Utility of SPECT imaging for determination of vertebral metastases in patients with known primary tumors

Determining the etiology of a focal lesion seen on bone scan in patients with primary tumors usually requires the use of other imaging procedures or biopsy. Single positron emission computed tomography (SPECT) with high resolution multidetector systems can localize the specific site of a vertebral l...

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Bibliographic Details
Published in:Skeletal radiology 1995-01, Vol.24 (1), p.13-16
Main Authors: Bushnell, D L, Kahn, D, Huston, B, Bevering, C G
Format: Article
Language:English
Subjects:
Colonic Neoplasms - pathology
Diagnosis, Differential
Diagnostic Imaging
Follow-Up Studies
Humans
Image Enhancement
Lumbar Vertebrae - diagnostic imaging
Lung Neoplasms - pathology
Male
Osteoarthritis - diagnostic imaging
Prostatic Neoplasms - pathology
Sensitivity and Specificity
Spinal Diseases - diagnostic imaging
Spinal Neoplasms - diagnostic imaging
Spinal Neoplasms - secondary
Technetium Tc 99m Medronate
Thoracic Vertebrae - diagnostic imaging
Tomography, Emission-Computed, Single-Photon - methods
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Summary:Determining the etiology of a focal lesion seen on bone scan in patients with primary tumors usually requires the use of other imaging procedures or biopsy. Single positron emission computed tomography (SPECT) with high resolution multidetector systems can localize the specific site of a vertebral lesion and in this way potentially differentiate between benign and metastatic disease. SPECT images of the lower thoracic and lumbar spine were reviewed for lesion location and intensity by two experienced interpreters. Follow-up data were adequate to ascertain the cause of 71 lesions seen on SPECT in 29 patients. Twenty-six of these lesions were not seen on planar images. Of the 71 lesions, 44 were benign and 27 metastatic. Of the 15 lesions where the pedicle was involved, 11 were found to metastatic. There were a total of 14 facet lesions, 9 of which were present in vertebra with no lesions at sites other than the facets. All 9 of these isolated facet lesions turned out to be benign. Lesion intensity did not distinguish benign from malignant disease. We conclude that SPECT imaging is useful in determining the etiology of focal lesions seen on bone scan in patients with a known primary tumor referred for evaluation of metastatic disease.
ISSN:0364-2348
1432-2161
DOI:10.1007/BF02425938