Transitioning to whole-body SPECT/CT in prostate cancer staging: a new concept for a better imaging workflow.

Clicks: 232
ID: 65009
2019
 Whole-body bone scan (BS) is the clinical standard in detecting bone metastases in prostate cancer patients. Additional SPECT/CT has allowed to significantly increase its diagnostic accuracy. However, performing both planar and additional SPECT/CT prolongs the total examination time and lowers patient throughput. In this study we aim to assess the diagnostic performance of a SPECT/CT-only protocol compared to the traditional procedure that is BS with a facultative SPECT/CT in case of unclear findings. 50 patients with high-risk prostate cancer and suspected bone metastases were enrolled in this retrospective study. All patients received a whole-body Tc-99m-DPD BS followed by a 3 field-of-view (FOV) SPECT/CT (GE Discovery 670 Pro) covering an area from the vertex to the mid-femur. Metastatic lesions were evaluated visually on BS and SPECT/CT and correlated to PSA-levels. Detection rate was up to 50 % higher in SPECT/CT than in BS (n = 2829 vs. n = 1942; p < 0.001), but 31/1942 (1.5 %) lesions detected on BS were located out of the SPECT/CT field-of-view. In our analysis a PSA-level of > 80 µg/l could be defined as a cut-off-value for metastatic spread beyond mid-thigh, as no patient with PSA< 80 µg/l had localizations outside the SPECT/CT field-of-view (AUCPSA = 0.95, p < 0.001 sensitivity: 100 %, specificity: 77 %, NPV: 100 %, PPV: 67 %). The SPECT/CT-only protocol did not prolong acquisition time significantly as compared to BS. In patients with high-risk prostate cancer presenting with PSA < 80 µg/l and absent clinical symptoms, vertex to mid-thighs 3-FOV-SPECT/CT was representative for the entire skeletal system and was able to detect more lesions than planar acquisition. This procedure did not prolong patient handling time significantly.
Reference Key
weissinger2019transitioningnuklearmedizin Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Weissinger, Matthias;Kupferschläger, Jürgen;La Fougère, Christian;Dittmann, Helmut;Fiz, Francesco;
Journal nuklearmedizin nuclear medicine
Year 2019
DOI 10.1055/a-1022-4115
URL
Keywords

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

No comments yet. Be the first to comment on this article.