Suppiah Subapriya, Mohd Rohani Mohd Fazrin, Zanial Ahmad Zaid, Ahmad Shahrir Ahmad Danial, Khairuman Khairul Aliff, Vinjamuri Sobhan
Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia.
Department of Nuclear Medicine, Nuclear Imaging Unit, Hospital Pengajar Universiti Putra Malaysia, Universiti Putra Malaysia, Seri Kembangan, Malaysia.
Indian J Nucl Med. 2023 Apr-Jun;38(2):191-200. doi: 10.4103/ijnm.ijnm_142_22. Epub 2023 Jun 8.
Planar whole-body bone scanning (WBS) is widely used to evaluate skeletal lesions seen in cancer and noncancer cases. Frequently, degenerative, or other benign bony changes may give rise to indeterminate lesions that mimic bone metastases. In the post-COVID-19 era, there is an evolutionary phase that puts importance on global development and adaptability, which encompasses to include nuclear medicine practices worldwide. Single-photon emission computed tomography/computed tomography (SPECT/CT) can be used to improve the characterization of these lesions and help to resolve the diagnostic conundrum while reducing the need for patients to undergo multiple different examinations at various imaging departments. The fusion of SPECT and CT allows morphological characterization of functional abnormality detected by focal tracer uptake on planar scintigraphy, which provides a one-stop center imaging in nuclear medicine departments. The objective of this study was to review the diagnostic accuracy of SPECT/CT in diagnosing bone metastases in a variety of oncology and nononcology cases and to determine the feasibility of performing bone SPECT/CT in all suspected cancer cases, including cases of bone infection instead of planar imaging alone. The utilization of hybrid SPECT/CT in indeterminate bone lesions detected on planar WBS can significantly increase the diagnostic confidence and accuracy of image interpretation. Recognition of patterns of disease identified using hybrid imaging can improve the management of patients with potentially lower costs in the long term. Currently, hybrid SPECT/CT machines are becoming a norm in nuclear medicine departments, thus potentially making single planar application machines obsolete in the near future. We hypothesize that in the interest of providing a meaningful interpretation of isotope bone scans, the default protocol should involve the option of acquiring SPECT/CT images rather than relying on whole-body scans only. Departments choosing to upgrade existing equipment or those choosing to invest in only one gamma camera should proactively opt for hybrid SPECT/CT systems.
平面全身骨扫描(WBS)被广泛用于评估癌症和非癌症病例中出现的骨骼病变。通常,退行性或其他良性骨改变可能会产生类似骨转移的不确定病变。在新冠疫情后时代,存在一个重视全球发展和适应性的演变阶段,这包括全球范围内的核医学实践。单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)可用于改善这些病变的特征描述,并有助于解决诊断难题,同时减少患者在不同影像科室接受多种不同检查的需求。SPECT和CT的融合能够对平面闪烁显像中局部示踪剂摄取所检测到的功能异常进行形态学特征描述,这在核医学科室提供了一站式成像。本研究的目的是回顾SPECT/CT在诊断各种肿瘤学和非肿瘤学病例中的骨转移的诊断准确性,并确定在所有疑似癌症病例(包括骨感染病例)中进行骨SPECT/CT而非仅进行平面成像的可行性。在平面WBS上检测到的不确定骨病变中使用混合SPECT/CT可显著提高图像解读的诊断信心和准确性。识别使用混合成像确定的疾病模式可从长远来看以可能更低的成本改善患者管理。目前,混合SPECT/CT机器正在成为核医学科室的标准设备,因此可能在不久的将来使单一平面应用机器过时。我们假设,为了对同位素骨扫描进行有意义的解读,默认方案应包括获取SPECT/CT图像的选项,而不是仅依赖全身扫描。选择升级现有设备的科室或那些只选择投资一台伽马相机的科室应积极选择混合SPECT/CT系统。