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Wang N, Qu S, Kong W, Hua Q, Hong Z, Liu Z, Shi Y. Establishment and validation of novel predictive models to predict bone metastasis in newly diagnosed prostate adenocarcinoma based on single-photon emission computed tomography radiomics. Ann Nucl Med 2024; 38:734-743. [PMID: 38822897 DOI: 10.1007/s12149-024-01942-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/12/2024] [Indexed: 06/03/2024]
Abstract
PURPOSE To establish and validate novel predictive models for predicting bone metastasis (BM) in newly diagnosed prostate adenocarcinoma (PCa) via single-photon emission computed tomography radiomics. METHOD In a retrospective review of the clinical single-photon emission computed tomography (SPECT) database, 176 patients (training set: n = 140; validation set: n = 36) who underwent SPECT/CT imaging and were histologically confirmed to have newly diagnosed PCa from June 2016 to June 2022 were enrolled. Radiomic features were extracted from the region of interest (ROI) in a targeted lesion in each patient. Clinical features, including age, total prostate-specific antigen (t-PSA), and Gleason grades, were included. Statistical tests were then employed to eliminate irrelevant and redundant features. Finally, four types of optimized models were constructed for the prediction. Furthermore, fivefold cross-validation was applied to obtain sensitivity, specificity, accuracy, and area under the curve (AUC) for performance evaluation. The clinical usefulness of the multivariate models was estimated through decision curve analysis (DCA). RESULTS A radiomics signature consisting of 27 selected features which were obtained by radiomics' LASSO treatment was significantly correlated with bone status (P < 0.01 for both training and validation sets). Collectively, the models showed good predictive efficiency. The AUC values ranged from 0.87 to 0.98 in four models. The AUC values of the human experts were 0.655 and 0.872 in the training and validation groups, respectively. Most radiomic models showed better diagnostic accuracy than human experts in the training and validation groups. DCA also demonstrated the superiority of the radiomics models compared to human experts. CONCLUSION Radiomics models are superior to humans in differentiating between benign bone and prostate cancer bone metastases; it can be used to facilitate personalized prediction of BM in newly diagnosed PCa patients.
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Affiliation(s)
- Ning Wang
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
- Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, 215004, Jiangsu, Suzhou, China
| | - Shihui Qu
- Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, 215004, Jiangsu, Suzhou, China
| | - Weiwei Kong
- Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, 215004, Jiangsu, Suzhou, China
| | - Qian Hua
- Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, 215004, Jiangsu, Suzhou, China
| | - Zhihui Hong
- Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, 215004, Jiangsu, Suzhou, China
| | - Zengli Liu
- Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, 215004, Jiangsu, Suzhou, China
| | - Yizhen Shi
- Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, 215004, Jiangsu, Suzhou, China.
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Alqahtani MM. Whole-Body SPECT/CT: Protocol Variation and Technical Consideration-A Narrative Review. Diagnostics (Basel) 2024; 14:1827. [PMID: 39202315 PMCID: PMC11353707 DOI: 10.3390/diagnostics14161827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/13/2024] [Accepted: 08/16/2024] [Indexed: 09/03/2024] Open
Abstract
Introducing a hybrid imaging approach, such as single-photon emission computerized tomography with X-ray computed tomography (SPECT)/CT, improves diagnostic accuracy and patient management. The ongoing advancement of SPECT hardware and software has resulted in the clinical application of novel approaches. For example, whole-body SPECT/CT (WB-SPECT/CT) studies cover multiple consecutive bed positions, similar to positron emission tomography-computed tomography (PET/CT). WB-SPECT/CT proves to be a helpful tool for evaluating bone metastases (BM), reducing equivocal findings, and enhancing user confidence, displaying effective performance in contrast to planar bone scintigraphy (PBS). Consequently, it is increasingly utilized and might substitute PBS, which leads to new questions and issues concerning the acquisition protocol, patient imaging time, and workflow process. Therefore, this review highlights various aspects of WB-SPECT/CT acquisition protocols that need to be considered to help understand WB-SPECT/CT workflow processes and optimize imaging protocols.
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Affiliation(s)
- Mansour M. Alqahtani
- Department of Radiology and Medical Imaging, Faculty of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia;
- Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Meena A, Kumari M, Anand R, Solanki RS, Nair N, Pathania OP, Nangia A, Prasad SN. Correlation Between Morphological Patterns and Multidetector Computed Tomography (MDCT) Enhancement Patterns in Gallbladder Carcinoma With Locoregional Infiltration. Cureus 2024; 16:e67266. [PMID: 39301356 PMCID: PMC11412273 DOI: 10.7759/cureus.67266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2024] [Indexed: 09/22/2024] Open
Abstract
OBJECTIVE This study aimed to explore the correlation between morphological patterns and multidetector computed tomography (MDCT) enhancement patterns in gallbladder cancer with locoregional infiltration among the Indian population. METHODOLOGY This cross-sectional study was conducted across the pathology, surgery, and radiodiagnosis departments at Lady Hardinge Medical College, New Delhi. It focused on patients diagnosed with gallbladder disorders during the study period, identified through clinical examination or MDCT. Each patient underwent a fasting computed tomography (CT) scan using a Philips Brilliance 40-slice MDCT scanner. A neutral oral contrast, consisting of 1200 ml of water and 300 ml of 20% w/v mannitol, was administered. Additionally, for two patients suspected of gallbladder perforation extending to the pyloric duodenal area, a 2% non-ionic water-soluble contrast agent was used. RESULTS The study found no statistically significant association between intraluminal polypoidal growth and other infiltration sites. However, wall thickening was significantly associated with various infiltration sites, including the liver, colon, bile ducts, and vascular structures. A strong positive correlation was observed between portovenous hyperenhancement and all examined morphological patterns, with the most notable correlations found with non-contrast CT (NCCT) hypo-isoenhancement. Conversely, arterial hyperenhancement showed an inverse relationship with some morphological patterns, with correlation coefficients of -0.60 for intraluminal polypoidal growth versus gallbladder wall thickening and mass replacement of the gallbladder versus intraluminal polypoidal growth. CONCLUSION Gallbladder cancer frequently leads to the replacement or damage of the gallbladder, with both focal and diffuse wall thickening being common findings. Hypo-isoenhancement was the most prevalent imaging pattern, while hyperenhancement was less common. Although intraluminal polypoidal growth did not significantly correlate with metastasis, wall thickening was significantly associated. These results emphasize the importance of specific imaging patterns in assessing the severity of gallbladder cancer and informing treatment strategies.
