Evaluation of Oncologic Patients with Suspected Lesions on Planar Bone Scintigraphy Using SPECT/CT

Öz

Aim: This study aimed to evaluate the diagnostic accuracy of SPECT/CT to clinical management in oncologic patients with indeterminate lesions on planar bone scintigraphy. Methods: A total of 1170 oncologic patients who underwent planar bone scintigraphy between March 2010 and September 2012 were retrospectively reviewed. Benign and malignant lesions could be differentiated on planar bone scintigraphy in 670 patients, whereas the remaining 500 patients with indeterminate findings were included in the study. The final diagnosis was established by clinical follow-up, diagnostic CT, MRI, F-18 FDG PET/CT, biopsy, or a combination of these reference standard methods. Results: Of the 500 patients included in the study, 261 were male and 239 were female, with a mean age of 59.5±14.3 years. Based on SPECT/CT findings, 306 patients (61.2%) were classified as benign, 129 (25.8%) as malignant, and 65 (13.0%) as indeterminate. Of the 306 patients classified as benign on SPECT/CT, 4 (0.8%) were subsequently confirmed to have bone metastases, whereas 4 (0.8%) of the 129 patients classified as malignant were ultimately diagnosed as benign. Of the 65 patients with indeterminate SPECT/CT findings, 21 (4.2%) were confirmed to have malignant lesions, whereas 44 (8.8%) were found to have benign lesions. The sensitivity, specificity, PPV, NPV, and overall diagnostic accuracy of SPECT/CT were 97.3%, 86.3%, 75.3%, 98.7%, and 89.6%, respectively (p<0.001). Conclusion: SPECT/CT improves diagnostic accuracy in oncologic patients with indeterminate findings on planar bone scintigraphy and provides significant clinical value in the evaluation of skeletal lesions, particularly by markedly increasing specificity.

Anahtar Kelimeler

• Bone scintigraphy
• SPECT/CT
• bone metastasis
• hybrid imaging

Destekleyen Kurum

Not applicable

Etik Beyan

Ethical approval was obtained from the Ethics Committee of Ankara Numune Training and Research Hospital (Meeting Date: September 5, 2012, Decision No. 2012-438). The study was conducted in accordance with the ethical principles of the Declaration of Helsinki.

Teşekkür

Not applicable

Planar kemik sintigrafisinde şüpheli hastalık saptanan onkolojik hasta grubunun SPECT/BT ile değerlendirilmesi

Öz

Amaç: Bu çalışmada, planar kemik sintigrafisinde belirsiz lezyon saptanan onkolojik hastalarda SPECT/BT'nin tanısal doğruluğunun ve klinik yönetime katkısının değerlendirilmesi amaçlandı. Yöntem: Mart 2010 ile Eylül 2012 tarihleri arasında planar kemik sintigrafisi uygulanan toplam 1170 onkolojik hasta retrospektif olarak incelendi. Planar kemik sintigrafisi ile 670 hastada benign ve malign lezyonlar ayırt edilebilirken, belirsiz bulgular saptanan kalan 500 hasta çalışmaya dahil edildi. Nihai tanı; klinik izlem, tanısal BT, MRG, F-18 FDG PET/BT, biyopsi veya bu referans standart yöntemlerin kombinasyonu ile doğrulandı. Bulgular: Çalışmaya dahil edilen 500 hastanın 261'i erkek, 239'u kadın olup yaş ortalaması 59,5±14,3 yıl idi. SPECT/BT bulgularına göre 306 hasta (%61,2) benign, 129 hasta (%25,8) malign ve 65 hasta (%13,0) belirsiz olarak sınıflandırıldı. SPECT/BT'de benign olarak değerlendirilen 306 hastanın 4'ünde (%0,8) daha sonra kemik metastazı doğrulanırken, malign olarak sınıflandırılan 129 hastanın 4'ü (%0,8) nihai değerlendirmede benign olarak tanımlandı. SPECT/BT bulguları belirsiz olan 65 hastanın 21'inde (%4,2) malign lezyon doğrulanırken, 44'ünde (%8,8) benign lezyon saptandı. SPECT/BT'nin duyarlılığı, özgüllüğü, pozitif prediktif değeri, negatif prediktif değeri ve genel tanısal doğruluğu sırasıyla %97,3, %86,3, %75,3, %98,7 ve %89,6 olarak hesaplandı (p<0,001). Sonuç: SPECT/BT, planar kemik sintigrafisinde belirsiz bulgular saptanan onkolojik hastalarda tanısal doğruluğu artırmakta ve özellikle özgüllüğü belirgin ölçüde yükselterek iskelet lezyonlarının değerlendirilmesinde önemli klinik katkı sağlamaktadır.

Anahtar Kelimeler

• Kemik sintigrafisi
• SPECT/BT
• kemik metastazı
• hibrit görüntüleme

Destekleyen Kurum

Bulunmamaktadır

Etik Beyan

Ankara Numune Eğitim ve Araştırma Hastanesi Etik Kurulu'ndan etik onay alınmıştır (Toplantı Tarihi: 5 Eylül 2012, Karar No: 2012-438). Çalışma, Helsinki Bildirgesi'nin etik ilkelerine uygun olarak yürütülmüştür.

Teşekkür

Bulunmamaktadır

Kaynakça

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