Standardized uptake values of 99mTc-MDP in normal vertebrae assessed using quantitative SPECT/CT for differentiation diagnosis of benign and malignant bone lesions

Abstract

Background Quantitative bone SPECT/CT is useful for disease follow up and inter-patient comparison. For bone metastatic malignant lesions, spine is the most commonly invaded site. However, Quantitative studies with large sample size investigating all the segments of normal cervical, thoracic and lumbar vertebrae are seldom reported. This study was to evaluate the quantitative tomography of normal vertebrae using 99mTc-MDP with SPECT/CT to investigate the feasibility of standardized uptake value (SUV) for differential diagnosis of benign and malignant bone lesions. Methods A retrospective study was carried out involving 221 patients (116 males and 105 females) who underwent SPECT/CT scan using 99mTc-MDP. The maximum SUV (SUVmax), mean SUV (SUVmean) and CT values (Hounsfield Unit, HU) of 2416 normal vertebrae bodies, 157 benign bone lesions and 118 malignant bone metastasis foci were obtained. The correlations between SUVmax of normal vertebrae and CT values of normal vertebrae, age, height, weight, BMI of patients were analyzed. Statistical analysis was performed with data of normal, benign and malignant groups corresponding to same sites and gender. Results The SUVmax and SUVmean of normal vertebrae in males were markedly higher than those in females (P < 0.0009). The SUVmax of each normal vertebral segment showed a strong negative correlation with CT values in both males and females (r = − 0.89 and − 0.92, respectively; P < 0.0009). The SUVmax of normal vertebrae also showed significant correlation with weight, height, and BMI in males (r = 0.4, P < 0.0009; r = 0.28, P = 0.005; r = 0.22, P = 0.026), and significant correlation with weight and BMI in females (r = 0.32, P = 0.009; r = 0.23, P = 0.031). The SUVmax of normal group, benign bone lesion group and malignant bone metastasis foci group showed statistical differences in both males and females. Conclusion Our study evaluated SUVmax and SUVmean of normal vertebrae, benign bone lesion and malignant bone metastasis foci with a large sample population. Preliminary results proved the potential value of SUVmax in differentiation benign and malignant bone lesions. The results may provide a quantitative reference for clinical diagnosis and the evaluation of therapeutic response in vertebral lesions.

A Simple Kit Formulation for Preparation and Exploratory Human Studies of a Novel 99mTc-Labeled Fibroblast Activation Protein Inhibitor Tracer for Imaging of the Fibroblast Activation Protein in Cancers

“…The rates of empty needle and full needle count and injection time were recorded before and after injection to calculate the maximum standardized uptake values (SUVmax) based on the ordered subset conjugate gradient-modified reconstruction algorithm. This method of quantitative reconstruction is called “xSPECT Quant” (xQ), which is a new SPECT reconstruction method launched by Siemens in January 2014 and approved by the FDA and CFDA. , Reconstruction with xQ precisely determines images in units of becquerel/milliliter that are converted using system planar sensitivity with an NIST traceable 57 Co source . The data were automatically converted to quantitative SPECT/CT data by VB10 software (Siemens Healthineers).…”

“…This method of quantitative reconstruction is called "xSPECT Quant" (xQ), which is a new SPECT reconstruction method launched by Siemens in January 2014 and approved by the FDA and CFDA. 21,22 Reconstruction with xQ precisely determines images in units of becquerel/milliliter that are converted using system planar sensitivity with an NIST traceable 57 Co source. 23 The data were automatically converted to quantitative SPECT/ CT data by VB10 software (Siemens Healthineers).…”

Deep learning enhanced ultra-fast SPECT/CT bone scan: quantitative assessment and clinical performance

“…Our previous study has shown that SUV max obtained from SPECT/CT could play an important role in differentiating benign and malignant bone diseases [27]. In this study, the SUV max obtained from 3min-DL and 20min SPECT images has no statistical difference (P = 0.973), there was a strong linear relationship between the SUV max of lesions in 3min-DL and 20min images (r = 0.987; P < 0.0001).…”

What validation tests can be done by the clinical medical physicist while waiting for the standardization of quantitative SPECT/CT imaging?

“…For a correct interpretation of the clinical SPECT/CT image, it is advisable know the reference values of the SUV for normal tissues. Currently published papers concern the possibility of identifying the stage of the disease as well as differentiating inflammatory and neoplastic lesions using the SUV index measured in clinical SPECT images [24,25]. In this case, PET is a bit ahead of SPECT.…”