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Affiliation(s)
- Anamika Meena
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, IND
| | - Madhuri Kumari
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, IND
| | - Rama Anand
- Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, IND
| | - R S Solanki
- Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, IND
| | - Nikhil Nair
- Department of Radiology, Bedford Hospital, National Health Service (NHS) Trust, Bedford, GBR
| | - O P Pathania
- Department of Surgery, Lady Hardinge Medical College, New Delhi, IND
| | - Anita Nangia
- Department of Pathology, Lady Hardinge Medical College, New Delhi, IND
| | - Surya N Prasad
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, IND
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Wang H, Chen Y, Qiu J, Xie J, Lu W, Ma J, Jia M. Machine learning based on SPECT/CT to differentiate bone metastasis and benign bone lesions in lung malignancy patients. Med Phys 2024; 51:2578-2588. [PMID: 37966123 DOI: 10.1002/mp.16839] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Bone metastasis is a common event in lung cancer progression. Early diagnosis of lung malignant tumor with bone metastasis is crucial for selecting effective treatment strategies. However, 14.3% of patients are still difficult to diagnose after SPECT/CT examination. PURPOSE Machine learning analysis of [99mTc]-methylene diphosphate (99mTc-MDP) SPECT/CT scans to distinguish bone metastases from benign bone lesions in patients with lung cancer. METHODS One hundred forty-one patients (69 with bone metastases and 72 with benign bone lesions) were randomly assigned to the training group or testing group in a 7:3 ratio. Lesions were manually delineated using ITK-SNAP, and 944 radiomics features were extracted from SPECT and CT images. The least absolute shrinkage and selection operator (LASSO) regression was used to select the radiomics features in the training set, and the single/bimodal radiomics models were established based on support vector machine (SVM). To further optimize the model, the best bimodal radiomics features were combined with clinical features to establish an integrated Radiomics-clinical model. The diagnostic performance of models was evaluated using receiver operating characteristic (ROC) curve and confusion matrix, and performance differences between models were evaluated using the Delong test. RESULTS The optimal radiomics model comprised of structural modality (CT) and metabolic modality (SPECT), with an area under curve (AUC) of 0.919 and 0.907 for the training and testing set, respectively. The integrated model, which combined SPECT, CT, and two clinical features, exhibited satisfactory differentiation in the training and testing set, with AUC of 0.939 and 0.925, respectively. CONCLUSIONS The machine learning can effectively differentiate between bone metastases and benign bone lesions. The Radiomics-clinical integrated model demonstrated the best performance.
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Affiliation(s)
- Huili Wang
- College of Preventive Medicine & Institute of Radiation Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Yiru Chen
- Department of Nuclear Medicine, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Jianfeng Qiu
- School of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Jindong Xie
- College of Preventive Medicine & Institute of Radiation Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Weizhao Lu
- School of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Junchi Ma
- School of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Mingsheng Jia
- Department of Nuclear Medicine, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
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Yang Y, Fan R, Chen X. Risk factors for rib metastases of lung cancer patients with high-uptake rib foci on 99Tcm-MDP SPECT/CT. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF... 2024; 68:84-91. [PMID: 35762663 DOI: 10.23736/s1824-4785.22.03444-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND 99Tcm-MDP SPECT/CT is widely used to diagnose early bone metastasis. Ribs are high-risk bone metastasis sites, while few study is related to ribs. The study is to investigate the risk factors of rib metastases in lung cancer patients. METHODS We retrospectively analyzed the patients' clinical characteristics and SPECT/CT imaging features. The patients were divided into a rib metastasis group (108 cases) and a non-rib metastasis group (103 cases). RESULTS In 211 patients, rib metastases were closely related to tumor markers, T stage, N stage, clinical staging, lymph node (LN) involvement, number of rib foci, localization on rib and foci type (P<0.05). In 93 patients with pure rib foci, rib metastases were affected by clinical staging, LN involvement, localization on the rib and primary lung cancer localization (P<0.001, 0.038,<0.001, 0.034, respectively). In 100 patients with a solitary rib focus, rib metastases were associated with clinical staging, localization on the rib, and LN involvement (P<0.001, 0.001, and 0.014, respectively). In all 633 rib foci, localization on the rib was an effective risk factor for rib metastases (P<0.001). CONCLUSIONS Patients with increased tumor markers, stage IV lung adenocarcinoma and multiple rib foci located ipsilaterally with the primary lung tumor, or rib foci accompanied other bone foci are more likely to develop rib metastasis. Patients with pure rib foci or a solitary rib focus, especially in the anterior rib with negative LN involvement, have a low probability of rib metastasis.
