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A new SPECT/CT reconstruction algorithm: reliability and accuracy in clinical routine for non-oncologic bone diseases

  • Delcroix, Olivier1
  • Robin, Philippe1, 2, 3
  • Gouillou, Maelenn4
  • Le Duc-Pennec, Alexandra1
  • Alavi, Zarrin5
  • Le Roux, Pierre-Yves1, 2, 3
  • Abgral, Ronan1, 2, 3
  • Salaun, Pierre-Yves1, 2, 3
  • Bourhis, David1, 2, 3
  • Querellou, Solène1, 2, 3, 6
  • 1 CHRU Hospital Morvan, Nuclear Medicine Department, Brest, France , Brest (France)
  • 2 Service de Médecine Nucléaire, EA 3878 GETBO IFR 148, Brest, France , Brest (France)
  • 3 Université de Bretagne Occidentale, Brest, France , Brest (France)
  • 4 CHRU Brest, Brest, France , Brest (France)
  • 5 Brest Medical University Hospital—Inserm CIC 1412, Brest, France , Brest (France)
  • 6 University Hospital, Nuclear Medicine Department, Boulevard Tanguy Prigent, Brest, 29200, France , Brest (France)
Published Article
EJNMMI Research
Springer (Biomed Central Ltd.)
Publication Date
Feb 12, 2018
DOI: 10.1186/s13550-018-0367-7
Springer Nature


BackgroundxSPECT Bone® (xB) is a new reconstruction algorithm developed by Siemens® in bone hybrid imaging (SPECT/CT). A CT-based tissue segmentation is incorporated into SPECT reconstruction to provide SPECT images with bone anatomy appearance. The objectives of this study were to assess xB/CT reconstruction diagnostic reliability and accuracy in comparison with Flash 3D® (F3D)/CT in clinical routine. Two hundred thirteen consecutive patients referred to the Brest Nuclear Medicine Department for non-oncological bone diseases were evaluated retrospectively. Two hundred seven SPECT/CT were included. All SPECT/CT were independently interpreted by two nuclear medicine physicians (a junior and a senior expert) with xB/CT then with F3D/CT three months later. Inter-observer agreement (IOA) and diagnostic confidence were determined using McNemar test, and unweighted Kappa coefficient. The study objectives were then re-assessed for validation through > 18 months of clinical and paraclinical follow-up.ResultsNo statistically significant differences between IOA xB and IOA F3D were found (p = 0.532). Agreement for xB after categorical classification of the diagnoses was high (κxB = 0.89 [95% CI 0.84 –0.93]) but without statistically significant difference F3D (κ F3D = 0.90 [95% CI 0.86 – 0.94]). Thirty-one (14.9%) inter-reconstruction diagnostic discrepancies were observed of which 21 (10.1%) were classified as major. The follow-up confirmed the diagnosis of F3D in 10 cases, xB in 6 cases and was non-contributory in 5 cases.ConclusionsxB reconstruction algorithm was found reliable, providing high interobserver agreement and similar diagnostic confidence to F3D reconstruction in clinical routine.

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