scholarly journals Quantitative bone SPECT/CT: high specificity for identification of prostate cancer bone metastases

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Flavian Tabotta ◽  
Mario Jreige ◽  
Niklaus Schaefer ◽  
Fabio Becce ◽  
John O. Prior ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
High Specificity ◽  
Emission Computed Tomography ◽  
Neoplastic Disease ◽  
Operating Characteristics ◽  
Quantitative Spect ◽  
Bone Spect

Abstract Purpose Bone scintigraphy with 99mTc-labeled diphosphonates can identify prostate cancer bone metastases with high sensitivity, but relatively low specificity, because benign conditions such as osteoarthritis can also trigger osteoblastic reactions. We aimed to investigate the diagnostic performance of 99mTc-2,3-dicarboxy propane-1,1-diphosphonate (99mTc-DPD) uptake quantification by single-photon emission computed tomography coupled with computed tomography (SPECT/CT) for distinguishing prostate cancer bone metastases from spinal and pelvic osteoarthritic lesions. Methods We retrospectively assessed 26 bone scans from 26 patients with known prostate cancer bone metastases and 13 control patients with benign spinal and pelvic osteoarthritic changes without known neoplastic disease. Quantitative SPECT/CT (xSPECT, Siemens Symbia Intevo, Erlangen, Germany) was performed and standardized uptake values (SUVs) were quantified with measurements of SUVmax and SUVmean (g/mL) in all bone metastases for the prostate cancer group and in spinal and pelvic osteoarthritic changes for the control group. We used receiver operating characteristics (ROC) curves to determine the optimum SUVmax cutoff value to distinguish between bone metastases and benign spinal and pelvic lesions. Results In total, 264 prostate cancer bone metastases were analyzed, showing a mean SUVmax and SUVmean of 34.6 ± 24.6 and 20.8 ± 14.7 g/mL, respectively. In 24 spinal and pelvic osteoarthritic lesions, mean SUVmax and SUVmean were 14.2 ± 3.8 and 8.9 ± 2.2 g/mL, respectively. SUVmax and SUVmean were both significantly different between the bone metastases and osteoarthritic groups (p ≤ 0.0001). Using a SUVmax cutoff of 19.5 g/mL for prostate cancer bone metastases in the spine and pelvis, sensitivity, specificity, positive and negative predictive values were 87, 92, 99 and 49%, respectively. Conclusion This study showed significant differences in quantitative 99mTc-DPD uptake on bone SPECT/CT between prostate cancer bone metastases and spinal and pelvic osteoarthritic changes, with higher SUVmax and SUVmean in metastases. Using a SUVmax cutoff of 19.5 g/mL, high specificity and positive predictive value for metastases identification in the spine and pelvis were found, thus increasing accuracy of bone scintigraphy.

scholarly journals Quantitative Bone SPECT/CT: High Specificity for Identification of Prostate Cancer Bone Metastases

2019 ◽  
Author(s):  
Flavian Tabotta ◽  
Mario Jre ◽  
Niklaus Schaefer ◽  
Fabio Becce ◽  
Christine Geldhof ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
High Specificity ◽  
Emission Computed Tomography ◽  
Neoplastic Disease ◽  
Operating Characteristics ◽  
Quantitative Spect ◽  
Bone Spect

