DOI: 10.1186/s13550-018-0367-7Pages: 1-9

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

1. CHRU Hospital Morvan, Nuclear Medicine Department

2. CHRU Brest

3. Service de Médecine Nucléaire

4. Université de Bretagne Occidentale

5. Brest Medical University Hospital—Inserm CIC 1412

6. University Hospital, Nuclear Medicine Department

Correspondence to:
Solène Querellou
Tel: 0033298223327




xSPECT 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.


No 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.


xB reconstruction algorithm was found reliable, providing high interobserver agreement and similar diagnostic confidence to F3D reconstruction in clinical routine.

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  • Accepted: Jan 31, 2018
  • Online: Feb 12, 2018

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