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Diagnostic performance of whole-body bone scintigraphy in combination with SPECT/CT for detection of bone metastases

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Abstract

Objective

This retrospective study investigated the performance of whole-body bone scintigraphy combined with SPECT/CT and established a grading diagnostic criterion for bone metastases.

Methods

We summarized signs of whole-body bone imaging combined with SPECT in nuclear medicine and CT signs of corresponding parts. Then we established a diagnostic criterion for bone metastases by using whole-body bone scintigraphy combined with local SPECT/CT. The criterion is classified into five grades. 120 patients with a total of 141 lesions underwent whole-body bone scintigraphy and SPECT/CT. Two reviewers read the images according to the diagnostic criterion. With pathological diagnosis as the “gold standard”, the diagnostic efficacy for bone metastases and the diagnostic agreement between the two reviewers were analyzed to validate the feasibility of the criterion. Diagnostic effectiveness was expressed in terms of sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.

Results

The diagnostic accuracy of the two reviewers was 90.1% and 92.9% respectively, sensitivity was both 100%, specificity was 41.7% and 58.3%, positive predictive value was 89.3% and 92.1%, and negative predictive value was both 100%. The kappa value of the diagnostic tests performed by the two reviewers on whole-body bone scintigraphy combined with SPECT/CT was 0.919 (P < 0.001).

Conclusion

The grading diagnostic criterion for bone metastases by whole-body bone scintigraphy combined with SPECT/CT has high diagnostic accuracy and good consistency between reviewers, but the specificity was still low even with SPECT/CT.

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Acknowledgements

This work was supported by the Scientific Research Program of Shanghai Municipal Commission of Health and Family Planning (Grant no. 201740201), the Shanghai Municipal Key Clinical Specialty (Grant no. shslczdzk03401) and the Technology Support Projects of Shanghai Science and Technology Committee (Grant no. 17411950300).

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Author notes

  1. Yiqiu Zhang and Beilei Li contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

    Yiqiu Zhang, Beilei Li, Bing Wu, Haojun Yu, Yan Xiu & Hongcheng Shi

  2. Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China

    Yiqiu Zhang, Beilei Li, Bing Wu, Haojun Yu, Yan Xiu & Hongcheng Shi

  3. Shanghai Institute of Medical Imaging, Shanghai, 200032, China

    Yiqiu Zhang, Beilei Li, Bing Wu, Haojun Yu, Yan Xiu & Hongcheng Shi

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  1. Yiqiu Zhang
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  2. Beilei Li
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  3. Bing Wu
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  4. Haojun Yu
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  5. Junyi Song
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  6. Yan Xiu
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  7. Hongcheng Shi
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Correspondence to Hongcheng Shi.

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Zhang, Y., Li, B., Wu, B. et al. Diagnostic performance of whole-body bone scintigraphy in combination with SPECT/CT for detection of bone metastases. Ann Nucl Med 34, 549–558 (2020). https://doi.org/10.1007/s12149-020-01488-1

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  • DOI: https://doi.org/10.1007/s12149-020-01488-1

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