RT Journal Article SR Electronic T1 ROC analysis for xSPECT Bone JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 1279 OP 1279 VO 56 IS supplement 3 A1 Alexander Hans Vija A1 Jun Ma A1 Peter Bartenstein A1 Jerry Froelich A1 Torsten Kuwert A1 Homer Macapinlac A1 Aaron Jessop A1 Harun Ilhan A1 Shirley Yang A1 Zsolt Szabo YR 2015 UL http://jnm.snmjournals.org/content/56/supplement_3/1279.abstract AB 1279 Objectives We previously reported a high concordance and increased confidence when reading bone scans reconstructed with xSPECT Bone (xB) compared to conventional Flash 3D (F3D;OSEM3D) [SNMMI 2014]. We now report on sensitivity and specificity using a surrogate truth model from available data and majority rule.Methods Following the concordance reading (76 patients with breast or prostate carcinoma, 3 VOI/Pat, [malignant: 40%,benign: 40%: questionable existence:10%, negative control: 10%], 4 modalities, 9 readers; 2052 randomized reads), the truth reading was conducted, where readers reviewed F3D or xB scans, displayed together with CT, whole body planar and clinical reports. We determined a final decision for each lesion by majority voting of truth readings, combined with references from the original clinical reports which included all clinically available information such as tumor histology or presence of lesions. The blind readings of F3D, xB, F3D/CT or xB/CT were compared against final truth decisions using ROC (Receiver Operating Characteristic) curves and the Area-Under-Curve (AUC) values.Results xB yielded a sensitivity of 73%, a specificity of 95%, and an AUC of 0.84 (95% CI 0.82 - 0.86), which represented a significant improvement over F3D’s sensitivity of 68%, specificity of 89%, and AUC 0.79 (95 % CI 0.77 - 0.80). xB/CT resulted in a sensitivity of 82%, a specificity of 96%, and an AUC of 0.89 (95% CI 0.88-0.90) whereas F3D/CT shows a sensitivity of 82%, a specificity of 94%, and an AUC of 0.88 (95% CI 0.86-0.89). SPECT/CT fused display reading was significantly better than reading either xB or F3D without the CT.Conclusions When reading nuclear SPECT scans without CT, xB has significantly higher accuracy than F3D to discern malignant lesions. This accuracy is further validated against current gold standard (F3D/CT) when xB is fused with CT.