Utility of SPECT imaging for determination of vertebral metastases in patients with known primary tumors |
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Authors: | D L Bushnell MD D Kahn B Huston C G Bevering |
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Institution: | (1) Nuclear Medicine Service, Iowa City VA Medical Center, 52246 Iowa City, IA;(2) Division of Nuclear Medicine Department of Radiology, University of Iowa Hospital, 52242 Iowa City, IA, USA |
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Abstract: | 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. |
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Keywords: | SPECT Bone metastases |
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