Résumé
Objetivo El objetivo del presente trabajo es evaluar el valor adicional del spect/ct sobre el Centellograma de Cuerpo Entero (cce) y la spect en pacientes con cáncer de mama con mínimo dos estudios: tiempo inicial (i) y evolución (e). Material y método Se evaluaron retrospectivamente 208 lesiones en 186 pacientes. Se realizaron imágenes: cce, spect y spect/ct del esqueleto axial con 99mTcmdp y equipo híbrido Infinia Hawkeye 4 GE. Las lesiones se caracterizaron del siguiente modo: benigna (b); maligna (m); y equívocas: probablemente benigna (pb) y probablemente maligna (pm). Resultados spect/cti clasificó 197/208 lesiones (94,7%), specti 155/208 (74,5%) y ccei 130/208 (51%). Los tres métodos coincidieron inicialmente en 138 lesiones: 106 b (77%), 23 m (17%) y 9 equívocas (6%), y en la evolución en 155: 110 b (71%), 44 m (28%), 1 equívoca (1%). La sensibilidad, especificidad y exactitud inicial para diagnóstico de metástasis (incluyendo como malignas las lesiones probablemente malignas) fueron 92/70/51% (ccei), 100/78/75% (specti) y 100/97/95% (spect/cti). Diferencias de a pares: ccei vs specti y spect/cti para sensibilidad (p<0,05) y specti y ccei vs spect/cti especificidad y exactitud (p<0,001). Conclusiones El aporte de spect/ct incrementó la precisión y certeza diagnóstica para diferenciar las lesiones benignas, malignas y equívocas. Su utilización debería ser rutinaria en la detección de metástasis óseas en pacientes con carcinoma de mama
Objective To assess the additional value of spect/ct on whole-body scintigraphy (wbs) and spect in patients with breast cancer, with a minimum of two tests: start time (i) and assessment (e). Materials and method Retrospective assessment of 208 lesions in 186 patients. Images were taken by wbs, spect and spect/ct of the axial skeleton with 99mTc- mdp and hybrid equipment Infinia Hawkeye 4 GE. Characterization of the lesions: benign (b), malignant (m) and equivocal: likely to be benign or malignant. Results By using spect/cti, 197/208 lesions (94.7%), specti 155/208 (74.5%) and wbsi 130/208 (51%) were classified. The three methods initially coincided on 138 lesions: 106 b (77%), 23 m (17%) and 9 equivocal (6%); and on assessment on 155: 110 b (71%), 44 m (28%), 1 equivocal (1%). The initial sensitivity, specificity and accuracy for the diagnosis of metastases (including as malignant those lesions which were likely to be so) were as follows: 92/70/51% (wbsi), 100/78/75% (specti) and 100/97/95% (spect/cti). Differences by pairs: wbsi vs specti and spect/cti for sensitivity (p<0,05) and specti and wbsi vs spect/cti for specificity and accuracy (p<0,001). On assessment 99%. Conclusions The contribution of spect/ct has increased diagnostic accuracy and certainty to differentiate benign, malignant and equivocal lesions. It should be used routinely for the detection of bone metastases in patients with breast cancer