Is quantitative analysis of planar bone scan useful in assessment of response in bone metastases? | ||||
| SECI Oncology Journal | ||||
| Volume 11, Issue 2, May 2023, Page 116-122 | ||||
 View on SCiNiTO | ||||
| Abstract | ||||
| Background: One of most common and economical method for identifying bone metastases in clinical workflow is a bone scan. However, its clinical significance for determining how well patients with advanced metastatic bone disease are responding to therapy is still restricted, partly due to the absence of a reliable approach for measuring changes in bone scans. Objectives: using quantitative analysis of planar images as compared to qualitative assessment in cancer patients receiving treatment for bone metastasis, radiotracer uptake was observed between first and follow-up scans. This method of imaging interpretation can be used to produce a more reliable and consistent manner of patient follow-up analysis, which is essential for researching. Methods: This prospective study involved 37 patients who were known to have primary malignant tumor and osseous metastases. They underwent two bone scintigraphies before and after the therapy, each involved certain osseous lesion for further analysis by planar images. 47 osseous lesions were interpretated firstly by visual assessment by 3 physicians and interpretated by (progressive, regressive, stationary) opinion. Secondly, the same osseous lesions analyzed by quantifications of planar images were added by measuring mean and maximum of standardized uptake value of osseous lesions (SUV mean and max). All of quantification is considered progressive (more than 30% rise), regressive (more than 30% reduction) and stationary (rest in between). The results of agreement between 3 readers visually and between visual and quantitative assessment was done using Cohen’s kappa test. Results: Inter-observer agreement of the visual analysis between readers 1 and 2 was in 32 lesions of total 47 lesions, k = 0.519 (moderate degree) for planar scintigraphy. By the same way the agreement between readers 1 and 3 was in 36 lesions, k= 0.662 (substantial degree). In addition, inter-method agreement between reader 2 and reader 3 was in 27 lesions k = 0.358 (fair degree). On the other side, 19 (40.4%) of the total 47 lesions had visual and quantitative assessments that were in agreement. The quantitative and visual analyses' intramethod agreement was k= 0.049. (Poor degree). Conclusions: For up to 57% of the total lesions, visual assessment of bone scintigraphy for changes in tumor metabolism produced conflicting results. In addition, visual analysis revealed moderate to significant inter-observer agreement. This suggests that, to maximize consistency in treatment planning, continuous monitoring of bone scanning for variations in the tracer uptake of lesions should be carried out using quantification of tracer uptake rather than just by visual evaluation. | ||||
| Keywords | ||||
| Bone scan; quantitative analysis; visual assessment; assessment of response | ||||
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