Olga Kagna MD, Abstract Co-Author: Nothing to Disclose

Natalia Puchkov, Abstract Co-Author: Nothing to Disclose

Natalia Pirmisashvili, Abstract Co-Author: Nothing to Disclose

Daniela Militianu MD, Abstract Co-Author: Nothing to Disclose

Gad Abikhzer MD, Presenter: Nothing to Disclose

Ora Israel MD, Abstract Co-Author: Consultant, General Electric Company

Bone scintigraphy (BS) is the most frequently performed general nuclear medicine procedure. Present study assesses referral patterns to bone SPECT/CT as well as its frequency and type of incremental value to functional assessment of the skeleton.

Bone SPECT/16-CT (Discovery 670, GE Healthcare) was performed after administration of 925 MBq 99mTc-MDP and after completion of the planar BS. Studies performed over a 20 months period in 135 patients (80 M,55 F, age 7-85) were retrieved and retrospectively reviewed for referral criteria and the presence of any incremental value (defined as lesion localization and characterization). Indications for BS included skeletal pain (n=71), fracture or infection (n=30), metastatic survey (n=25), inconclusive prior imaging tests (n=9). The decision for performing SPECT/CT was based on findings on planar BS, on known clinical complaints and/or on results of prior imaging test.

Four groups of referral criteria to SPECT/CT were found. A. unclear localization of lesions to bone or soft tissue (ST) - 19 pts (14%). SPECT/CT correctly localized all sites (10 bone,5 ST, 4 bone+ST) and had an added value in 17/19 cases (89%) characterizing 15 and guiding further tests in 2 lesions. B. unclear localization of lesions to specific parts of bone - 59 pts (44%). SPECT/CT correctly localized all foci and characterized 55/59 (93%). C. diagnosis of bone lesion -52 pts (38%). SPECT/CT had an added value in 47/52 lesions (90%) defining 37 and guiding further tests in 10. D. diagnosis of ST lesions - 5 pts (4%). SPECT/CT had an added value in all cases (100%),defining 3 and guiding further tests in 2 sites. Overall SPECT/CT correctly localized all sites of skeletal and ST uptake and improved the diagnostic accuracy of BS with precise characterization of lesions in 110/135 pts (81%) and guiding further tests in 14/135 pts (10%).

The use of bone SPECT/CT was associated with an incremental improvement in the diagnostic capabilities and clinical impact of BS. Bone SPECT/CT was of value in all cases with unclear lesion localization. Furthermore it provided additional information for precise characterization of abnormal tracer uptake in the majority (91%) of patients.

SPECT/CT is of value for improving the diagnostic accuracy and clinical impact as an adjunct to bone scintigraphy

Kagna, O, Puchkov, N, Pirmisashvili, N, Militianu, D, Abikhzer, G, Israel, O, SPECT/CT —A Valuable Adjunct to Bone Scintigraphy  [ MI Scavenger Hunt! ].  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045658.html