BONE SCINTIGRAPHY – CONTRIBUTION OF HYBRID IMAGING (SPECT/CT)

Scintigrafija skeleta hibridnom tehnikom (SPECT/CT) s 99mTc-difosfonatima je dijagnostička nuklearno-medicinska pretraga koju karakterizira vrlo visoka osjetljivost te prikaz patoloških procesa i prije nego što su vidljivi drugim metodama snimanja. Ova se pretraga najčešće izvodi kod sumnje na metastatsko širenje malignog tumora u skelet (karcinom dojke, prostate, pluća ili drugih sijela), primarnih koštanih tumora, sumnje na osteomijelitis ili septički artritis te sistemskih bolesti koje izazivaju promjene na kostima. Ciljevi ovog istraživanja bili su utvrditi učestalost izvođenja SPECT/CT snimanja kod scintigrafije skeleta, ustanoviti jesu li SPECT/CT snimke zadovoljavajuće kvalitete te utvrditi doprinos hibridnog snimanja planarnoj tehnici u smislu eventualno dodatno otkrivenih lezija ili lakše karakterizacije lezija. Od ukupno 322 pacijenta kojima je u periodu od travnja do lipnja 2022. godine snimljena scintigrafija skeleta, odabrano je 50 ispitanika kojima je uz klasično, planarno, učinjeno i hibridno, SPECT/CT snimanje dijela tijela u kojem je uočen suspektni nalaz, odnosno patološka akumulacija radiofarmaka koja se nije mogla jasno interpretirati. U ispitivanje su uključeni odrasli ispitanici oba spola. Podaci koji su analizirani su dob, spol, uputna dijagnoza, učestalost snimanja pojedinih regija tijela, broj dodatno otkrivenih ili isključenih lezija te onih koje su se na SPECT/CT snimkama mogle bolje okarakterizirati. Zaključeno je da je doprinos hibridnog snimanja planarnoj tehnici značajan te su uglavnom potvrđene postavljene hipoteze.Hybrid bone scintigraphy with 99mTc-diphosphonates is a diagnostic nuclear medicine procedure characterized by very high sensitivity and detectness of pathological processes even before they are visible with conventional methods. This procedure is usually performed in cases of suspected metastatic spread of a malignant tumor to the skeleton (breast, prostate, lung, or other organs cancer), primary bone tumors, suspected osteomyelitis or septic arthritis, and systemic diseases that cause changes in the bones. The objectives of this research were to determine the frequency of performing SPECT/CT imaging in skeletal scintigraphy and whether SPECT/CT imaging is of satisfactory quality and to determine the contribution of hybrid imaging to the planar technique in terms of additionally detected lesions or easier characterization of lesions. From a total of 322 patients who underwent bone scintigraphy in the period from April to June 2022, 50 subjects were selected who underwent hybrid imaging bone scintigraphy (SPECT/CT) because of suspicious finding on planar scan or pathological accumulation of radiopharmaceuticals. Adult subjects of both sexes were included in the study. The data that were analyzed were age, gender, referring diagnosis, frequency of imaging of certain regions of the body, and the number of additional detected lesions on SPECT/CT scans. A significant contribution of hybrid imaging to the planar technique was concluded, given that some lesions were additionally detected or excluded as artifacts, and the remaining lesions were easily characterized as more likely degenerative and more likely malignant