Abstract
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Objectives: To assess feasibility and compare diagnostic performance of whole body SPECT (WBS) versus traditional whole body planar (WBP) bone scans in oncology patients.
Methods: 32 consenting patients underwent skeletal scintigraphy on a Siemens Symbia T. A 3-bed, 7 min/bed SPECT acquisition (head to thighs) was acquired 2.5hr after injection of 1000 MBq of Tc-99m MDP. A single WB image was reconstructed using Flash3D. A 20 min WBP scan was acquired following the WPS. WBS and WBP images were blinded and interpreted independently by three nuclear medicine physicians. The number of benign, malignant, and non-specific lesions was recorded for each of 8 anatomical regions. Paired t-test analyzed difference in lesion counts between WBS and WBP.
Results: WBS detected 0.7±1.4 more benign lesions for all regions above the pelvis, compared to WBP (p<0.05). WBS resulted in 0.25±0.98 more non-specific lesions being reported for the skull, shoulders/ribs, and arms, compared to WBP (p<0.05). There was no significant difference between the two techniques for either the number of malignant lesions reported for any site (p<0.05) or in the number of patients diagnosed with metastases (p=0.3). However, no WBS subjects were classified as normal, compared to an average of 3.7±2.7 normals report for WBP. There was no difference in the number of malignant legions reported by each physician, except in the shoulder/rib region (p=0.02).
Conclusions: Whole body bone SPECT can be performed without impact on patient positivity for metastatic disease, compared to traditional planar imaging, and may improve patient throughput by eliminating additional single site SPECT added to standard planar scans. The significant number of additional benign and non-specific lesions detected by whole body SPECT warrants a new learning curve.
- Society of Nuclear Medicine, Inc.