The Role Of Whole-Body SPECT/CT Using Tc-99m MDP In Characterization Of Osseous Lesions In Breast Cancer Patients

Document Type : Original Paper, Diagnostic NM

Authors

1 Oncology and nuclear medicine department, Kasr Alainy, Cairo University

2 Nuclear Medicine Department Kasr Alainy Cairo University

3 Nuclear Medicine Department, Kasr Alainy Cairo University

4 Nuclear Medicine Kasr Alainy Cairo University

Abstract

Introduction: breast cancer is the second greatest cause of death in women, affecting women of all ages, races, and geographical locations [1]. Bone, lungs, and liver are the most common locations of distant metastases [2]. The most extensively used approach for detecting bone metastases is whole-body bone scintigraphy with technetium99m tagged diphosphonates [4]. Objectives: Compare the rate of detectability of bone metastases in breast cancer patients utilizing whole body single photon emission computed tomography/ computed tomography against planar conventional bone scintigraphy. Material and methods: prospective study included 50 female patients diagnosed with breast cancer, with an average age of 46.9 ± 15 years. Planar bone scintigraphy was performed on the patients, followed by whole body SPECT/CT scans by administering 1110 MBq of Tc99m MDP intravenously. Full body scan was performed (table rate 12 cm/min). A total of 32 frames with 15 seconds per frame were used to collect SPECT and CT images of the entire body over a 360-degree arc with a 128*128 matrix and iterative filtration (four iterations, four subsets, and Gaussian filter 8). Both modalities were read independently by two competent nuclear medicine experts. Results: The sensitivity, specificity, positive predictive value, and negative predictive value of Planar bone scintigraphy and W.B. SPECT/CT images were 52.2 % Vs 87 %, 92.6 % Vs 96.3 %, 85.7 % Vs 95.2 %, and 69.4 % Vs 89.7 %, respectively. The difference in sensitivity between the two modalities was statistically significant (P-value = 0.001), whereas the difference in specificity was statistically inconsequential (P-value = 0.5). Conclusions: whole-body SPECT/CT bone scintigraphy improves the sensitivity of the bone scan for detecting osseous metastases and minimizes the number of equivocal lesions.

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