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Affiliation(s)
- Yuanyuan Yang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Nuclear Medicine, Chongqing University Cancer Hospital, Chongqing, China
| | - Rongqin Fan
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Nuclear Medicine, Chongqing University Cancer Hospital, Chongqing, China
| | - Xiaoliang Chen
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Nuclear Medicine, Chongqing University Cancer Hospital, Chongqing, China -
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Groheux D. Breast Cancer Systemic Staging (Comparison of Computed Tomography, Bone Scan, and 18F-Fluorodeoxyglucose PET/Computed Tomography). PET Clin 2023; 18:503-515. [PMID: 37268506 DOI: 10.1016/j.cpet.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
After an overview of the principles of bone scintigraphy, contrast-enhanced computed tomography (CE-CT) and 18F-fluorodeoxyglucose (FDG)-PET/CT, the advantages and limits of these modalities in the staging of breast cancer are discussed in this paper. CT and PET/CT are not optimal for delineating primary tumor volume, and PET is less efficient than the sentinel node biopsy to depict small axillary lymph node metastases. In large breast cancer tumor, FDG PET/CT is useful to show extra-axillary lymph nodes. FDG PET/CT is superior to bone scan and CE-CT in detecting distant metastases, and it results in a change of treatment plan in nearly 15% of patients.
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Affiliation(s)
- David Groheux
- Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France; University Paris-Diderot, INSERM U976, HIPI, Paris, France; Centre d'Imagerie Radio-isotopique, La Rochelle, France.
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Suppiah S, Mohd Rohani MF, Zanial AZ, Ahmad Shahrir AD, Khairuman KA, Vinjamuri S. A Review on the Usage of Bone Single-Photon Emission Computed Tomography/Computed Tomography in Detecting Skeletal Metastases in the Post-COVID-19 Era: Is it Time to Ditch Planar and Single-Photon Emission Computed Tomography only Gamma Camera Systems? Indian J Nucl Med 2023; 38:191-200. [PMID: 37456181 PMCID: PMC10348494 DOI: 10.4103/ijnm.ijnm_142_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/08/2022] [Indexed: 07/18/2023] Open
Abstract
Planar whole-body bone scanning (WBS) is widely used to evaluate skeletal lesions seen in cancer and noncancer cases. Frequently, degenerative, or other benign bony changes may give rise to indeterminate lesions that mimic bone metastases. In the post-COVID-19 era, there is an evolutionary phase that puts importance on global development and adaptability, which encompasses to include nuclear medicine practices worldwide. Single-photon emission computed tomography/computed tomography (SPECT/CT) can be used to improve the characterization of these lesions and help to resolve the diagnostic conundrum while reducing the need for patients to undergo multiple different examinations at various imaging departments. The fusion of SPECT and CT allows morphological characterization of functional abnormality detected by focal tracer uptake on planar scintigraphy, which provides a one-stop center imaging in nuclear medicine departments. The objective of this study was to review the diagnostic accuracy of SPECT/CT in diagnosing bone metastases in a variety of oncology and nononcology cases and to determine the feasibility of performing bone SPECT/CT in all suspected cancer cases, including cases of bone infection instead of planar imaging alone. The utilization of hybrid SPECT/CT in indeterminate bone lesions detected on planar WBS can significantly increase the diagnostic confidence and accuracy of image interpretation. Recognition of patterns of disease identified using hybrid imaging can improve the management of patients with potentially lower costs in the long term. Currently, hybrid SPECT/CT machines are becoming a norm in nuclear medicine departments, thus potentially making single planar application machines obsolete in the near future. We hypothesize that in the interest of providing a meaningful interpretation of isotope bone scans, the default protocol should involve the option of acquiring SPECT/CT images rather than relying on whole-body scans only. Departments choosing to upgrade existing equipment or those choosing to invest in only one gamma camera should proactively opt for hybrid SPECT/CT systems.
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Affiliation(s)
- Subapriya Suppiah
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Department of Nuclear Medicine, Nuclear Imaging Unit, Hospital Pengajar Universiti Putra Malaysia, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Pusat Pengimejan Diagnostik Nuklear, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Mohd Fazrin Mohd Rohani
- Department of Nuclear Medicine, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Ahmad Zaid Zanial
- Department of Nuclear Medicine, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
- Department of Nuclear Medicine, Royal Liverpool and Broadgreen University Hospitals, NHS Trusts, Liverpool, England
| | - Ahmad Danial Ahmad Shahrir
- Department of Nuclear Medicine, Nuclear Imaging Unit, Hospital Pengajar Universiti Putra Malaysia, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Khairul Aliff Khairuman
- Department of Nuclear Medicine, Nuclear Imaging Unit, Hospital Pengajar Universiti Putra Malaysia, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Sobhan Vinjamuri
- Department of Nuclear Medicine, Royal Liverpool and Broadgreen University Hospitals, NHS Trusts, Liverpool, England
