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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
Author(s) -
Haraldsen Ate,
Bluhme Henrik,
Røhl Lisbeth,
Pedersen Erik Morre,
Jensen Anders Bonde,
Hansen Eva Boysen,
Nellemann Hanne,
Rasmussen Finn,
Morsing Anni
Publication year - 2016
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/cpf.12191
Subject(s) - medicine , nuclear medicine , single photon emission computed tomography , breast cancer , bone scintigraphy , radiology , emission computed tomography , spect imaging , tomography , positron emission tomography , cancer
Summary 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 /ld CT ) and SPECT /contrast enhanced diagnostic CT ( SPECT /cd CT ) 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 /ld CT , SPECT /cd CT 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 /ld CT and SPECT /cd CT . A significantly increased specificity of SPECT /cd CT compared to WBS and SPECT /ld CT 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 /ld CT 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.