Enhanced diagnostic value of 99Tcm-MDP SPECT/CT in patients with spinal bone malignancy / 中华核医学杂志

ABSTRACT

Objective To investigate the additional diagnostic value of 99Tcm-MDP SPECT/CT over conventional SPECT scan in patients with spinal bone malignancy. Methods Fifty-two patients (mean age (56±14) years) with suspicious spinal bone diseases underwent both bone SPECT and SPECT/CT imaging right after 99Tcm-MDP whole-body planar bone scintigraphy. All patients were pathologically diagnosed by either spine operation or trans-spinal biopsy. The images were evaluated by two independent reviewers; inter-reviewer agreement was evaluated using a weighted Kappa score. Each focus of abnormality was recorded using a 4-point diagnostic confidence scale benign (B), possibly benign (PB), possibly malignant (PM) or malignant (M). Results Accord to the pathological results, 36 patients had bone malignancy (19 with metastatic tumors and 17 with non-metastatic tumors) and 16 had benign lesions. Over SPECT images, two reviewers rated 73.1% (38/52) and 67.3% (35/52) the lesions as the equivocal (PB or PM) respectively. Over SPECT/CT images, they rated only 25.0% (13/52) and 13.5% (7/52) lesions as the equivocal. Inter-reviewer agreement was 63.5% (weighted Kappa score=0.62) for SPECT and 78.9% (weighted Kappa score=0.81) for SPECT/CT. Conclusions Compared with99Tcm-MDP SPECT, 99Tcm-MDP SPECT/CT results in a significant reduction of equivocal diagnoses for the spinal bone malignancy.