Abstract Purpose: Bone scintigraphy with 99mTc-labeled diphosphonates can identify prostate cancer bone metastases with high sensitivity, but relatively low specificity, because benign conditions such as osteoarthritis can also trigger osteoblastic reactions. We aimed to investigate the diagnostic performance of 99mTc-2,3-dicarboxy propane-1,1-diphosphonate (99mTc-DPD) uptake quantification by single-photon emission computed tomography coupled with computed tomography (SPECT/CT) for distinguishing prostate cancer bone metastases from spinal and pelvic osteoarthritic lesions. Methods: We retrospectively assessed 26 bone scans from 26 patients with known prostate cancer bone metastases and 13 control patients with benign spinal and pelvic osteoarthritic changes without known neoplastic disease. Quantitative SPECT/CT (xSPECT, Siemens Symbia Intevo, Erlangen, Germany) was performed and standardized uptake values (SUVs) were quantified with measurements of SUVmax and SUVmean (g/mL) in all bone metastases for the prostate cancer group and in lumbar and pelvic osteoarthritic changes for the control group. We used receiver operating characteristics (ROC) curves to determine the optimum SUVmax cutoff value to distinguish between bone metastases and benign spinal and pelvic lesions. Results: In total, 264 prostate cancer bone metastases were analyzed, showing a mean SUVmax and SUVmean of 34.6±24.6 and 20.8±14.7 g/mL, respectively. In 24 spinal and pelvic osteoarthritic lesions, mean SUVmax and SUVmean were 14.2±3.8 and 8.9±2.2 g/mL, respectively. SUVmax and SUVmean were both significantly different between the bone metastases and osteoarthritic groups (p≤0.0001). Using a SUVmax cutoff of 19.5 g/mL for prostate cancer bone metastases in the spine and pelvis, sensitivity, specificity, positive and negative predictive values were 87%, 92%, 99% and 49%, respectively. Conclusion: This study showed significant differences in quantitative 99mTc-DPD uptake on bone SPECT/CT between prostate cancer bone metastases and spinal and pelvic osteoarthritic changes, with higher SUVmax and SUVmean in metastases. Using a SUVmax cutoff of 19.5 g/mL, high specificity and positive predictive value for metastases identification in the spine and pelvis were found, thus increasing accuracy of bone scintigraphy.

scholarly journals Quantitative Bone SPECT/CT: High Specificity for Identification of Prostate Cancer Bone Metastases

2019 ◽  
Author(s):  
Flavian Tabotta ◽  
Mario Jre ◽  
Niklaus Schaefer ◽  
Fabio Becce ◽  
John O. Prior ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
High Specificity ◽  
Emission Computed Tomography ◽  
Neoplastic Disease ◽  
Operating Characteristics ◽  
Quantitative Spect ◽  
Bone Spect

Abstract Purpose: Bone scintigraphy with 99mTc-labeled diphosphonates can identify prostate cancer bone metastases with high sensitivity, but relatively low specificity, because benign conditions such as osteoarthritis can also trigger osteoblastic reactions. We aimed to investigate the diagnostic performance of 99mTc-2,3-dicarboxy propane-1,1-diphosphonate (99mTc-DPD) uptake quantification by single-photon emission computed tomography coupled with computed tomography (SPECT/CT) for distinguishing prostate cancer bone metastases from spinal and pelvic osteoarthritic lesions. Methods: We retrospectively assessed 26 bone scans from 26 patients with known prostate cancer bone metastases and 13 control patients with benign spinal and pelvic osteoarthritic changes without known neoplastic disease. Quantitative SPECT/CT (xSPECT, Siemens Symbia Intevo, Erlangen, Germany) was performed and standardized uptake values (SUVs) were quantified with measurements of SUVmax and SUVmean (g/mL) in all bone metastases for the prostate cancer group and in lumbar and pelvic osteoarthritic changes for the control group. We used receiver operating characteristics (ROC) curves to determine the optimum SUVmax cutoff value to distinguish between bone metastases and benign spinal and pelvic lesions. Results: In total, 264 prostate cancer bone metastases were analyzed, showing a mean SUVmax and SUVmean of 34.6±24.6 and 20.8±14.7 g/mL, respectively. In 24 spinal and pelvic osteoarthritic lesions, mean SUVmax and SUVmean were 14.2±3.8 and 8.9±2.2 g/mL, respectively. SUVmax and SUVmean were both significantly different between the bone metastases and osteoarthritic groups (p≤0.0001). Using a SUVmax cutoff of 19.5 g/mL for prostate cancer bone metastases in the spine and pelvis, sensitivity, specificity, positive and negative predictive values were 87%, 92%, 99% and 49%, respectively. Conclusion: This study showed significant differences in quantitative 99mTc-DPD uptake on bone SPECT/CT between prostate cancer bone metastases and spinal and pelvic osteoarthritic changes, with higher SUVmax and SUVmean in metastases. Using a SUVmax cutoff of 19.5 g/mL, high specificity and positive predictive value for metastases identification in the spine and pelvis were found, thus increasing accuracy of bone scintigraphy.

