The Incremental Value of SPECT/CT in Characterizing Solitary Spine Lesions

Basit Iqbal, Geoffrey Currie, Janelle Wheat, Hassan Raza, Hosen Kiat

Research output: Contribution to journalArticle

25 Citations (Scopus)
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Abstract

The purpose of this study was to investigate the incremental value and diagnostic impact of SPECT/CT in patients who had a solitary spinal lesion on a bone scan. Methods: A prospective study was performed on 80 patients (50 with known cancer) who underwent 99mTc-methylene diphosphonate whole-body planar bone scintigraphy and had a solitary spinal lesion. These lesions were then further evaluated using SPECT/CT. Results: Lesions were localized to the vertebral body in 38 patients (47.5%), pedicle in 15 (18.8%), facet joint in 15 (18.8%), transverse process in 2 (2.5%), spinous process in 2 (2.5%), lamina in 3 (3.8%), and end plates in 5 (6.2%). Although the specificity of planar bone scans was excellent (100%), sensitivity was only 6.1% but increased to 78.8% after the addition of SPECT/CT. The results provide evidence of a substantial incremental increase in diagnostic accuracy using SPECT/CT over planar imaging alone for patients in whom a solitary spinal lesion is noted. Conclusion: The addition of SPECT/CT significantly reduced the number of false-negative results and increased the number of true-positive results. SPECT/CT also reduced the number of equivocal reports. A definitive diagnosis was given for most patients, indicating improved diagnostic confidence with the addition of SPECT/CT, compared with planar imaging alone, in patients with solitary spinal lesions.
Original languageEnglish
Pages (from-to)201-207
Number of pages7
JournalJournal of Nuclear Medicine Technology
Volume39
Issue number3
Publication statusPublished - 2011

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