Abstract

Background: Bone scintigraphy with 99mTc-labelled diphosphonates can identify prostate cancer (PCa) bone metastases with high sensitivity but relatively low specificity. Single photon emission computed tomography /computed tomography (SPECT/CT) can add value to the planar bone scintigraphy in the detection of bone metastases.
Case presentation: We present a diagnosed case of Prostatic Adenocarcinoma of a 62 year old male patient who underwent 99mTc-Methyldiphosphonate (MDP) planar bone scintigraphy followed by SPECT/CT as a part of staging algorithm. Planar bone imaging showed homogeneous and symmetrical tracer uptake throughout the visualized skeleton. As the patient had complaints of urinary obstruction and severe backache: so, the sacrum could not be adequately assessed on planar bone imaging; therefore SPECT/CT of lumbar spine and pelvic region was performed. His regional SPECT-CT study of the lumbar and pelvic region, revealed widespread diffuse tracer avid osteoblastic lesions throughout the visualized lower lumbar spine, sacrum, pelvis and proximal femori, suggestive of skeletal metastases.
Conclusion: We conclude that SPECT/CT scintigraphy has a diagnostic edge over planar bone imaging in detecting bone metastases in prostate cancer patients.

Key words: SPECT/CT, Planar bone scan, Prostate cancer, Prostate specific antigen, equivocal lesions, case report.