The value of SPECT/CT fusion imaging in the whole-body bone scan

Objectives The aim of the study was to evaluate the value of SPECT/CT fusion imaging in the differential diagnosis of benign and malignant lesions in the ^99mTc-MDP whole-body bone scan.

Methods 321 bone lesions and 29 not bone ones of 225 cancer patients for whom the natures of the lesions were not able to be determined by the whole-body bone scan, were simultaneously examined in the whole-body and SPECT/CT fusion imaging by the GE infinia^VC Hawkeye SPECT, data acquirements of SPECT/CT fusion imaging with a matrix size up to 128x128, 25 secs-per-frame, and CT with 1 cm-per-slice. The natures of the lesions were eventually confirmed by pathology or follow-up diagnosis six months later.

Results The malignancy or benignancy of the bone lesion not only relate to the location, but also to the characteristic appearance of the one, especially small osteolysis, single spinal, femoral head and joint lesions, et al; The not bone lesion relate to differential drug pollution, tissue calcification, some malignancy and gastrointestinal tract, et al. The diagnostic sensitivity of SPECT and SPECT/CT for the 321 bone lesions was 81.5% and 98.2% respectively. The specificity was 63.7% and 93.4% respectively. The accuracy was 72.8% and 95.3% respectively. The specificity and accuracy of SPECT/CT for diagnosing bone lesions were significantly higher than those of SPECT (P<0.05).

Conclusions SPECT/CT can effectively differentiate benign and malignant bone lesions, especially small osteolysis, single spinal, femoral head, joint lesions, and not bone lesion.