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Usmani S, Ahmed N, Gnanasegaran G, Al Kandari F, Marafi F, Bani-Mustafa A, Musbah A, Jassem Almashmoum M, Van den Wyngaert T. Prospective study of Na[ 18F]F PET/CT for cancer staging in morbidly obese patients compared with [ 99mTc]Tc-MDP whole-body planar, SPECT and SPECT/CT. Acta Oncol 2022; 61:1230-1239. [PMID: 35862646 DOI: 10.1080/0284186x.2022.2101899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE This prospective study aims to assess the diagnostic test characteristics of Na[18F]F PET/CT for the skeletal staging of cancer in morbidly obese patients compared with 99mTc-methylene diphosphonate (MDP), whole-body planar (WBS), SPECT, and SPECT/CT acquisitions. MATERIAL AND METHODS One hundred seventeen obese patients (BMI 46.5 ± 6.1 kg/m2 and mean age, 59.0 years; range 32-89 years) with BMI > 40 kg/m2 were prospectively enrolled and underwent [99mTc]Tc-MDP WBS, SPECT, SPECT/CT, and Na[18F]F PET/CT within two weeks for the osseous staging of a malignancy. Images were assessed qualitatively using a 3-point scale. Patient and lesion-based diagnostic test characteristics were estimated using an optimistic and pessimistic dichotomization method. RESULTS Bone metastases were confirmed in 44 patients. Patient-based optimistic diagnostic test characteristics were (sensitivity, specificity, overall accuracy): Na[18F]F PET/CT (95.5%, 95.9%, 95.7%), [99mTc]Tc-MDP WBS (52.3%, 71.2%, 64.1%), SPECT (61.4%, 80.8%, 73.5%) and SPECT/CT (65.9%, 91.8%, 82.1%). Lesion-based optimistic diagnostic test characteristics were: Na[18F]F PET/CT (97.7%, 97.9%, 97.7%), [99mTc]Tc-MDP WBS (39%, 67%, 48.9%), SPECT (52.9%, 93.6%, 67.3%) and SPECT/CT (65.9%, 91.8%, 82.1%). There was no significant difference in the specificity of Na[18F]F and SPECT/CT. All other pairwise comparisons were significant (p<.001). ROC curve analysis showed a high overall accuracy of Na[18F]F with significantly higher AUCs for Na[18F]F PET/CT compared to [99mTc]Tc-MDP WBS, SPECT, and SPECT/CT on both patient and lesion-based analysis (p<.001). Moreover, Na[18F]F PET/CT changed patient management in 38% of patients. CONCLUSIONS Na[18F]F PET/CT may be the preferred imaging modality for skeletal staging in morbidly obese patients. The technique provides excellent diagnostic test characteristics superior to [99mTc]Tc-MDP bone scan (including SPECT/CT), impacts patient management, has an acceptable radiation exposure profile, and is well-tolerated. Further cost-effectiveness evaluations are warranted.
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Affiliation(s)
- Sharjeel Usmani
- Department of Nuclear Medicine, Kuwait Cancer Control Centre, Shuwaikh, Kuwait.,Jaber Al-Ahmad Molecular Imaging Center, Kuwait, Kuwait.,Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Najeeb Ahmed
- Jack Brignall PET/CT Centre, Castle Hill Hosptial, Cottingham, UK
| | | | - Fareeda Al Kandari
- Department of Nuclear Medicine, Kuwait Cancer Control Centre, Shuwaikh, Kuwait
| | - Fahad Marafi
- Jaber Al-Ahmad Molecular Imaging Center, Kuwait, Kuwait
| | - Ahmed Bani-Mustafa
- Department of Mathematics and Physics, Australian University of Kuwait, Kuwait
| | - Ahmed Musbah
- Department of Nuclear Medicine, Kuwait Cancer Control Centre, Shuwaikh, Kuwait
| | | | - Tim Van den Wyngaert
- Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Jin Z, Zhang F, Wang Y, Tian A, Zhang J, Chen M, Yu J. Single-Photon Emission Computed Tomography/Computed Tomography Image-Based Radiomics for Discriminating Vertebral Bone Metastases From Benign Bone Lesions in Patients With Tumors. Front Med (Lausanne) 2022; 8:792581. [PMID: 35059418 PMCID: PMC8764284 DOI: 10.3389/fmed.2021.792581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/22/2021] [Indexed: 12/31/2022] Open
Abstract
Purpose: The purpose of this study was to investigate the feasibility of Single-Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) image-based radiomics in differentiating bone metastases from benign bone lesions in patients with tumors. Methods: A total of 192 lesions from 132 patients (134 in the training group, 58 in the validation group) diagnosed with vertebral bone metastases or benign bone lesions were enrolled. All images were evaluated and diagnosed independently by two physicians with more than 20 years of diagnostic experience for qualitative classification, the images were imported into MaZda software in Bitmap (BMP) format for feature extraction. All radiomics features were selected by least absolute shrinkage and selection operator (LASSO) regression and 10-fold cross-validation algorithms after the process of normalization and correlation analysis. Based on these selected features, two models were established: The CT model and SPECT model (radiomics features were derived from CT and SPECT images, respectively). In addition, a combination model (ComModel) combined CT and SPECT features was developed in order to better evaluate the predictive performance of radiomics models. Subsequently, the diagnostic performance between each model was separately evaluated by a confusion matrix. Results: There were 12, 13, and 18 features contained within the CT, SPECT, and ComModel, respectively. The constructed radiomics models based on SPECT/CT images to discriminate between bone metastases and benign bone lesions not only had high diagnostic efficacy in the training group (AUC of 0.894, 0.914, 0.951 for CT model, SPECT model, and ComModel, respectively), but also performed well in the validation group (AUC; 0.844, 0.871, 0.926). The AUC value of the human experts was 0.849 and 0.839 in the training and validation groups, respectively. Furthermore, both SPECT model and ComModel show higher classification performance than human experts in the training group (P = 0.021 and P = 0.001, respectively) and the validation group (P = 0.037 and P = 0.007, respectively). All models showed better diagnostic accuracy than human experts in the training group and the validation group. Conclusion: Radiomics derived from SPECT/CT images could effectively discriminate between bone metastases and benign bone lesions. This technique may be a new non-invasive way to help prevent unnecessary delays in diagnosis and a potential contribution in disease staging and treatment planning.
