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Research ArticleIMAGING

The Incremental Value of SPECT/CT in Characterizing Solitary Spine Lesions

Basit Iqbal, Geoffrey M. Currie, Janelle M. Wheat, Hassan Raza and Hosen Kiat
Journal of Nuclear Medicine Technology September 2011, 39 (3) 201-207; DOI: https://doi.org/10.2967/jnmt.111.088351
Basit Iqbal
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Geoffrey M. Currie
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Janelle M. Wheat
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Hassan Raza
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Hosen Kiat
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  • FIGURE 1.
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    FIGURE 1.

    Baseline planar scan of spine.

  • FIGURE 2.
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    FIGURE 2.

    Baseline SPECT/CT scan. A color version of this figure is available as a supplemental file at http://tech.snmjournals.org.

  • FIGURE 3.
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    FIGURE 3.

    Bone scan showing L5 degenerative changes.

  • FIGURE 4.
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    FIGURE 4.

    SPECT/CT scan showing early metastasis. A color version of this figure is available as a supplemental file at http://tech.snmjournals.org.

  • FIGURE 5.
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    FIGURE 5.

    Bone scan suggesting posttraumatic or degenerative change.

  • FIGURE 6.
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    FIGURE 6.

    CT scan showing multiple lytic lesions.

  • FIGURE 7.
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    FIGURE 7.

    SPECT/CT scan highlighting metastatic disease. A color version of this figure is available as a supplemental file at http://tech.snmjournals.org.

  • FIGURE 8.
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    FIGURE 8.

    Bone scan showing L2 lesion.

  • FIGURE 9.
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    FIGURE 9.

    SPECT/CT scan showing vertebral body fracture. A color version of this figure is available as a supplemental file at http://tech.snmjournals.org.

  • FIGURE 10.
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    FIGURE 10.

    Planar bone scan.

  • FIGURE 11.
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    FIGURE 11.

    SPECT/CT scan showing intravertebral disk infection. A color version of this figure is available as a supplemental file at http://tech.snmjournals.org.

Tables

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    TABLE 1

    Criteria for Lesion Characterization

    BenignMalignant
    Facet jointBody and pedicle
    Costovertebral jointPhoton-deficient area (lytic area)
    Involvement of 2 adjacent
    vertebrae or endplates
    of vertebrae
    • View popup
    TABLE 2

    Comparative Results for Both Study Populations at Initial Imaging Session

    Imaging typeIndeterminateBenignMalignantTotal
    Planar51 (63.8%)27 (33.8%)2 (2.5%)80
    SPECT/CT11 (13.8%)39 (48.8%)30 (37.5%)80
    • View popup
    TABLE 3

    Outcomes for Baseline and Follow-up Planar Imaging and SPECT/CT in Oncology Cohort

    Imaging typeIndeterminateBenignMalignantTotal
    Baseline planar26 (52%)22 (44%)2 (4%)50
    Follow-up planar7 (14%)20 (40%)23 (46%)50
    Baseline5 (10%)17 (34%)28 (56%)50
    SPECT/CT5 (10%)17 (34%)28 (56%)50
    Follow-up SPECT/CT0 (0%)17 (34%)33 (66%)50
    • View popup
    TABLE 4

    Performance Analysis for Planar Imaging and SPECT/CT in Oncology Cohort

    IndexBaseline planarBaseline SPECT/CTFollow-up planar
    True-negative171517
    False-negative31710
    True-positive22623
    False-positive020
    Sensitivity (true-positive rate)6.1%78.8%69.7%
    Specificity (true-negative rate)100%88.2%100%
    Prevalence4%66%46%
    Positive value of positive result100%92.9%100%
    Positive value of negative result35.4%68.2%63.0%
    • View popup
    TABLE 5

    Comparison of Planar Imaging and SPECT/CT Outcomes in Nononcology Cohort

    Imaging typeDiagnosedUndiagnosed
    Planar5 (17%)25 (83%)
    SPECT/CT24 (80%)6 (20%)

Additional Files

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Journal of Nuclear Medicine Technology: 39 (3)
Journal of Nuclear Medicine Technology
Vol. 39, Issue 3
September 1, 2011
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The Incremental Value of SPECT/CT in Characterizing Solitary Spine Lesions
Basit Iqbal, Geoffrey M. Currie, Janelle M. Wheat, Hassan Raza, Hosen Kiat
Journal of Nuclear Medicine Technology Sep 2011, 39 (3) 201-207; DOI: 10.2967/jnmt.111.088351

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The Incremental Value of SPECT/CT in Characterizing Solitary Spine Lesions
Basit Iqbal, Geoffrey M. Currie, Janelle M. Wheat, Hassan Raza, Hosen Kiat
Journal of Nuclear Medicine Technology Sep 2011, 39 (3) 201-207; DOI: 10.2967/jnmt.111.088351
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