Accuracy of whole-body HDP SPECT/CT, FDG PET/CT, and their combination for detecting bone metastases in breast cancer: an intra-personal comparison

American Journal of Nuclear Medicine and Molecular Imaging

Antoine Poncet¹  Gaël Amzalag²  Olivier Rager³  Claire Tabouret-Viaud⁴  Ely R Felker⁵  Stephanie A Lee-Felker⁶ 

[1] CRC and Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva and University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil, 4, CH-1211 Geneva, Switzerland;Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, Netherlands;Department of Nuclear Medicine, Geneva University and University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil, 4, CH-1211 Geneva, Switzerland;Department of Radiology, Ronald Reagan-UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095, USA;Geneva Neuroscience Center, Geneva University, CH-1205 Geneva, Switzerland;IMGE (Imagerie Molculaire Genve), 20 Chemin Beau Soleil, CH-1206 Geneva, Switzerland

关键词: 99mTc HDP;    18F FDG;    bone scan;    breast cancer;    bone metastases;    molecular imaging;    oncology;    hybrid imaging;    diagnostic work-up;   

DOI  :  

学科分类：过敏症与临床免疫学

来源: e-Century Publishing Corporation

【 摘 要 】

New generation SPECT/CT scanners allow rapid whole-body imaging, and potentially facilitate significantly improved diagnostic accuracy. Thus, the aim of this study was to compare the diagnostic accuracy of whole-body Tc-99m-HDP SPECT/CT, F-18-FDG PET/CT, and their combination for detecting bone metastases in breast cancer. Women with biopsy-proven breast cancer that were referred for whole-body SPECT/CT and FDG PET/CT were consecutively included in this retrospective study. Two blinded readers independently interpreted all scans. In a per-patient analysis, the diagnostic performances of whole-body SPECT/CT, FDG PET/CT, and their combination were compared using receiver operating characteristic (ROC) analysis. In a per-lesion analysis, the performances were compared using figures of merit (FoM) differences in Jackknife alternative free-response ROC analysis, which considers the location information. Follow-up served as reference standard. Overall, 25 consecutive women (median age: 55; range 38-82) with 117 lesions were included. The median follow-up was 21 months (2-46 months). The per-patient analysis revealed no significant differences in diagnostic performance (P = 0.16), while the per-lesion analysis revealed a diagnostic superiority of whole-body SPECT/CT over FDG PET/CT (P = 0.004). Specifically, the PET/CT FoM was significantly lower than the SPECT/CT FoM (FoM difference = -0.11, 95% CI [-0.21; -0.02], P = 0.021). No significant difference was observed between SPECT/CT and the combination of SPECT/CT and PET/CT. The per-lesion analysis suggest that SPECT/CT has a higher diagnostic accuracy than FDG PET/CT for the detection of bone metastases. Thus, SPECT/CT may be a useful adjunct to FDG PET/CT for staging of breast cancer patients.

【 授权许可】

CC BY-NC