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Affiliation(s)
- Zhicheng Jin
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Fang Zhang
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Yizhen Wang
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Aijuan Tian
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Jianan Zhang
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Meiyan Chen
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Jing Yu
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
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Alqahtani MM, Willowson KP, Constable C, Fulton R, Kench PL. Optimization of
99m
Tc whole‐body SPECT/CT image quality: A phantom study. J Appl Clin Med Phys 2022; 23:e13528. [PMID: 35049129 PMCID: PMC8992937 DOI: 10.1002/acm2.13528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Mansour M. Alqahtani
- Faculty of Medicine and Health University of Sydney Sydney Australia
- Department of Radiological sciences College of Applied Medical Science Najran University Najran Saudi Arabia
| | - Kathy P. Willowson
- Department of Nuclear Medicine Royal North Shore Hospital Sydney Australia
- Institute of Medical Physics Faculty of Science The University of Sydney Sydney Australia
| | - Chris Constable
- Faculty of Medicine and Health University of Sydney Sydney Australia
- HERMES Medical Solutions, Strandbergsgatan 16 Stockholm Sweden
| | - Roger Fulton
- Faculty of Medicine and Health University of Sydney Sydney Australia
- Department of Medical Physics Westmead Hospital Sydney Australia
| | - Peter L. Kench
- Faculty of Medicine and Health University of Sydney Sydney Australia
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11
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Kapsoritakis N, Stathaki M, Bourogianni O, Tsaroucha A, Papadaki E, Simos P, Koukouraki S. Clinical impact of targeted single-photon emission computed tomography/computed tomography (SPECT/CT) bone scintigraphy on the assessment of bone metastasis in cancer patients. Nucl Med Commun 2021; 42:1202-1208. [PMID: 34149007 DOI: 10.1097/mnm.0000000000001455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We investigated the clinical impact of single-photon emission computed tomography/computed tomography (SPECT/CT) bone scintigraphy combined with 16-slice CT on metastatic workup and treatment planning in a large cancer patient series. METHODS Between January 2019 and January 2020, a total of 600 cancer patients were prospectively evaluated with whole-body planar bone scan (wbPBS) for staging or restaging purposes. 272/600 had equivocal lesions on wbPBS and 265/272 underwent additionally a targeted SPECT/CT bone scintigraphy on designated regions. Findings were classified as benign (score 1), metastatic (score 2) and inconclusive (score 3). Findings from SPECT/CT bone scintigraphy were compared with the results of wbPBS. RESULTS A total of 668 lesions were considered as unclear οn wbPBS and were re-evaluated through targeted SPECT/CT bone scintigraphy. Definite diagnostic findings on SPECT/CT bone scintigraphy were obtained in 227/265 (85.7%) patients and in 592/668 (88.6%) lesions vs. 15.4% of wbPBS alone. On per-patient analyses, 38.9% of patients were considered definitely nonmetastatic and 46.8% as definitely metastatic. On per lesion analyses using SPECT/CT bone scintigraphy, corresponding diagnostic rates were 47.5 and 41.2%. Although the addition of SPECT/CT bone scintigraphy significantly reduced the rate of equivocal wbPBS results (83.1%), it failed to provide a conclusive diagnosis in a relatively small proportion of lesions 76/668 (11.4%) in 38 patients. CONCLUSIONS SPECT/CT bone scintigraphy afforded a significant reduction of the number of patients with equivocal findings who needed further evaluation with other imaging modalities, preventing unnecessary delays in diagnosis and potential changes in disease staging and treatment planning. Moreover, SPECT/CT bone scintigraphy slightly increased diagnostic sensitivity.
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Affiliation(s)
| | - Maria Stathaki
- Department of Nuclear Medicine, School of Medicine, University of Crete
| | - Olga Bourogianni
- Department of Nuclear Medicine, School of Medicine, University of Crete
| | | | | | - Panagiotis Simos
- Department of Psychiatry, School of Medicine, University of Crete &Institute of Computer Science, Foundation for Research and Technology-Hellas, Crete, Greece
| | - Sophia Koukouraki
- Department of Nuclear Medicine, School of Medicine, University of Crete
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Binte Alam S, Nii M, Shimizu A, Kobashi S. Spatiotemporal Statistical Shape Model for Temporal Shape Change Analysis of Adult Brain. Curr Med Imaging 2021; 16:499-506. [PMID: 32484084 DOI: 10.2174/1573405615666181120141147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 07/31/2018] [Accepted: 09/14/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study presents a novel method of constructing a spatiotemporal statistical shape model (st-SSM) for adult brain. St-SSM is an extension of statistical shape model (SSM) in the temporal domain which will represent the statistical variability of shape as well as the temporal change of statistical variance with respect to time. AIMS Expectation-Maximization (EM) based weighted principal component analysis (WPCA) using a temporal weight function is applied where the eigenvalues of each data are estimated by Estep using temporal eigenvectors, and M-step updates Eigenvectors in order to maximize the variance. Both E and M-step are iterated until updating vectors reaches the convergence point. A weight parameter for each subject is allocated in accordance with the subject's age to calculate the weighted variance. A Gaussian function is utilized to define the weight function. The center of the function is a time point while the variance is a predefined parameter. METHODS The proposed method constructs adult brain st-SSM by changing the time point between minimum to maximum age range with a small interval. Here, the eigenvectors changes with aging. The feature vector of representing adult brain shape is extracted through a level set algorithm. To validate the method, this study employed 103 adult subjects (age: 22 to 93 y.o. with Mean ± SD = 59.32±16.89) from OASIS database. st-SSM was constructed for time point 40 to 90 with a step of 2. RESULTS We calculated the temporal deformation change between two-time points and evaluated the corresponding difference to investigate the influence of analysis parameter. An application of the proposed model is also introduced which involves Alzheimer's disease (AD) identification utilizing support vector machine. CONCLUSION In this study, st-SSM based adult brain shape feature extraction and classification techniques are introduced to classify between normal and AD subject as an application.
