RATIONALE: The isotope bone scan is routinely used in the management of prostate cancer as the skeleton is the second most common area of metastasis after lymph nodes. A classic site of involvement in the pelvis is the ischium, and the aim of this study was to assess the value of single-photon emission computed tomography/computed tomography (SPECT/CT) imaging in patients with focal ischial uptake on the planar scan. MATERIALS AND METHODS: This was a retrospective study of consecutive 150 patients with prostate cancer who were referred for a whole-body bone scan between August 2007 and 2008. Two experienced nuclear medicine consultants along with a musculoskeletal radiologist reviewed the scans. RESULTS: Sixty-eight patients were diagnosed with widespread metastases and 46 patients showed typical degenerative disease changes on planar whole-body imaging. SPECT/CT imaging was done in 36 patients to clarify the diagnosis in areas of indeterminate uptake noted on planar whole-body imaging. Ten of these 36 patients who had focal increased ischial uptake were included in the study. Only three of these 10 patients were diagnosed as having a metastatic lesion with the presence of an enthesopathy, a common finding. CONCLUSION: Isolated focal uptake in the ischium is a relatively common finding in patients with prostate cancer and there is concern that this, on occasion, could be misinterpreted as metastasis. SPECT/CT imaging has an important role in differentiating a benign from a malignant lesion.
RATIONALE: The isotope bone scan is routinely used in the management of prostate cancer as the skeleton is the second most common area of metastasis after lymph nodes. A classic site of involvement in the pelvis is the ischium, and the aim of this study was to assess the value of single-photon emission computed tomography/computed tomography (SPECT/CT) imaging in patients with focal ischial uptake on the planar scan. MATERIALS AND METHODS: This was a retrospective study of consecutive 150 patients with prostate cancer who were referred for a whole-body bone scan between August 2007 and 2008. Two experienced nuclear medicine consultants along with a musculoskeletal radiologist reviewed the scans. RESULTS: Sixty-eight patients were diagnosed with widespread metastases and 46 patients showed typical degenerative disease changes on planar whole-body imaging. SPECT/CT imaging was done in 36 patients to clarify the diagnosis in areas of indeterminate uptake noted on planar whole-body imaging. Ten of these 36 patients who had focal increased ischial uptake were included in the study. Only three of these 10 patients were diagnosed as having a metastatic lesion with the presence of an enthesopathy, a common finding. CONCLUSION: Isolated focal uptake in the ischium is a relatively common finding in patients with prostate cancer and there is concern that this, on occasion, could be misinterpreted as metastasis. SPECT/CT imaging has an important role in differentiating a benign from a malignant lesion.
Authors: L C McLoughlin; F O'Kelly; C O'Brien; M Sheikh; J Feeney; W Torreggiani; J A Thornhill Journal: Ir J Med Sci Date: 2014-11-14 Impact factor: 1.568
Authors: Stepan Capek; Benjamin M Howe; Adam T Froemming; Kimberly K Amrami; Robert J Spinner Journal: Skeletal Radiol Date: 2015-04-12 Impact factor: 2.199