Diagnostic value of Thallium-201 scintigraphy in differentiating malignant bone tumors from benign bone lesions

• Published in: Annals of nuclear medicine Vol. 29; no. 8; pp. 674 - 681
• Main Authors: Inai, Ryota, Shinya, Takayoshi, Tada, Akihiro, Sato, Shuhei, Fujiwara, Tomohiro, Takeda, Ken, Kunisada, Toshiyuki, Yanai, Hiroyuki, Ozaki, Toshifumi, Kanazawa, Susumu
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.10.2015; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bone Neoplasms - diagnostic imaging; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; Original Article; Radiology; Radionuclide Imaging; Retrospective Studies; ROC Curve; Signal-To-Noise Ratio; Thallium Radioisotopes; Young Adult; Benign bone tumor; Malignant bone tumor; Thallium-201 scintigraphy; Receiver operating characteristic (ROC) analysis; Tumor-to-background contrast (TBC)
• ISSN: 0914-7187; 1864-6433
• DOI: 10.1007/s12149-015-0990-6

Objective This retrospective study aims to evaluate the diagnostic capacity of thallium-201 (201Tl) scintigraphy for differentiating malignant bone tumors from benign bone lesions. Methods Between January 2006 and December 2012, 279 patients with bone lesions (51 malignant and 228 benign) underwent 201Tl scintigraphy before treatment. To evaluate 201Tl uptake, we investigated tumor-to-background contrast (TBC) as well as TBC washout rate (WR). The differences of TBC on early and delayed images and WR were estimated by the Mann–Whitney U test. Receiver operating characteristic (ROC) analyses were used to determine the cut-off TBC values for differentiating malignant bone tumors from benign bone lesions. Results There were statistically significant differences in median TBC between malignant tumors and benign lesions. These differences occurred for early imaging (1.57 vs. 0.09, p  < 0.001) as well as for delayed imaging (0.83 vs. 0.07, p  < 0.001). However, there was no statistical difference in WR between malignant tumors and benign lesions (44 vs. 43 %, NS). The chosen TBC cut-off value was 0.68 for early imaging and 0.38 for delayed imaging. Using these cut-off values, the prediction of malignancy had a 77 % sensitivity, 74 % specificity, and 75 % accuracy for early imaging and an 80 % sensitivity, 76 % specificity, and 77 % accuracy for delayed imaging. Conclusions 201Tl scintigraphy may have the ability to distinguish malignant bone tumors from benign bone lesions.