Additional benefit of SPECT/CT in bone scanning of metastatic renal cell carcinoma

A whole body bone scan with SPECT/CT of the thoracolumbar spine was performed on a patient with metastatic renal cell carcinoma. Bone scan demonstrated widespread skeletal metastases. In addition, CT identified a lytic lesion on the right side of T12 that was at risk for causing nerve root compression but was "cold" on bone scan. This was confirmed on MRI. Bone lesions associated with renal cell carcinoma are typically osteolytic and generally very aggressive, with a relatively high incidence of cold lesions. This case demonstrates that SPECT/CT not only allows more accurate lesion localization, but provided additional information complementary to SPECT alone. © 2007 Lippincott Williams & Wilkins, Inc.