Research ArticleCLINICAL INVESTIGATIONS

SPECT-Guided CT for Evaluating Foci of Increased Bone Metabolism Classified as Indeterminate on SPECT in Cancer Patients

Wolfgang Römer, Anton Nömayr, Michael Uder, Werner Bautz and Torsten Kuwert
Journal of Nuclear Medicine July 2006, 47 (7) 1102-1106;

Article Figures & Data

Figures

  • FIGURE 1. 
    FIGURE 1. 

    99mTc-Dicarboxypropane diphosphonate SPECT/CT was performed with CT field of view from C4 to T4 in 74-y-old woman with breast cancer. SPECT images (left) show focally increased bone metabolism localized in vertebral body of C6. CT (right) discloses osteochondrosis in C6−C7, with vacuum phenomenon clearly matched to area of increased bone metabolism seen on fused images (middle). No osteolysis is detectable on CT. Top row is axial slices; bottom row, sagittal slices.

  • FIGURE 2. 
    FIGURE 2. 

    99mTc-Dicarboxypropane diphosphonate SPECT/CT was performed with CT field of view from C3 to T3 in 44-y-old woman with breast cancer. SPECT images (left) show focally increased bone metabolism localized in vertebral body of C5. CT (right) discloses clear-cut osteolysis in vertebral body of C5, with destruction of posterior corticalis clearly matched to area of increased bone metabolism seen on fused images (middle). No degenerative lesion is detectable on CT. Top row is axial slices; bottom row, sagittal slices.

Tables

  • TABLE 1

    Type and Incidence of Malignant Disease Within Study Group

    Type of malignancyNo. of patients
    Breast cancer25
    Lung cancer5
    Bladder cancer2
    Renal cancer2
    Rectosigmoidal cancer2
    Other*8

    • ↵* Prostate cancer, Ewing sarcoma, thyroid cancer, synovial carcinoma, lymphoma, oropharyngeal cancer, squamous cell carcinoma with unknown primary, or carcinoma of unknown primary.

  • TABLE 2

    Anatomic Regions Exhibiting Indeterminate Findings on SPECT

    Anatomic regionn%
    Cervical spine1121.2
    Thoracic spine1223.1
    Lumbar spine1019.2
    Pelvis611.5
    Rib815.4
    Scapula23.8
    Sternoclavicular joint11.9
    Sternum11.9
    Clavicula11.9
  • TABLE 3

    SPECT/CT Classification of Originally Indeterminate Findings

    Anatomic regionBenign (n)Indeterminate (n)Malignant (n)
    Cervical spine1001
    Thoracic spine705
    Lumbar spine703
    Pelvis402
    Rib422
    Scapula100
    Sternoclavicular joint100
    Sternum001
    Clavicula001
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