scholarly journals Quantitative Bone SPECT/CT: High Specificity for Identification of Prostate Cancer Bone Metastases

2019 ◽  
Author(s):  
Flavian Tabotta ◽  
Mario Jre ◽  
Niklaus Schaefer ◽  
Christine Geldhof ◽  
Fabio Becce ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
High Specificity ◽  
Emission Computed Tomography ◽  
Neoplastic Disease ◽  
Operating Characteristics ◽  
Quantitative Spect ◽  
Bone Spect

Abstract Purpose: Bone scintigraphy with 99mTc-labeled diphosphonates can identify prostate cancer bone metastases with high sensitivity, but relatively low specificity, because benign conditions such as osteoarthritis can also trigger osteoblastic reactions. We aimed to investigate the diagnostic performance of 99mTc-2,3-dicarboxy propane-1,1-diphosphonate (99mTc-DPD) uptake quantification by single-photon emission computed tomography coupled with computed tomography (SPECT/CT) for distinguishing prostate cancer bone metastases from spinal and pelvic osteoarthritic lesions. Methods: We retrospectively assessed 26 bone scans from 26 patients with known prostate cancer bone metastases and 13 control patients with benign spinal and pelvic osteoarthritic changes without known neoplastic disease. Quantitative SPECT/CT (xSPECT, Siemens Symbia Intevo, Erlangen, Germany) was performed and standardized uptake values (SUVs) were quantified with measurements of SUVmax and SUVmean (g/mL) in all bone metastases for the prostate cancer group and in lumbar and pelvic osteoarthritic changes for the control group. We used receiver operating characteristics (ROC) curves to determine the optimum SUVmax cutoff value to distinguish between bone metastases and benign spinal and pelvic lesions. Results: In total, 264 prostate cancer bone metastases were analyzed, showing a mean SUVmax and SUVmean of 34.6±24.6 and 20.8±14.7 g/mL, respectively. In 24 spinal and pelvic osteoarthritic lesions, mean SUVmax and SUVmean were 14.2±3.8 and 8.9±2.2 g/mL, respectively. SUVmax and SUVmean were both significantly different between the bone metastases and osteoarthritic groups (p≤0.0001). Using a SUVmax cutoff of 19.5 g/mL for prostate cancer bone metastases in the spine and pelvis, sensitivity, specificity, positive and negative predictive values were 87%, 92%, 99% and 49%, respectively. Conclusion: This study showed significant differences in quantitative 99mTc-DPD uptake on bone SPECT/CT between prostate cancer bone metastases and spinal and pelvic osteoarthritic changes, with higher SUVmax and SUVmean in metastases. Using a SUVmax cutoff of 19.5 g/mL, high specificity and positive predictive value for metastases identification in the spine and pelvis were found, thus increasing accuracy of bone scintigraphy.

Computerized Tomography (CT) Updates and Challenges in Diagnosis of Bone Metastases During Prostate Cancer

2020 ◽  
Vol 16 (5) ◽  
pp. 565-571
Author(s):  
Jinguo Zhang ◽  
Guanzhong Zhai ◽  
Bin Yang ◽  
Zhenhe Liu
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Bone Metastases ◽  
Computerized Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Major Complication ◽  
Tracer Uptake ◽  
Emission Computed Tomography ◽  
Pet Ct

Prostate cancer is one of the most common cancers in men. This cancer is often associated with indolent tumors with little or no lethal potential. Some of the patients with aggressive prostate cancer have increased morbidity and early deaths. A major complication in advanced prostate cancer is bone metastasis that mainly results in pain, pathological fractures, and compression of spinal nerves. These complications in turn cause severe pain radiating to the extremities and possibly sensory as well as motor disturbances. Further, in patients with a high risk of metastases, treatment is limited to palliative therapies. Therefore, accurate methods for the detection of bone metastases are essential. Technical advances such as single-photon emission computed tomography/ computed tomography (SPECT/CT) have emerged after the introduction of bone scans. These advanced methods allow tomographic image acquisition and help in attenuation correction with anatomical co-localization. The use of positron emission tomography/CT (PET/CT) scanners is also on the rise. These PET scanners are mainly utilized with 18F-sodium-fluoride (NaF), in order to visualize the skeleton and possible changes. Moreover, NaF PET/CT is associated with higher tracer uptake, increased target-to-background ratio and has a higher spatial resolution. However, these newer technologies have not been adopted in clinical guidelines due to lack of definite evidence in support of their use in bone metastases cases. The present review article is focused on current perspectives and challenges of computerized tomography (CT) applications in cases of bone metastases during prostate cancer.