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Affiliation(s)
| | - Manabu Nii
- Graduate School of Engineering, University of Hyogo, Hyogo, Japan
| | - Akinobu Shimizu
- Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Syoji Kobashi
- Graduate School of Engineering, University of Hyogo, Hyogo, Japan
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Ming H, Chen Y, Yu H. Elevated 99mTcO4- Activity in Adenocarcinoma of the Lung. Clin Nucl Med 2021; 46:483-484. [PMID: 33782284 DOI: 10.1097/rlu.0000000000003581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT A 73-year-old man experienced chest tightness and shortness of breath for 9 months. Chest CT revealed a large right upper lobe mass. Pathology from CT-guided biopsy demonstrated poorly differentiated adenocarcinoma of the lung. Whole-body bone scan was acquired to evaluate possible bone metastasis. However, he was injected with 99mTcO4- erroneously instead of 99mTc-MDP. The images showed a focus of elevated activity of 99mTcO4- in the known lung lesion.
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Affiliation(s)
- Hui Ming
- From the Department of Nuclear Medicine, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi, China
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14
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Mostafa R, Abdelhafez YG, Abougabal M, Nardo L, Elkareem MA. Two-bed SPECT/CT versus planar bone scintigraphy: prospective comparison of reproducibility and diagnostic performance. Nucl Med Commun 2021; 42:360-368. [PMID: 33346602 DOI: 10.1097/mnm.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the reproducibility and diagnostic performance of two-bed single-photon emission computed tomography/computed tomography (SPECT/CT) images (TBSCT), compared to conventional planar bone scintigraphy (PBS) for the diagnosis of osseous metastasis. METHODS Patients with known solid tumor, referred to perform PBS, were included in this prospective study. PBS acquisition was followed by TBSCT images, covering at least the chest, abdomen and pelvis. Each modality was interpreted during a separate session by two independent nuclear medicine physicians with 12- and 3-year experience. Reference standard was formulated on the basis of subsequent clinical/imaging/histopathological evidence. RESULTS One-hundred and six patients were finally included in our study. A moderate agreement between the two physicians was seen for PBS readings [k = 0.74; 95% confidence interval (CI), 0.61-0.86] which increased to 0.87 (95% CI, 0.77-0.96) for TBSCT. PBS readings were inconclusive in 29/106, compared to 6 for TBSCT. For each reader, TBSCT showed significantly greater sensitivity and accuracy compared to PBS. There was no significant difference in the sensitivity, specificity or accuracy of both modalities in patients with the breast cancer group, whereas TBSCT images have shown significant higher sensitivity and accuracy compared to PBS (P = 0.02 and 0.002, respectively) in nonbreast cancer patients. CONCLUSION TBSCT demonstrated higher reproducibility and significantly decreased the proportion of inconclusive readings of PBS. TBSCT resulted in significant gain in sensitivity and accuracy in the unselected group of patients with solid tumors. However, that gain may be better appreciated in patients with nonbreast cancer.
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Affiliation(s)
- Rehab Mostafa
- Nuclear Medicine Unit, Department of Radiation Oncology and Nuclear Medicine, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Yasser G Abdelhafez
- Nuclear Medicine Unit, Department of Radiation Oncology and Nuclear Medicine, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
- Department of Radiology, University of California Davis, Sacramento, California, USA
| | - Mahasen Abougabal
- Nuclear Medicine Unit, Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Lorenzo Nardo
- Department of Radiology, University of California Davis, Sacramento, California, USA
| | - Maha A Elkareem
- Nuclear Medicine Unit, Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
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Miyaji N, Miwa K, Motegi K, Yamashita K, Terauchi T, Onoguchi M. Patient arm position during quantitative bone single-photon emission computed tomography/computed tomography acquisition can affect image quality and quantitative accuracy: a phantom study. Nucl Med Commun 2021; 42:267-275. [PMID: 33323866 DOI: 10.1097/mnm.0000000000001338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The present study used a phantom to determine the effects of various arm positions on bone SPECT/computed tomography (CT) images and the optimal arm position to acquire good-quality and quantitatively accurate images. MATERIALS AND METHODS We designed a phantom study of five simulated arm positions that are assumed during SPECT image acquisition. All SPECT data were acquired during a total of 120 projections of 10 and 100 s/view over 360° in a non-circular mode and reconstructed using Flash 3D (Siemens Healthineers). We evaluated contrast (QH,17 mm), image noise (NB,17 mm), contrast-to-noise ratios (QNRs), and visual scores according to the guidelines for bone SPECT acquisition protocols published by the Japanese Society of Nuclear Medicine Technology. The SUVmean, SUVmax, and SUVpeak were calculated and quantitative errors were evaluated using the recovery coefficient (RC) and the root means square error (RMSE). RESULTS The spatial resolution of SPECT images was better when the arms were down than raised with simulated shoulder disorders. Raised arms with shoulder disorders significantly increased the NB,17 mm and decreased the QH,17 mm, and the QNR in each image differed over a range from 2.2 to 5.2. The visual score was >1.5 with the arms down, raised normally, and raised with moderate shoulder disorders. The SUVmax and SUVpeak were overestimated compared with 100-min data for all images, whereas SUVmean was underestimated. Raised arms with a shoulder disorder decreased RCmax, and RCmean and RCpeak suppressed differences among arm positions. In addition, RMSE with the arms down and raised normally were close to that for 100-min data. CONCLUSION Bone SPECT images with good quality and quantitative accuracy can be acquired with patients holding their arms down by their sides. This will help patients with shoulder pain who have difficulties raising their arms.
