) and without (NAC) attenuation and scatter correction. SPECT (NAC), SPECT-ldCT (NAC), and SPECT-ldCT (AC) were reviewed independently and in a blinded manner. Reader interpretation of images was compared with the final clinical diagnosis.
RESULTS: : Subjects were referred for oncologic (28%) and nononcologic (72%) indications. Attenuation correction significantly improved perceived image quality (P = 0.012), but did not significantly alter diagnostic confidence (P = 0.96). Availability of ldCT data during interpretation of the SPECT images yielded a significant increase in the level of diagnostic confidence (P < 0.001). When the ldCT data were available, 18 of 200 bone SPECT reads recommended additional diagnostic CT imaging, compared with 70 when ldCT data were unavailable at the time of reading (P < 0.001). The sensitivity, specificity, and accuracy of SPECT-ldCT (with or without attenuation and scatter correction) in the diagnosis of osseous processes were 90.9%, 85.9%, and 87.0%, respectively, and these values did not differ significantly from those obtained with SPECT alone.
CONCLUSIONS: : Bone SPECT-ldCT provides interpreting physicians a significantly greater level of diagnostic confidence and reduces additional diagnostic imaging studies, but the overall diagnostic accuracy of SPECT-ldCT was not affected when compared with SPECT alone, suggesting that SPECT-ldCT should be used on a patient-by-patient basis.
Authors:
Benjamin L Franc; Richard Myers; Thomas R Pounds; George Bolton; Frederic Conte; Margo Bartheld; Angela J Da Silva
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  37     ISSN:  1536-0229     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  26-34     Citation Subset:  IM    
Affiliation:
From the *Division of Nuclear Medicine, Radiological Associates of Sacramento, Sacramento, CA; †Department of Radiology, University of California, San Francisco, CA; and ‡Philips Healthcare, San Jose, CA.
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