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

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State: Public
Version: author
License: CC BY 4.0
Serval ID
serval:BIB_9CA6F1B30D5E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Quantitative bone SPECT/CT: high specificity for identification of prostate cancer bone metastases.
Journal
BMC musculoskeletal disorders
Author(s)
Tabotta F., Jreige M., Schaefer N., Becce F., Prior J.O., Nicod Lalonde M.
ISSN
1471-2474 (Electronic)
ISSN-L
1471-2474
Publication state
Published
Issued date
26/12/2019
Peer-reviewed
Oui
Volume
20
Number
1
Pages
619
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Bone scintigraphy with <sup>99m</sup> Tc-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 <sup>99m</sup> Tc-2,3-dicarboxy propane-1,1-diphosphonate ( <sup>99m</sup> Tc-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.
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 SUV <sub>max</sub> and SUV <sub>mean</sub> (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 SUV <sub>max</sub> cutoff value to distinguish between bone metastases and benign spinal and pelvic lesions.
In total, 264 prostate cancer bone metastases were analyzed, showing a mean SUV <sub>max</sub> and SUV <sub>mean</sub> of 34.6 ± 24.6 and 20.8 ± 14.7 g/mL, respectively. In 24 spinal and pelvic osteoarthritic lesions, mean SUV <sub>max</sub> and SUV <sub>mean</sub> were 14.2 ± 3.8 and 8.9 ± 2.2 g/mL, respectively. SUV <sub>max</sub> and SUV <sub>mean</sub> were both significantly different between the bone metastases and osteoarthritic groups (p ≤ 0.0001). Using a SUV <sub>max</sub> 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.
This study showed significant differences in quantitative <sup>99m</sup> Tc-DPD uptake on bone SPECT/CT between prostate cancer bone metastases and spinal and pelvic osteoarthritic changes, with higher SUV <sub>max</sub> and SUV <sub>mean</sub> in metastases. Using a SUV <sub>max</sub> 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.
Keywords
Aged, Aged, 80 and over, Bone Neoplasms/diagnostic imaging, Bone Neoplasms/secondary, Bone and Bones/diagnostic imaging, Bone and Bones/pathology, Diphosphonates, Humans, Male, Middle Aged, Organotechnetium Compounds, Prostatic Neoplasms/pathology, Retrospective Studies, Sensitivity and Specificity, Single Photon Emission Computed Tomography Computed Tomography, 99mTc-DPD, Bone metastases, Bone scintigraphy, Prostate cancer, Prostate cancer metastases, Quantitative SPECT, SPECT/CT, SUV, Spinal osteoarthritis, xSPECT
Pubmed
Web of science
Open Access
Yes
Create date
03/01/2020 21:49
Last modification date
18/06/2020 5:21
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