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Bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work

Skeletal whole-body scintigraphy (WBS), although widely used as a sensitive tool for detecting metastatic bone disease in oncology cases, has relatively low specificity. Indeterminate bone lesions (IBLs) detected by WBS cause a diagnostic dilemma, which hampers further management plans. In the adven...

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Main Authors: Mohd Rohani, Mohd Fazrin, Zanial, Ahmad Zaid, Suppiah, Subapriya, Khor, Phay Phay, Mohamed Aslum Khan, Farahnaz, Mohamad Najib, Fatin Hayyani, Mohd Noor, Noramaliza, Arumugam, Manohar, Amir Hassan, Siti Zarina, Vinjamuri, Sobhan
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Published: Lippincott, Williams & Wilkins 2021
Online Access:http://psasir.upm.edu.my/id/eprint/96258/
https://journals.lww.com/nuclearmedicinecomm/Fulltext/2021/01000/Bone_single_photon_emission_computed.3.aspx
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spelling my.upm.eprints.962582023-01-31T02:54:00Z http://psasir.upm.edu.my/id/eprint/96258/ Bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work Mohd Rohani, Mohd Fazrin Zanial, Ahmad Zaid Suppiah, Subapriya Khor, Phay Phay Mohamed Aslum Khan, Farahnaz Mohamad Najib, Fatin Hayyani Mohd Noor, Noramaliza Arumugam, Manohar Amir Hassan, Siti Zarina Vinjamuri, Sobhan Skeletal whole-body scintigraphy (WBS), although widely used as a sensitive tool for detecting metastatic bone disease in oncology cases, has relatively low specificity. Indeterminate bone lesions (IBLs) detected by WBS cause a diagnostic dilemma, which hampers further management plans. In the advent of hybrid imaging, single-photon emission computed tomography/computed tomography (SPECT/CT) has been gaining popularity as a tool to improve the characterisation of IBLs detected by WBS. As yet, there has not been a systematic review to objectively evaluate the diagnostic capabilities of SPECT/CT in this area. We conducted a systematic review of relevant electronic databases up to 30 August 2020. The outcomes of interest were the reporting of SPECT/CT to identify benign and malignant IBLs and the calculation of the sensitivity and specificity of the index test, based on histopathological examination or clinical and imaging follow-up as the reference standard. After the risk of bias and eligibility assessment, 12 articles were identified and synthesised in the meta-analysis. The pooled sensitivity and specificity of SPECT/CT for diagnosing IBLs are 93.0% [95% confidence interval (CI) 0.91-0.95] and 96.0% (95% CI 0.94-0.97), respectively. There was heterogeneity of the articles due to variable imaging protocols, duration of follow-up and scoring methods for interpreting the SPECT/CT results. The heterogeneity poses a challenge for accurate interpretation of the true diagnostic capability of SPECT/CT. In conclusion, targeted SPECT/CT improves the specificity of diagnosing bone metastases, but efforts need to be made to standardise the thresholds for SPECT/CT, methodology, as well as harmonising the reporting and interpretation criteria. We also make some recommendations for future works. Lippincott, Williams & Wilkins 2021 Article PeerReviewed Mohd Rohani, Mohd Fazrin and Zanial, Ahmad Zaid and Suppiah, Subapriya and Khor, Phay Phay and Mohamed Aslum Khan, Farahnaz and Mohamad Najib, Fatin Hayyani and Mohd Noor, Noramaliza and Arumugam, Manohar and Amir Hassan, Siti Zarina and Vinjamuri, Sobhan (2021) Bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work. Nuclear Medicine Communications, 42 (1). pp. 9-20. ISSN 0143-3636; ESSN: 1473-5628 https://journals.lww.com/nuclearmedicinecomm/Fulltext/2021/01000/Bone_single_photon_emission_computed.3.aspx 10.1097/MNM.0000000000001306
institution Universiti Putra Malaysia
building UPM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Putra Malaysia
content_source UPM Institutional Repository
url_provider http://psasir.upm.edu.my/
description Skeletal whole-body scintigraphy (WBS), although widely used as a sensitive tool for detecting metastatic bone disease in oncology cases, has relatively low specificity. Indeterminate bone lesions (IBLs) detected by WBS cause a diagnostic dilemma, which hampers further management plans. In the advent of hybrid imaging, single-photon emission computed tomography/computed tomography (SPECT/CT) has been gaining popularity as a tool to improve the characterisation of IBLs detected by WBS. As yet, there has not been a systematic review to objectively evaluate the diagnostic capabilities of SPECT/CT in this area. We conducted a systematic review of relevant electronic databases up to 30 August 2020. The outcomes of interest were the reporting of SPECT/CT to identify benign and malignant IBLs and the calculation of the sensitivity and specificity of the index test, based on histopathological examination or clinical and imaging follow-up as the reference standard. After the risk of bias and eligibility assessment, 12 articles were identified and synthesised in the meta-analysis. The pooled sensitivity and specificity of SPECT/CT for diagnosing IBLs are 93.0% [95% confidence interval (CI) 0.91-0.95] and 96.0% (95% CI 0.94-0.97), respectively. There was heterogeneity of the articles due to variable imaging protocols, duration of follow-up and scoring methods for interpreting the SPECT/CT results. The heterogeneity poses a challenge for accurate interpretation of the true diagnostic capability of SPECT/CT. In conclusion, targeted SPECT/CT improves the specificity of diagnosing bone metastases, but efforts need to be made to standardise the thresholds for SPECT/CT, methodology, as well as harmonising the reporting and interpretation criteria. We also make some recommendations for future works.
format Article
author Mohd Rohani, Mohd Fazrin
Zanial, Ahmad Zaid
Suppiah, Subapriya
Khor, Phay Phay
Mohamed Aslum Khan, Farahnaz
Mohamad Najib, Fatin Hayyani
Mohd Noor, Noramaliza
Arumugam, Manohar
Amir Hassan, Siti Zarina
Vinjamuri, Sobhan
spellingShingle Mohd Rohani, Mohd Fazrin
Zanial, Ahmad Zaid
Suppiah, Subapriya
Khor, Phay Phay
Mohamed Aslum Khan, Farahnaz
Mohamad Najib, Fatin Hayyani
Mohd Noor, Noramaliza
Arumugam, Manohar
Amir Hassan, Siti Zarina
Vinjamuri, Sobhan
Bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work
author_facet Mohd Rohani, Mohd Fazrin
Zanial, Ahmad Zaid
Suppiah, Subapriya
Khor, Phay Phay
Mohamed Aslum Khan, Farahnaz
Mohamad Najib, Fatin Hayyani
Mohd Noor, Noramaliza
Arumugam, Manohar
Amir Hassan, Siti Zarina
Vinjamuri, Sobhan
author_sort Mohd Rohani, Mohd Fazrin
title Bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work
title_short Bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work
title_full Bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work
title_fullStr Bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work
title_full_unstemmed Bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work
title_sort bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work
publisher Lippincott, Williams & Wilkins
publishDate 2021
url http://psasir.upm.edu.my/id/eprint/96258/
https://journals.lww.com/nuclearmedicinecomm/Fulltext/2021/01000/Bone_single_photon_emission_computed.3.aspx
_version_ 1756685785821609984
score 13.211869

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