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SPECT versus planar liver scintigraphy: is SPECT worth it?
1Department of Radiology, University of Texas Medical Branch, Galveston 77550.
Summary
Single-photon emission computed tomography (SPECT) hepatic studies offer a marginal benefit over planar scintigraphy for detecting focal liver disease. SPECT imaging slightly improves correct readings and reduces the need for additional ultrasound or computed tomography referrals.
Area of Science:
- Nuclear medicine
- Diagnostic imaging
- Hepatobiliary system
Background:
- Planar scintigraphy is a standard imaging technique for hepatic disease.
- Focal liver lesions require accurate diagnosis to guide treatment.
- Ultrasound/computed tomography (US/CT) are often used as secondary diagnostic tools.
Purpose of the Study:
- To compare the diagnostic performance of SPECT hepatic imaging versus planar scintigraphy.
- To evaluate the impact of SPECT on the rate of US/CT referrals for equivocal findings.
- To assess the clinical utility of SPECT in detecting focal liver disease.
Main Methods:
- Retrospective review of 503 planar and SPECT hepatic studies.
- Independent assessment by two experienced observers for focal disease detection.
- Analysis of correct reading rates and US/CT referral rates based on SPECT findings.
- Calculation of benefits across varying rates of liver involvement.
Main Results:
- SPECT imaging demonstrated a marginal increase in correct readings compared to planar scintigraphy.
- SPECT referrals resulted in fewer US/CT consultations per 100 cases for both positive and negative readings.
- The observed benefits were consistent across different positive rates of liver disease.
Conclusions:
- SPECT hepatic imaging provides a modest improvement in diagnostic accuracy over planar scintigraphy.
- SPECT can potentially reduce healthcare costs by decreasing unnecessary US/CT referrals.
- SPECT represents a valuable adjunct in the evaluation of focal hepatic lesions.