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		Epidémiologie clinique (115) Imagerie Médicale (TEP et TEMP) (542) Laboratoire de neuroimagerie et de traceurs moléculaires innovants (984)
Project		Swiss National Science Foundation: 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