PT  - JOURNAL ARTICLE
AU  - Pareek, Vipul
AU  - R Mittal, B
AU  - Sharma, Anju
AU  - Dutta, Shweta
AU  - Bhattacharya, A
AU  - Singh, B
TI  - Radioisotope bone scanning and SPECT/CT in patients of carcinoma cervix
DP  - 2009 May 01
TA  - Journal of Nuclear Medicine
PG  - 513--513
VI  - 50
IP  - supplement 2
4099  - http://jnm.snmjournals.org/content/50/supplement_2/513.short
4100  - http://jnm.snmjournals.org/content/50/supplement_2/513.full
SO  - J Nucl Med2009 May 01; 50
AB  - 513 Objectives The value of bone scan and fusion SPECT/CT imaging was evaluated by review of patient records and radioisotope studies with an aim of defining the frequency of bone metastasis in patients suffering from cervical carcinoma. Methods 34 females (age 35-75yrs) underwent bone scan as a part of post treatment management of cervical carcinoma.3 patients were in stageI,6 in stageII,14 in stage 3 and 11 were in stage 4 according to FIGO classification. Patients with doubtful uptake anywhere in skeleton underwent fusion SPECT/CT to characterize the lesion. Results Bony metastases were found in 10(29%) patients. In our series none of the patient in stage I and stage II showed presence of skeletal metastasis. 6 /14 patients in stage 3, and 4 /11 patients in stage IV showed presence of metastasis. Pelvis (4) and vertebrae (6) was the commonest site of involvement.4 lesions were of mixed variety showing osteolytic and osteoblastic pattern of uptake while rest of the lesion were osteoblastic variety. Apart from bone metastases, doubtful abnormal tracer uptake was noticed in pelvis in 3 other patients which on SPECT/CT fusion imaging were shown to be due to radiation necrosis caused by external radiotherapy. Conclusions Although this series is small but the incidence of bony metastasis in our study was much higher than reported in literature probably due to more no of patients in stage 3 and 4 as compared to lower stages which probably don’t need bone scan for screening purpose. Bone pain in irradiated pelvis due to radiation necrosis can be picked up much earlier on bone scan. Symmetrical uptake in pelvis might provide a clue to this entity but in asymmetric cases, fusion imaging like SPECT/CT or CT scan with clinical follow up is necessary.