Evaluation of changes in Bone Scan Index at different acquisition time‐points in bone scintigraphy

Abstract

Bone Scan Index (BSI) is a validated imaging biomarker to objectively assess tumour burden in bone in patients with prostate cancer, and can be used to monitor treatment response. It is not known if BSI is significantly altered when images are acquired at a time difference of 1 h. The aim of this study was to investigate if automatic calculation of BSI is affected when images are acquired 1 hour apart, after approximately 3 and 4 h. We prospectively studied patients with prostate cancer who were referred for bone scintigraphy according to clinical routine. The patients performed a whole-body bone scan at approximately 3 h after injection of radiolabelled bisphosphonate and a second 1 h after the first. BSI values for each bone scintigraphy were obtained using EXINI bone software. A total of 25 patients were included. Median BSI for the first acquisition was 0·05 (range 0-11·93) and for the second acquisition 0·21 (range 0-13·06). There was a statistically significant increase in BSI at the second image acquisition compared to the first (P<0·001). In seven of 25 patients (28%) and in seven of 13 patients with BSI > 0 (54%), a clinically significant increase (>0·3) was observed. The time between injection and scanning should be fixed when changes in BSI are important, for example when monitoring therapeutic efficacy.

Stability of standardized uptake values for quantitative bone SPECT for jawbone lesions: a single-center cross-sectional study

“…Shintawati et al found that both the BSI and number of hotspots tend to increase with an increase in uptake duration (i.e., 2-h, 4-h, or 6-h); therefore, they suggested that the uptake time for each patient should be fixed during follow-up or monitoring [ 18 ]. In addition, Kaboteh et al reported a statistically significant increase in the BSI between uptake times of 1 h, 3 h, and 4 h [ 19 ]. They also suggested that the uptake time should be standardized if patients are repeatedly monitored using bone scintigraphy.…”

Stability of Standardized Uptake Values of Quantitative Bone SPECT for the Jawbone Lesions: A Single-center Cross-sectional Study

“…reported a statistically signi cant increase in the BSI between uptake times of 1 h, 3 h, and 4 h. [17] They also suggested that the uptake time should be standardized if patients are repeatedly monitored using bone scintigraphy. Based on our ndings that the mean difference in SUVmax in the parietal bones and jawbone lesion was − 0.04 and 3.8%, respectively, we concluded that the difference in the SUVmax of the 2-and 3-h images was clinically negligible.…”

Analysis of Bone Scans in Various Tumor Entities Using a Deep-Learning-Based Artificial Neural Network Algorithm—Evaluation of Diagnostic Performance

“…A further limitation influencing the performance of the BSI methodology was the kinetics of the tracer. A prolonged time span between administration of the radiopharmaceutical and imaging is known to result in a significantly higher BSI [ 23 , 39 ]. Significant changes in BSI were observed when uptake time was extended from three to four hours post-injection [ 39 ].…”

“…A prolonged time span between administration of the radiopharmaceutical and imaging is known to result in a significantly higher BSI [ 23 , 39 ]. Significant changes in BSI were observed when uptake time was extended from three to four hours post-injection [ 39 ]. Since all evaluated bone scans were performed in the context of clinical routine, the uptake time was chosen within the limits of the respective guidelines.…”