Whole body bone SPET/CT can successfully replace the conventional bone scan in breast cancer patients. A prospective study of 257 patients / Eleni Mavriopoulou, Petros Zampakis, Evaggelia Smpiliri, Trifon Spyridonidis, Efthymia Rapti, Uwe Haberkorn, Thomas Makatsoris, Dimitrios J. Apostolopoulos
OBJECTIVE: Single photon emission tomography/computed tomography (SPET/CT) is usually recommended after ambiguous whole body bone scan (WBS) findings. We investigated the value of routine 2-field ("near" whole-body) SPET/CT application in breast cancer (BC) patients. - SUBJECTS AND METHODS: In this prospective study planar WBS and 2-field SPET/CT was performed in 257 consecutive BC patients referred for a bone scan. Whole body scan and SPET/CT were interpreted separately. Additional imaging studies and clinical follow-up for 30±24 months elucidated uncertain findings. - RESULTS: Bone metastases were confirmed in 65 patients (25.3%). Sensitivity, specificity, accuracy, positive and negative predictive value per-patient was 63.1%, 81.3%, 76.7%, 53.2% and 86.7% for WBS and 96.9%, 87.5%, 89.9%, 72.4% and 98,8% for SPET/CT; differences were statistically significant except for specificity. Respective values of sensitivity per-lesion were 47.6% and 98.9% (P<0.001). Eleven percent of true positive findings were noticed only in the low-dose CT images, while 7% only in SPET. Single photon emission tomography/CT exhibited higher specificity than WBS in the spine (94.8% vs. 88.7%, P=0.04). Whole body scan interpretation changed after SPET/CT in 74 (28.8%) patients. Thirty-two patients with positive/suspicious WBS turned to be metastases-free after the interpretation of SPET/CT while 42 with unremarkable WBS turned to be positive/suspicious. Of these cases, metastases were confirmed in one with negative and 23 with positive/suspicious SPET/CT. The SPET/CT results prompted treatment plan changes in 23 cases (8.9%). - CONCLUSION: Whole-body bone SPET/CT scan outperformed WBS in terms of sensitivity, accuracy, positive and negative predictive value and impacted on patient management. Therefore, its use is recommended as a routine procedure in BC patients, even after a negative WBS..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
10 August 2018 2018 |
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| Erschienen: |
10 August 2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
Hellenic journal of nuclear medicine - 21(2018), 2, Seite 125-133 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mavriopoulou, Eleni [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Anmerkungen: |
Gesehen am 23.03.2020 |
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| Umfang: |
9 |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Whole body bone SPET/CT can successfully replace the conventional bone scan in breast cancer patients. A prospective study of 257 patients |c Eleni Mavriopoulou, Petros Zampakis, Evaggelia Smpiliri, Trifon Spyridonidis, Efthymia Rapti, Uwe Haberkorn, Thomas Makatsoris, Dimitrios J. Apostolopoulos |
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| 520 | |a OBJECTIVE: Single photon emission tomography/computed tomography (SPET/CT) is usually recommended after ambiguous whole body bone scan (WBS) findings. We investigated the value of routine 2-field ("near" whole-body) SPET/CT application in breast cancer (BC) patients. - SUBJECTS AND METHODS: In this prospective study planar WBS and 2-field SPET/CT was performed in 257 consecutive BC patients referred for a bone scan. Whole body scan and SPET/CT were interpreted separately. Additional imaging studies and clinical follow-up for 30±24 months elucidated uncertain findings. - RESULTS: Bone metastases were confirmed in 65 patients (25.3%). Sensitivity, specificity, accuracy, positive and negative predictive value per-patient was 63.1%, 81.3%, 76.7%, 53.2% and 86.7% for WBS and 96.9%, 87.5%, 89.9%, 72.4% and 98,8% for SPET/CT; differences were statistically significant except for specificity. Respective values of sensitivity per-lesion were 47.6% and 98.9% (P<0.001). Eleven percent of true positive findings were noticed only in the low-dose CT images, while 7% only in SPET. Single photon emission tomography/CT exhibited higher specificity than WBS in the spine (94.8% vs. 88.7%, P=0.04). Whole body scan interpretation changed after SPET/CT in 74 (28.8%) patients. Thirty-two patients with positive/suspicious WBS turned to be metastases-free after the interpretation of SPET/CT while 42 with unremarkable WBS turned to be positive/suspicious. Of these cases, metastases were confirmed in one with negative and 23 with positive/suspicious SPET/CT. The SPET/CT results prompted treatment plan changes in 23 cases (8.9%). - CONCLUSION: Whole-body bone SPET/CT scan outperformed WBS in terms of sensitivity, accuracy, positive and negative predictive value and impacted on patient management. Therefore, its use is recommended as a routine procedure in BC patients, even after a negative WBS. | ||
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