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  NUCLEAR MEDICINE APPLICATIONS FOR BONE METASTASES


The Quarterly Journal of Nuclear Medicine 2001 Marzo;45(1):27-37

lingua: Inglese

Bone scintigraphy and the added value of SPECT (single photon emission tomography) in detecting skeletal lesions

Savelli G., Maffioli L. *, Maccauro M., De Deckere E. **, Bombardieri E.

From the Division of Nuclear Medicine Istituto Nazionale Tumori, Milano, Italy
*Division of Nuclear Medicine Ospedale Generale, Lecco, Italy
**Division of Nuclear Medicine Leiden University Medical Centre, Leiden, The Netherlands


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Skeletal metas­ta­ses are one of the ­major clin­i­cal prob­lems for the oncol­o­gist. Over the ­last sev­er­al ­decades ­bone scin­tig­ra­phy has ­been ­used exten­sive­ly in detect­ing ­bone involve­ment ­since it can pro­vide infor­ma­tion ­about dis­ease loca­tion, prog­no­sis and the effec­tive­ness of treat­ment. Bone ­scan ­offers the advan­tage of ­total ­body exam­ina­tion, and imag­es ­bone ­lesions ear­lier ­than oth­er tech­niques. In ­this ­paper the ­main clin­i­cal prob­lems relat­ed to the ­most com­mon appli­ca­tions of ­bone ­scan in ­breast, pros­tate, ­lung can­cer and oth­er ­tumours are dis­cussed. The expe­ri­ence car­ried out at the National Cancer Institute of Milan by ­using ­bone ­SPECT to ­detect sin­gle ­bone metas­ta­ses is report­ed. One hundred and eighteen ­patients ­with ­bone metas­ta­ses (­from dif­fer­ent ­tumour ­types: ­breast, ­lung, pros­tate, lym­pho­mas, etc.) ­were stud­ied by pla­nar scin­tig­ra­phy, ­SPECT and oth­er radio­log­i­cal modal­ities (CT, MRI or X-­rays). The over­all per­for­manc­es of ­bone ­SPECT ­were sen­si­tiv­ity: 90.5% (19/21), spec­i­fic­ity 92.8% (90/97), pos­i­tive pre­dic­tive val­ue 73% (19/26), neg­a­tive pre­dic­tive val­ue 97.8% (90/92), accu­ra­cy 92.4% (109/118). Considering ­breast can­cer, the ­most fre­quent pathol­o­gy in our ­series, and the lum­bar spi­nal ­tract, the ­most com­mon skel­e­tal seg­ment ­involved, the fig­ures of mer­it of ­SPECT ­were: sen­si­tiv­ity 100% (4/4), spec­i­fic­ity 95.3% (41/43), pos­i­tive pre­dic­tive val­ue 66.7% (4/6), neg­a­tive pre­dic­tive val­ue 100% (41/41), accu­ra­cy 95.7% (45/47). In con­clu­sion ­bone ­SPECT ­showed ­very ­good per­for­manc­es, in par­tic­u­lar improv­ing the pre­dic­tive val­ue of pla­nar ­scan in the diag­no­sis of ver­te­bral metas­ta­ses.

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