Characterization of Focal Bone Lesions in the Axial Skeleton: Performance of Planar Bone Scintigraphy Compared with SPECT and SPECT Fused with CT

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Abstract
OBJECTIVE. The purpose of this study was to evaluate the diagnostic performance of planar 99mTc methylene diphosphonate bone scintigraphy compared with SPECT and SPECT fused with CT in patients with focal bone lesions of the axial skeleton.SUBJECTS AND METHODS. Thirty-seven patients with 42 focal lesions of the axial skeleton were included in this prospective study. All patients underwent planar scintigraphy, SPECT through the focal lesions, and SPECT-guided CT. SPECT and CT images then were fused digitally. The three types of images were evaluated separately from one another by two experienced reviewers working to consensus. Visibility of the lesions, diagnostic performance, and certainty in diagnosis were evaluated. Performance for specific diagnoses also was evaluated. Histologic, MRI, and clinical follow-up findings were used as the reference standard.RESULTS. Visibility of the lesions was significantly better with SPECT than with planar scintigraphy (p < 0.0001). Sensitivity and specificity for diffe...