scholarly journals An alternative method for radioactivity measurement in quantitative bone SPECT/CT imaging

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110283
Author(s):  
Masaru Ishihara ◽  
Yasuaki Kato ◽  
Masahisa Onoguchi ◽  
Takayuki Shibutani
Keyword(s):  
Computed Tomography ◽  
Analytical Methods ◽  
Measurement Method ◽  
Ct Imaging ◽  
Emission Computed Tomography ◽  
Post Injection ◽  
Quantitative Spect ◽  
Quantitative Parameters ◽  
Alternative Method ◽  
Bone Spect

Bone scintigraphy with combined single-photon emission computed tomography (SPECT) and computed tomography (CT) has become widely used for the detection of bone metastases. However, calculation of the semi-quantitative standardized uptake value (SUV) requires measurement of the pre- and post-injection radioactivity of the radiopharmaceutical. This study aimed to compare measured and fixed input radioactivity values for quantitative SPECT/CT bone imaging to examine whether the fixed measurement method of radiopharmaceutical radioactivity could be used as an alternative method. Four different methods were used to quantify the Tc-99m hydroxymethylene diphosphonate input radioactivity: (A) measured pre- and post-injection radioactivity values; (B) measured pre-injection and fixed post-injection radioactivity values; (C) fixed pre-injection and measured post-injection radioactivity values; (D) fixed pre- and post-injection radioactivity values. All SPECT/CT acquisitions were analyzed using bone SPECT analysis software, and the semi-quantitative parameters (SUVpeak and SUVmean) were recorded and compared for each analytical method. Two semi-quantitative parameters showed significant differences between analytical methods A and B, A and D, and C and D. However, an additional subgroup analysis performed on patients whose median post-injection measured radioactivity value was <1.5 MBq showed no significant differences in parameters between all analytical methods. Measurement of the radiopharmaceutical radioactivity can be an alternative method because it reduces the volume of radioactivity post-injection. The simplified fixed measurement method of radiopharmaceutical radioactivity can be used as an alternative method in cases when measuring the radioactivity in quantitative bone SPECT/CT imaging is missed.

scholarly journals Nuclear Imaging for Bone Metastases in Prostate Cancer: The Emergence of Modern Techniques Using Novel Radiotracers

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 117
Author(s):  
Wietske I. Luining ◽  
Dennie Meijer ◽  
Max R. Dahele ◽  
André N. Vis ◽  
Daniela E. Oprea-Lager
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Nuclear Imaging ◽  
Prostate Specific Membrane Antigen ◽  
Conventional Imaging ◽  
Psma Pet ◽  
Pet Ct ◽  
Specific Membrane

Accurate staging of prostate cancer (PCa) at initial diagnosis and at biochemical recurrence is important to determine prognosis and the optimal treatment strategy. To date, treatment of metastatic PCa has mostly been based on the results of conventional imaging with abdominopelvic computed tomography (CT) and bone scintigraphy. However, these investigations have limited sensitivity and specificity which impairs their ability to accurately identify and quantify the true extent of active disease. Modern imaging modalities, such as those based on the detection of radioactively labeled tracers with combined positron emission tomography/computed tomography (PET/CT) scanning have been developed specifically for the detection of PCa. Novel radiotracers include 18F-sodium fluoride (NaF), 11C-/18F-fluorocholine (FCH), 18F-fluordihydrotestosterone (FDHT), 68Gallium and 18F-radiolabeled prostate-specific membrane antigen (e.g., 68Ga-PSMA-11, 18F-DCFPyL). PET/CT with these tracers outperforms conventional imaging. As a result of this, although their impact on outcome needs to be better defined in appropriate clinical trials, techniques like prostate-specific membrane antigen (PSMA) PET/CT have been rapidly adopted into clinical practice for (re)staging PCa. This review focuses on nuclear imaging for PCa bone metastases, summarizing the literature on conventional imaging (focusing on CT and bone scintigraphy—magnetic resonance imaging is not addressed in this review), highlighting the prognostic importance of high and low volume metastatic disease which serves as a driver for the development of better imaging techniques, and finally discussing modern nuclear imaging with novel radiotracers.

