Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 1856  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 16  |  Issue : 4  |  Page : 303-310

Incremental value of single-photon emission computed tomography-computed tomography for characterization of skeletal lesions in breast cancer patients


1 Department of Molecular Imaging and Nuclear Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
2 National Heart Institute, Kuala Lumpur, Malaysia

Correspondence Address:
Thanuja Mahaletchumy
Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur
Malaysia
Login to access the Email id


DOI: 10.4103/1450-1147.215496

PMID: 29033679

Rights and Permissions

The incremental value of single-photon emission computed tomography-computed tomography (SPECT-CT) over planar bone scintigraphy and SPECT in detecting skeletal lesions in breast cancer patients and its effect on patient management is assessed in this study. This is a prospective study which was conducted over 1-year duration. Whole-body planar scintigraphy, SPECT, and SPECT-CT were performed in 85 breast cancer patients with total of 128 lesions. Correlative imaging and clinical follow-up was used as the reference standard. McNemar's multistep analysis was performed for each patient and each lesion. On patient-wise analysis, 47 patients had equivocal diagnosis on planar bone scintigraphy, 28 on SPECT, and eight on SPECT-CT. On lesion-wise analysis, there were 72 equivocal lesions on planar bone scintigraphy, 48 on SPECT, and 15 on SPECT-CT. Overall, SPECT-CT resulted in a significant reduction in the proportion of equivocal diagnosis on both patient-wise (P < 0.004) and lesion-wise basis (P < 0.004), irrespective of the skeletal region involved. The sensitivity on a per-patient basis was 43%, 58%, and 78% for planar bone scintigraphy, SPECT, and SPECT-CT, respectively. Similarly, the specificity was 85%, 92%, and 94% for planar bone scintigraphy, SPECT, and SPECT-CT, respectively. Patient management was correctly altered in 32% of the patients based on SPECT-CT interpretation. Our data suggest that adding SPECT-CT to whole-body imaging significantly improves sensitivity and specificity in diagnosing bone metastases and significantly reduces the proportion of equivocal diagnosis in all regions of the skeleton. The most important outcome is derived from the accurate alteration in patient management clinically by down- and up-staging of patients and a more precise identification of metastatic extent.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1822    
    Printed51    
    Emailed0    
    PDF Downloaded212    
    Comments [Add]    
    Cited by others 3    

Recommend this journal