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Affiliation(s)
- Noriaki Miyaji
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
- Department of Quantum Medical Technology, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa
| | - Kenta Miwa
- Department of Radiological Sciences, School of Health Science, International University of Health and Welfare, Tochigi, Japan
| | - Kazuki Motegi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
| | - Kosuke Yamashita
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
| | - Takashi Terauchi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa
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Diagnostic performance of whole-body SPECT/CT in bone metastasis detection using 99mTc-labelled diphosphate: a systematic review and meta-analysis. Clin Radiol 2020; 75:961.e11-961.e24. [DOI: 10.1016/j.crad.2020.07.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/09/2020] [Indexed: 11/17/2022]
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Tulik M, Tulik P, Kowalska T. On the optimization of bone SPECT/CT in terms of image quality and radiation dose. J Appl Clin Med Phys 2020; 21:237-246. [PMID: 33111500 PMCID: PMC7700938 DOI: 10.1002/acm2.13069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/03/2020] [Accepted: 10/05/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The purpose of this study was to present the optimization process of CT parameters to reduce patient exposure during bone SPECT/CT without affecting the quality of SPECT images with attenuation correction (AC). MATERIAL AND METHODS A fillable phantom reflecting realistic bone scintigraphy conditions was developed and acquired on an AnyScan SC. SPECT/CT scans were carried out with different x-ray tube current values (10, 20, 30, 40, 50, 60, 70, 90, 110, 130, 150, and 200 mA) at three different high-voltage values (80, 100, and 120 kV). The contrast (C) and coefficients of variation (CV) in the SPECT images as well as the signal-to-noise ratio (SNR) and noise (SDCT ) in the CT images with CTDIvol were measured. An optimal acquisition protocol that obtained SPECT/CT images with no artifacts on both CT and SPECT images, acceptable C, SNR, CV, and SDCT values, and the largest reduction in patient exposure compared to the reference acquisition procedure was sought. RESULTS The optimal set of parameters for bone SPECT/CT was determined based on a phantom study. It has been implemented in clinical practice. Two groups of patients were examined according to the baseline and optimized protocols, respectively. The new SPECT/CT protocol substantially reduced patients' radiation exposure compared to the old protocol while maintaining the required diagnostic quality of SPECT and CT images. CONCLUSIONS In the study, we present a methodology that finds a compromise between diagnostic information and patient exposure during bone SPECT/CT procedures.
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Affiliation(s)
- Monika Tulik
- Maria Sklodowska-Curie National Research Institute of Oncology Krakow Branch, Krakow, Poland
| | - Piotr Tulik
- Warsaw University of Technology, Faculty of Mechatronics, Institute of Metrology and Biomedical Engineering, Warsaw, Poland
| | - Teresa Kowalska
- Maria Sklodowska-Curie National Research Institute of Oncology Krakow Branch, Krakow, Poland
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Nuclear Medicine Imaging Techniques of the Musculoskeletal System. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Yolcu YU, Lehman VT, Bhatti AUR, Goyal A, Alvi MA, Bydon M. Use of Hybrid Imaging Techniques in Diagnosis of Facet Joint Arthropathy: A Narrative Review of Three Modalities. World Neurosurg 2019; 134:201-210. [PMID: 31655232 DOI: 10.1016/j.wneu.2019.10.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 11/18/2022]
Abstract
Facet joint osteoarthritis/arthropathy of the spine is a common cause of back and neck pain that frequently overlaps clinically with other diseases of the spine. Because of the possible overlap, it is crucial to have an accurate diagnostic strategy, especially when determining the management approach. Various strategies have been suggested and adopted, with several these still being used in clinics. Over the years, because of the disadvantages of single-modality imaging methods (computed tomography, magnetic resonance imaging, single-photon emission computed tomography), the interest in radiologic examination started to move toward hybrid imaging techniques. Although the data are mixed, many initial studies have shown promise. However, there are relatively few data with comparative medial branch blocks, and further investigation is needed. Given the advantages and disadvantages of these new techniques, the imaging results have to be interpreted within clinical context and with consideration of the current state of knowledge in the decision-making process.
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Affiliation(s)
- Yagiz Ugur Yolcu
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Vance T Lehman
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Atiq Ur Rehman Bhatti
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Anshit Goyal
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mohammed Ali Alvi
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mohamad Bydon
- Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
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Israel O, Pellet O, Biassoni L, De Palma D, Estrada-Lobato E, Gnanasegaran G, Kuwert T, la Fougère C, Mariani G, Massalha S, Paez D, Giammarile F. Two decades of SPECT/CT - the coming of age of a technology: An updated review of literature evidence. Eur J Nucl Med Mol Imaging 2019; 46:1990-2012. [PMID: 31273437 PMCID: PMC6667427 DOI: 10.1007/s00259-019-04404-6] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/14/2019] [Indexed: 02/08/2023]
Abstract
PURPOSE Single-photon emission computed tomography (SPECT) combined with computed tomography (CT) was introduced as a hybrid SPECT/CT imaging modality two decades ago. The main advantage of SPECT/CT is the increased specificity achieved through a more precise localization and characterization of functional findings. The improved diagnostic accuracy is also associated with greater diagnostic confidence and better inter-specialty communication. METHODS This review presents a critical assessment of the relevant literature published so far on the role of SPECT/CT in a variety of clinical conditions. It also includes an update on the established evidence demonstrating both the advantages and limitations of this modality. CONCLUSIONS For the majority of applications, SPECT/CT should be a routine imaging technique, fully integrated into the clinical decision-making process, including oncology, endocrinology, orthopaedics, paediatrics, and cardiology. Large-scale prospective studies are lacking, however, on the use of SPECT/CT in certain clinical domains such as neurology and lung disorders. The review also presents data on the complementary role of SPECT/CT with other imaging modalities and a comparative analysis, where available.
