Aims: The combined application of baseline whole-body bone scan (WBBS), followed by more specific techniques such as SPECT-CT fusion is an advanced approach for the diagnosis, differential diagnosis and staging of osseous metastases. The purpose of this work was to assess SPECT-CT images in diagnosis of suspected bone metastases in patients with oncological diseases. Methods: This study included 89 patients (54 females, 35 males aged 18-92 yrs) with different types of tumours. All patients underwent routine WBBS with 99mTc-MDP as well as target SPECT-CT imaging using a double-headed SPECT-CT camera coupled with a 2-slice CT scanner. Results: The skeletal findings with previously uncertain character were classified as definitely benign, indeterminate or definitely malignant. These included: 1) 33% benign degenerative lesions, 2) 28% single osseous metastases, 3) 10% direct bone infiltration, 4) 15% cold or osteolytic bone lesions, 5) 12% mixed type lesions and 6) 2% single extraosseous lesions. Conclusion: The most important clinical application of bone SPECT-CT imaging is for differential diagnosis between degenerative and metastatic foci with abnormal tracer uptake and similar scintigraphic appearance on the WBBS.
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