scholarly journals 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is accurate for high-grade prostate cancer bone staging when compared to bone scintigraphy

2021 ◽  
Vol 15 (10) ◽  
Author(s):  
Samuel Otis-Chapados ◽  
Cassandra Ringuette Goulet ◽  
Gabriel Dubois ◽  
Étienne Lavallée ◽  
Thierry Dujardin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Fdg Pet ◽  
Emission Tomography ◽  
High Grade ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Introduction: In this study, we compared 18F-FDG-postron emission tomography/computed tomography (PET/CT) and bone scintigraphy accuracies for the detection of bone metastases for primary staging in high-grade prostate cancer (PCa) patients to determine if 18F-FDG-PET/CT could be used alone as a staging modality. Methods: Men with localized high-grade PCa (n=256, Gleason 8–10, International Society of Urological Pathology [ISUP] grades 4 or 5) were imaged with bone scintigraphy and 18F-FDG-PET/CT. We compared on a per-patient basis the accuracy of the two imaging modalities, taking intermodality agreement as the standard of truth (SOT). Results: 18F-FDG-PET/CT detected at least one bone metastasis in 33 patients compared to only 26 with bone scan. Of the seven false-negative bone scintigraphies, four (57.1%) were solitary metastases (monometastatic), three (42.9%) were oligometastatic (2–4 lesions), and none were plurimetastatic (>4 lesions). Compared to SOT, 18F-FDG-PET/CT showed higher sensitivity and accuracy than bone scintigraphy (100% vs. 78.8%, and 98.7% vs. 98.2%) for the detection of skeletal lesions. Conclusions: 18F-FDG-PET/CT appears similar or better than conventional bone scans to assess for bone metastases in patients newly diagnosed with high-grade PCa. Since intraprostatic FDG-uptake is also a biomarker of failure to radical prostatectomy and that FDG-PET/CT has been shown to be accurate in detecting PCa lymph node metastasis, FDG-PET/CT has the potential to be used as the sole preoperative staging modality in high-grade PCa.

scholarly journals The Role of Bone Scintigraphy with SPECT/CT in the Characterization and Early Diagnosis of Stage 0 Charcot Neuroarthropathy

2020 ◽  
Vol 9 (12) ◽  
pp. 4123
Author(s):  
Raju Ahluwalia ◽  
Ahmad Bilal ◽  
Nina Petrova ◽  
Krishna Boddhu ◽  
Chris Manu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Early Diagnosis ◽  
Bone Scintigraphy ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Charcot Foot ◽  
Bone Pathology ◽  
Charcot Neuroarthropathy ◽  
Focal Uptake ◽  
Stage 1

We describe the use of Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) in the investigation and diagnosis of Charcot neuroarthropathy (CN) in patients with a hot swollen foot but normal radiographs and clinical suspicion of CN, usually termed Stage 0. This was a retrospective cohort review of 46 diabetes patients who underwent 3 phase bone scintigraphy with “High Resolution” SPECT/CT. The imaging demonstrated that Stage 0 Charcot foot has a distinct bone pathology, which can be classified into three groups: (1) fractures on Computed Tomography (CT) with accompanying focal uptake of tracer on SPECT, (2) bony abnormalities apart from fracture on CT with focal uptake of tracer on SPECT, and (3) normal CT but focal bony uptake of tracer on SPECT. The CT component of SPECT/CT detected bony fractures in 59% of patients. Early treatment with below knee cast and follow-up for 24 months showed only 4 patients who developed Stage 1 Eichenholtz Charcot foot. Our findings support the use of 3 phase bone scintigraphy with SPECT/CT in the characterization and early diagnosis of CN. Stage 0 Charcot foot has a distinct bone pathology which requires urgent treatment to prevent progression to Stage 1 Eichenholtz Charcot foot. If SPECT/CT is unavailable, CT alone will detect bone fracture in 59% patients.

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