The one-in-all diagnostic value of (99m)Tc-MDP bone scan combining with single-photon emission tomography (SPECT)/CT imaging in spinal osteoblastoma

BACKGROUND: Osteoblastoma (OB) is an intermediate lesion, which makes the accurate preoperative diagnosis very important. (99m)Tc-methylene diphosphonate ((99m)Tc-MDP) bone scan and SPECT/CT imaging were evaluated for their diagnostic value in spinal OB. METHODS: This study was a retrospective analysis of patients with spinal OB lesions confirmed by pathology and diagnosed with bone scan and SPECT/CT for preoperative diagnosis from January 2008 to December 2018. The uptake levels of OB on planar bone scan were divided into low, medium, and high groups by visual assessment referring to the uptake of the normal rib, spine, and bladder. X-ray, CT, MRI, bone scan, and SPECT/CT imaging of the patients were analyzed for characteristics summary. RESULTS: Twenty-five patients were diagnosed for spinal OB (17 males and 8 females with a proportion of 2.1:1), and the average age was 26.8 ± 10.8 years (range 5~59). There were 8 lesions located in the cervical, 6 in the thoracic, and 11 in the lumbar vertebrae. Twenty-four lesions involved posterior elements, especially the pedicles (14/25). Symptoms were predominantly painful with a duration of 18.3 ± 13.9 months (range 0.5~60 months). The lesion size ranged from 9 to 35 mm. All the lesions were low to high uptake in the planar bone scan, and the percentages of low to high levels were 1 (4%), 8 (32%), and 16 (64%) cases. CONCLUSIONS: Spinal OB mainly involved the posterior area, and elderly patients should be considered as well. SPECT/CT combined the characteristics of bone uptake and anatomical features of bone tumors, proving its one-in-all diagnostic value for spinal OB and other osteogenic tumors.