Can 16-detector multislice CT exclude skeletal lesions during tumour staging? Implications for the cancer patient.

@article{citeulike:2934492, abstract = {Current imaging guidelines recommend that many cancer patients undergo soft-tissue staging by computed tomography (CT) whilst the bones are imaged by skeletal scintigraphy (bone scan). New CT technology has now made it feasible, for the first time, to perform a detailed whole-body skeletal CT. This advancement could save patients from having to undergo duplicate investigations. Forty-three patients with known malignancy were investigated for bone metastasis using skeletal scintigraphy and 16-detector multislice CT. Both studies were performed within six weeks of each other. Whole-body images were taken 4 h after injection of 500 Mbq (99m)Tc-MDP using a gamma camera. CT was performed on a 16-detector multislice CT machine from the vertex to the knee. The examinations were reported independently and discordant results were compared at follow-up. Statistical equivalence between the two techniques was tested using the Newcombe-Wilson method within the pre-specified equivalence limits of +/-20\%. Scintigraphy detected bone metastases in 14/43 and CT in 13/43 patients. There were seven discordances; four cases were positive on scintigraphy, but negative on CT; three cases were positive on CT and negative on scintigraphy. There was equivalence between scintigraphy and CT in detecting bone metastases within +/-19\% equivalence limits. Patients who have undergone full whole-body staging on 16-detector CT may not need additional skeletal scintigraphy. This should shorten the cancer patient's diagnostic pathway.}, address = {Department of Radiology, Addenbrooke's Hospital NHS Trust and the University of Cambridge, Hills Rd, Box 218, Cambridge, CB2 2QQ, UK. drashleygroves@hotmail.com}, author = {Groves, A. M. and Beadsmoore, C. J. and Cheow, H. K. and Balan, K. K. and Courtney, H. M. and Kaptoge, S. and Win, T. and Harish, S. and Bearcroft, P. W. and Dixon, A. K. }, citeulike-article-id = {2934492}, doi = {http://dx.doi.org/10.1007/s00330-005-0042-z}, issn = {0938-7994}, journal = {European radiology}, keywords = {bone, ct, metastases, scan, skeletal}, month = {May}, number = {5}, pages = {1066--1073}, posted-at = {2008-06-27 12:18:58}, priority = {2}, title = {Can 16-detector multislice CT exclude skeletal lesions during tumour staging? Implications for the cancer patient.}, url = {http://dx.doi.org/10.1007/s00330-005-0042-z}, volume = {16}, year = {2006} }

TY - JOUR ID - citeulike:2934492 L3 - citeulike-article-id:2934492 TI - Can 16-detector multislice CT exclude skeletal lesions during tumour staging? Implications for the cancer patient. JF - European radiology VL - 16 IS - 5 SP - 1066 EP - 1073 AD - Department of Radiology, Addenbrooke's Hospital NHS Trust and the University of Cambridge, Hills Rd, Box 218, Cambridge, CB2 2QQ, UK. drashleygroves@hotmail.com SN - 0938-7994 N2 - Current imaging guidelines recommend that many cancer patients undergo soft-tissue staging by computed tomography (CT) whilst the bones are imaged by skeletal scintigraphy (bone scan). New CT technology has now made it feasible, for the first time, to perform a detailed whole-body skeletal CT. This advancement could save patients from having to undergo duplicate investigations. Forty-three patients with known malignancy were investigated for bone metastasis using skeletal scintigraphy and 16-detector multislice CT. Both studies were performed within six weeks of each other. Whole-body images were taken 4 h after injection of 500 Mbq (99m)Tc-MDP using a gamma camera. CT was performed on a 16-detector multislice CT machine from the vertex to the knee. The examinations were reported independently and discordant results were compared at follow-up. Statistical equivalence between the two techniques was tested using the Newcombe-Wilson method within the pre-specified equivalence limits of +/-20%. Scintigraphy detected bone metastases in 14/43 and CT in 13/43 patients. There were seven discordances; four cases were positive on scintigraphy, but negative on CT; three cases were positive on CT and negative on scintigraphy. There was equivalence between scintigraphy and CT in detecting bone metastases within +/-19% equivalence limits. Patients who have undergone full whole-body staging on 16-detector CT may not need additional skeletal scintigraphy. This should shorten the cancer patient's diagnostic pathway. KW - bone KW - ct KW - metastases KW - scan KW - skeletal AU - Groves, AM AU - Beadsmoore, CJ AU - Cheow, HK AU - Balan, KK AU - Courtney, HM AU - Kaptoge, S AU - Win, T AU - Harish, S AU - Bearcroft, PW AU - Dixon, AK PY - 2006/05// UR - http://dx.doi.org/10.1007/s00330-005-0042-z ER -