Medicinski vjesnik, Vol. 30 No. (1-2), 1998.
Stručni rad
The value of spect when added to planar scintigraphy in patients with metastases and benign disease of the spine
Irena Sedonja
Nataša V Budihna
Sažetak
Aim: The purpose of this study was to establish whether SPECT was more accurate than planar scintigraphy at differentiating between malignant and benign lesions and to compare the sensitivity of both methods in detection of metastases in the spine.
Methods: Planar scintigraphy and SPECT were performed in 37 patients with back pain without known malignancy and 38 patients with confirmed malignancy. Location, type and intensity of tracer accumulation were compared on planar and SPECT scans. Malignant or benign nature of lesions was proven by radiological methods, histology and during 6-month follow-up.
Results: More metastases were detected with SPECT (SPECT 58/64, planar sc. 42/64, p<0.01). In 3 out of 7 patients with known malignancy and normal planar scan only SPECT detected metastases. The lesion to background ratio was higher on SPECT than planar scans. Lesions showing increased radioactivity in lateral edges of the vertebral body, with prominence (n=8) or non-prominent (n=12), in terminal plate (n=3), in the spinous processus (n=29) and in facetal joint (n=29) noticed in patients with known malignancy were always
benign. Lesions were more often malignant (3/5) than benign (2/5) when seen in the pedicle, in the body with extension into pedicle (14/22, vs. 8/22) as well as in case of small lesions inside the vertebral body (4/5, vs. 1/5) and increased uptake in the whole vertebra (4/6 vs. 2/6).
Conclusions: SPECT can improve accuracy of planar bone scans in patients with known malignancy and clinical suspicion on skeletal metastases, in case of solitary lesions shown on planar scan, or when radioactivity in one or more vertebras is borderline increased.
Ključne riječi
SPECT; spine; metastasis; planar scintigraphy
Hrčak ID:
192093
URI
Datum izdavanja:
1.12.1998.
Posjeta: 3.637 *