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BioMed Research International
Volume 2017 (2017), Article ID 7039406, 8 pages
Research Article

Whole-Body SPECT/CT versus Planar Bone Scan with Targeted SPECT/CT for Metastatic Workup

1Division of Nuclear Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, rue Gabrielle-Perret-Gentil, No. 4, 1211 Geneva, Switzerland
2IMGE (Imagerie Moléculaire Genève), 20 chemin Beau Soleil, 1206 Geneva, Switzerland
3Department of Radiology, University of California, Los Angeles, 200 Medical Plaza, Room 165-53, Los Angeles, CA 90095, USA
4Division of Radiation Oncology, University of Geneva and Geneva University Hospitals, rue Gabrielle-Perret-Gentil, No. 4, 1211 Geneva, Switzerland

Correspondence should be addressed to Olivier Rager

Received 30 April 2017; Revised 14 June 2017; Accepted 22 June 2017; Published 24 July 2017

Academic Editor: Kazuma Ogawa

Copyright © 2017 Olivier Rager et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. The use of SPECT/CT in bone scans has been widespread in recent years, but there are no specific guidelines concerning the optimal acquisition protocol. Two strategies have been proposed: targeted SPECT/CT for equivocal lesions detected on planar images or systematic whole-body SPECT/CT. Our aim was to compare the diagnostic accuracy of the two approaches. Methods. 212 consecutive patients with a history of cancer were referred for bone scans to detect bone metastases. Two experienced readers randomly evaluated for each patient either planar images with one-field SPECT/CT targeted on equivocal focal uptakes (targeted SPECT/CT) or a whole-body (two-field) SPECT/CT acquisition from the base of the skull to the proximal femurs (whole-body SPECT/CT). The exams were categorized as “nonmetastatic,” “equivocal,” or “metastatic” on both protocols. The presence or absence of any extra-axial skeletal lesions was also assessed. The sensitivity and specificity of both strategies were measured using the results of subsequent imaging follow-up as the reference standard. Results. Whole-body SPECT/CT had a significantly higher sensitivity than targeted SPECT/CT to detect bone metastases and to detect extra-axial metastases . There was no significant difference in specificity among the two approaches. Conclusion. Whole-body SPECT/CT is the optimal modality of choice for metastatic workup, including detection of extra-axial lesions, with improved sensitivity and similar specificity compared to targeted SPECT/CT.