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Affiliation(s)
- Ora Israel
- Rappaport School of Medicine, Israel Institute of Technology, Haifa, Israel.
| | - O Pellet
- Nuclear Medicine and Diagnostic Imaging Section International Atomic Energy Agency, Vienna, Austria
| | - L Biassoni
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - D De Palma
- Nuclear Medicine Unit, Circolo Hospital, ASST-Settelaghi, Varese, Italy
| | - E Estrada-Lobato
- Nuclear Medicine and Diagnostic Imaging Section International Atomic Energy Agency, Vienna, Austria
| | - G Gnanasegaran
- Department of Nuclear Medicine, Royal Free NHS Foundation Trust, London, UK
| | - T Kuwert
- Clinic of Nuclear Medicine, University Hospital, Erlangen, Germany
| | - C la Fougère
- Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, University Hospital, Tubingen, Germany
| | - G Mariani
- Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy
| | - S Massalha
- Department of Medicine, University of Ottawa Heart Institute, Ottawa, Canada
- Department of Nuclear Medicine, Rambam Healthcare Campus, Haifa, Israel
| | - D Paez
- Nuclear Medicine and Diagnostic Imaging Section International Atomic Energy Agency, Vienna, Austria
| | - F Giammarile
- Nuclear Medicine and Diagnostic Imaging Section International Atomic Energy Agency, Vienna, Austria
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Fleury V, Ferrer L, Colombié M, Rusu D, Le Thiec M, Kraeber-Bodéré F, Campion L, Rousseau C. Advantages of systematic trunk SPECT/CT to planar bone scan (PBS) in more than 300 patients with breast or prostate cancer. Oncotarget 2018; 9:31744-31752. [PMID: 30167091 PMCID: PMC6114966 DOI: 10.18632/oncotarget.25860] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/18/2018] [Indexed: 01/03/2023] Open
Abstract
PROPOSE The aim of our study was to evaluate the potential benefit of a systematic trunk SPECT/CT associated with a Planar Bone Scan (PBS) in breast cancer (BC) and prostate cancer (PCa) patients at initial staging or recurrence. RESULTS In 328 patients, sensitivities and specificities were between 74.4-93% and 78.8-97.5% for PBS and 97.7-100% and 96.8-98.6% for SPECT/CT respectively. PBS was considered equivocal for 67 compared to only 6 patients for trunk SPECT/CT. Regardless of "optimistic" or "pessimistic" analysis of equivocal trunk SPECT/CT lesions, the trunk SPECT/CT was almost perfect, allowing to rely on this result for excluding metastatic disease which was corroborated by ROC curve analysis. The trunk SPECT/CT allowed downstaging for 62 patients (19%) and upstaging for 11 patients. MATERIALS AND METHODS PBS and a trunk SPECT/CT were systematically performed in all patients. Independent review of PBS and trunk SPECT/CT was performed for each patient and an abnormality interpretative score (Sc) with 3 levels was built: Sc 1: metastatic or probably metastatic pattern, Sc 2: equivocal pattern, Sc 3: benign or probably benign pattern or no abnormality. The bone pattern status was defined by at least 1 year follow-up. The clinical impact was evaluated in terms of down and upstaging in patient analysis. CONCLUSIONS Trunk SPECT/CT improves the performance of PBS in BC and PCa assessments and results in improvements in both the detection performance of bone metastases as well as a better characterization of equivocal lesions.
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Affiliation(s)
- Vincent Fleury
- Nuclear Medicine Unit, ICO Cancer Center, Saint Herblain, France
| | - Ludovic Ferrer
- Nantes-Angers Cancer Research Center, INSERM U892, CNRS UMR 6299, University of Nantes, Nantes, France
- Medical Physics Unit, ICO Cancer Center, Saint Herblain, France
| | | | - Daniéla Rusu
- Nuclear Medicine Unit, ICO Cancer Center, Saint Herblain, France
| | - Maëlle Le Thiec
- Nuclear Medicine Unit, ICO Cancer Center, Saint Herblain, France
| | - Françoise Kraeber-Bodéré
- Nuclear Medicine Unit, ICO Cancer Center, Saint Herblain, France
- Nantes-Angers Cancer Research Center, INSERM U892, CNRS UMR 6299, University of Nantes, Nantes, France
| | - Loïc Campion
- Nantes-Angers Cancer Research Center, INSERM U892, CNRS UMR 6299, University of Nantes, Nantes, France
- Biometrics Unit, ICO Gauducheau Cancer Center, Saint Herblain, France
| | - Caroline Rousseau
- Nuclear Medicine Unit, ICO Cancer Center, Saint Herblain, France
- Nantes-Angers Cancer Research Center, INSERM U892, CNRS UMR 6299, University of Nantes, Nantes, France
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