Comparison of the diagnostic accuracy of VSBONE BSI versions for detecting bone metastases in breast and prostate carcinoma patients using conventional and CZT detector gamma cameras.

Abstract

Objective: Bone scintigraphy is widely employed for detecting bone metastases, with the bone scan index (BSI) gaining traction as a quantitative tool in this domain. VSBONE BSI, an automated image analysis software, identifies abnormal hyperaccumulation areas in bone scintigraphy and computes BSI scores. The software, originally developed using data from conventional gamma cameras (C-Camera), has undergone two upgrades. This study hypothesized that the upgrades enhance the diagnostic accuracy for bone metastases and assessed the software's applicability to images obtained using a cadmium-zinc-telluride detector gamma camera (CZT-Camera). The aim was to compare the diagnostic accuracy of VSBONE BSI across software versions using both conventional and CZT detectors and to evaluate its utility.

Methods: A total of 287 patients with breast or prostate carcinoma who underwent whole-body bone scintigraphy were included. VSBONE BSI automatically analyzed and calculated the BSI. The analysis results were compared with the presence or absence of metastases for each software version by using detector type of camera. The diagnostic agreement was evaluated.

Results: Receiver operating characteristic analysis showed an area under the curve (AUC) exceeding 0.7 across all groups, indicating good diagnostic performance. AUC values significantly increased with version upgrades for all patients and for breast carcinoma patients. In metastasis-negative cases, BSI values decreased with each software version upgrade, with the reduction being more pronounced in breast carcinoma patients scanned with the CZT-Camera.

Conclusions: Using the VSBONE BSI, version 2 or 3 had a higher rate of diagnostic concordance with the clinical prognosis than version 1. In metastasis-negative patients, newer software versions yielded lower BSI values, especially for breast carcinoma patients scanned using the CZT-Camera, highlighting the improved diagnostic accuracy of the updated software.