title: The incremental value of SPECT/CT in characterizing solitary spine lesions.
abstract: The purpose of this study was to investigate the incremental value and diagnostic impact of SPECT/CT in patients who had a solitary spinal lesion on a bone scan.
  
  
  METHODS
  A prospective study was performed on 80 patients (50 with known cancer) who underwent (99m)Tc-methylene diphosphonate whole-body planar bone scintigraphy and had a solitary spinal lesion. These lesions were then further evaluated using SPECT/CT.
  
  
  RESULTS
  Lesions were localized to the vertebral body in 38 patients (47.5%), pedicle in 15 (18.8%), facet joint in 15 (18.8%), transverse process in 2 (2.5%), spinous process in 2 (2.5%), lamina in 3 (3.8%), and end plates in 5 (6.2%). Although the specificity of planar bone scans was excellent (100%), sensitivity was only 6.1% but increased to 78.8% after the addition of SPECT/CT. The results provide evidence of a substantial incremental increase in diagnostic accuracy using SPECT/CT over planar imaging alone for patients in whom a solitary spinal lesion is noted.
  
  
  CONCLUSIONS
  The addition of SPECT/CT significantly reduced the number of false-negative results and increased the number of true-positive results. SPECT/CT also reduced the number of equivocal reports. A definitive diagnosis was given for most patients, indicating improved diagnostic confidence with the addition of SPECT/CT, compared with planar imaging alone, in patients with solitary spinal lesions.
authors.affiliation: Faculty of Science, Charles Sturt University, Wagga Wagga, Australia.
authors.forename: Basit
authors.initials: B
authors.lastname: Iqbal
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Currie
authors.forename: Janelle M
authors.initials: JM
authors.lastname: Wheat
authors.forename: Hassan
authors.initials: H
authors.lastname: Raza
authors.forename: Hosen
authors.initials: H
authors.lastname: Kiat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D013669:Technetium Tc 99m Medronate; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate