TY - JOUR T1 - Diagnostic additional value and management impact of whole -body SPECT/CT associated with conventional bone scan in more 250 oncological patients JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1478 LP - 1478 VL - 57 IS - supplement 2 AU - Vincent Fleury AU - Daniela Rusu AU - Loïc Campion AU - Mathilde Colombie AU - Ludovic Ferrer AU - Dorothe Goulon AU - Maëlle Le Thiec AU - Francoise Bodere AU - Caroline ROUSSEAU Y1 - 2016/05/01 UR - http://jnm.snmjournals.org/content/57/supplement_2/1478.abstract N2 - 1478Objectives In oncological patients, bone scan short coming is its limited specificity in many cases. We aimed to assess the additional value of whole-body SPECT/CT systematically used with conventional bone scan (BS) in prostate and breast cancer patients and its effects on patient management.Methods In 265 consecutive patients (139 breast cancer, 126 prostate cancer), BS and trunk SPECT/CT, performed for staging and restaging, were retrospectively analyzed. Clinical and imaging follow-up were used as gold standard. BS and SPECT-CT images were independently evaluated in separate sessions. A scoring scale of 1 to 3 was used, with 1 being metastatic, 2 indeterminate, 3 benign. Sensitivity, specificity, and predictive values were calculated; a score ≤2 was defined as metastatic. The areas under the receiver operating characteristic curve (AUC) were calculated and compared. Clinical relevance was expressed in terms of downstaging and upstaging rates on a per-patient basis.Results In the total patient group, sensitivities, specificities, and negative and positive predictive values on a per-patient basis were 94.1%, 76.6%, 99% and 37% for BS, 100%, 96.1%, 100% and 79% for SPECT/CT respectively. For all patients, the diagnostic performance of the SPECT/CT was significantly better than with BS, respectively (AUC=0.98; 95%IC [0.97-0.99]) and (AUC=0.85; 95%IC [0.81-0.90]) (p< 10-6). For the two subgroups, the diagnostic superiority of SPECT/CT is also verified (p<10-3). In 54 indeterminate lesions observed by BS, 51 where correctly characterized by SPECT/CT (94%). Downstaging of metastatic disease in the total, breast cancer and prostate cancer groups using SPECT/CT was possible in 18.5% (49/265), 18.0% (25/139) and 19% (24/126) of patients, respectively. Upstaging, by additional SPECT/CT, in previously negative patients was observed only in two breast cancer patients (1.4%) (2/139).Conclusions Whole-body SPECT/CT significantly improved the specificity and positive predictive value of BS in cancer patients. SPECT/CT had a significant effect on clinical management because of correct downstaging/upstaging, the therapeutic management is promptly optimized. ER -