Evaluation of the diagnostic value of the single photon emission computed tomography coupled to tomodensitometry in characterization of solitary spinal lesions in cancer patients

Objective. - The purpose of our study was to investigate the contribution of the single photon emission computed tomography coupled to computed tomography (SPECT-CT) in cancer patients and to evaluate its ability to diagnose the solitary spinal lesions observed on planar bone scintigraphy (PBS). Subjects and methods. - From August 2012 to December 2013, all patients with confirmed malignancy, whose PBS showed a solitary spine 'Hot spot', underwent a SPECT-CT. The study included 54 patients (14 men, 41 women), with a mean age of 53.91 years (rang 28-75 years). The patients with apparent bone lesions, important pains or who had not benefited of a supplement by SPECT-CT were excluded from the study. The lesions were classified either as definitely benign, definitely malignant or indeterminate. Results. - Breast and nasopharyngeal carcinoma represented the approximately 72.21% of all cancers, with predominantly breast cancer. The PBS showed solitary spinal lesions in all our patients with a high prevalence of these lesions in the thoracolumbar spine (49 cases) 90%. The further consideration by SPECT-CT was used to classify lesions in benign 35 cases, in malignant 16 cases and indeterminate in 3 cases. Conclusion. - The acquisition SPECT-CT in patients on PBS with solitary spinal lesion improves the accuracy of diagnosis in patients referred for assessment or monitoring in oncology. It should therefore be performed in clinical routine as soon as possible. (authors)