Accuracy of whole-body HDP SPECT/CT, FDG PET/CT, and their combination for detecting bone metastases in breast cancer: an intra-personal comparison

Rager, Olivier; Lee-Felker, Stephanie A; Tabouret-Viaud, Claire; Felker, Ely R; Poncet, Antoine; Amzalag, Gaël; Garibotto, Valentina; Zaidi, Habib; Walter, Martin A

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Title		Accuracy of whole-body HDP SPECT/CT, FDG PET/CT, and their combination for detecting bone metastases in breast cancer: an intra-personal comparison
Authors		Rager, Olivier Lee-Felker, Stephanie A Tabouret-Viaud, Claire Felker, Ely R Poncet, Antoine Amzalag, Gaël Garibotto, Valentina Zaidi, Habib Walter, Martin A show all authors [1 - 9]
Published in		American Journal of Nuclear Medicine and Molecular Imaging. 2018, vol. 8, no. 3, p. 159-168
Abstract		New generation SPECT/CT scanners allow rapid whole-body imaging, and potentially facilitate significantly improved diagnostic accuracy. Thus, the aim of this study was to compare the diagnostic accuracy of whole-body Tc-99m-HDP SPECT/CT, F-18-FDG PET/CT, and their combination for detecting bone metastases in breast cancer. Women with biopsy-proven breast cancer that were referred for whole-body SPECT/CT and FDG PET/CT were consecutively included in this retrospective study. Two blinded readers independently interpreted all scans. In a per-patient analysis, the diagnostic performances of whole-body SPECT/CT, FDG PET/CT, and their combination were compared using receiver operating characteristic (ROC) analysis. In a per-lesion analysis, the performances were compared using figures of merit (FoM) differences in Jackknife alternative free-response ROC analysis, which considers the location information. Follow-up served as reference standard. Overall, 25 consecutive women (median age: 55; range 38-82) with 117 lesions were included. The median follow-up was 21 months (2-46 months). The per-patient analysis revealed no significant differences in diagnostic performance (P = 0.16), while the per-lesion analysis revealed a diagnostic superiority of whole-body SPECT/CT over FDG PET/CT (P = 0.004). Specifically, the PET/CT FoM was significantly lower than the SPECT/CT FoM (FoM difference = -0.11, 95% CI [-0.21; -0.02], P = 0.021). No significant difference was observed between SPECT/CT and the combination of SPECT/CT and PET/CT. The per-lesion analysis suggest that SPECT/CT has a higher diagnostic accuracy than FDG PET/CT for the detection of bone metastases. Thus, SPECT/CT may be a useful adjunct to FDG PET/CT for staging of breast cancer patients.
Identifiers		PMID: 30042868
Full text		Article (Published version) (569 Kb) - Free access Other version: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056244/
Structures		Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale
Research groups		Imagerie Médicale (TEP et TEMP) (542) Laboratoire de neuroimagerie et de traceurs moléculaires innovants (984)
Project		FNS: SNSF 320030_176052
Citation (ISO format)		RAGER, Olivier et al. Accuracy of whole-body HDP SPECT/CT, FDG PET/CT, and their combination for detecting bone metastases in breast cancer: an intra-personal comparison. In: American Journal of Nuclear Medicine and Molecular Imaging, 2018, vol. 8, n° 3, p. 159-168. https://archive-ouverte.unige.ch/unige:108511