title: Usefulness of single photon emission computed tomography imaging in the detection of lumbar vertebral metastases from prostate cancer.
abstract: OBJECTIVE
  To determine whether single photon emission computed tomography (SPECT) is useful in the detection of prostate cancer bone metastases in the lumbar vertebrae.
  
  
  METHODS
  Thirty-nine patients (12 with benign prostatic hyperplasia, 27 with prostate cancer) were considered and submitted to bone SPECT. All of them had increased uptake in lumbar vertebrae on bone scintigraphy. In those with prostate cancer, definitive diagnosis of bone metastases was established by magnetic resonance imaging (MRI). SPECT axial images were classified into five accumulation patterns: mosaic, large hot, diffuse, peripheral, and articular (or pediculate). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of bone SPECT were calculated.
  
  
  RESULTS
  Overall, 116 vertebral lesions (49 metastatic, 67 degenerative) were studied. Mosaic, large hot and diffuse patterns were more frequently associated with metastatic lesions (84.2%, 70.3%, and 63.1% of the cases, respectively). On the other hand, peripheral and articular (or pediculate) patterns were mostly ascribed to degenerative lesions (100% and 87.5% of the cases, respectively). Sensitivity, specificity, PPV and NPV of bone SPECT were 95.9% (47/49), 73.1% (49/67), 72.3% (47/65), and 96.1% (49/51), respectively.
  
  
  CONCLUSIONS
  Bone SPECT provides better accuracy than bone scintigraphy in differential diagnosis of lumbar vertebral lesions from prostate cancer.
authors.affiliation: Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Japan. nozaki0921@yahoo.co.jp
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nozaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Yasuda
authors.forename: Takuya
authors.initials: T
authors.lastname: Akashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Fuse
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000473:pathology*; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*