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Shibutani T, Konishi T, Ichikawa H, Onoguchi M, Yoneyama H, Ito T, Okuda K, Nakajima K. Detectability of cold tumors by xSPECT bone technology compared with hot tumors: a supine phantom study. Phys Eng Sci Med 2024; 47:287-294. [PMID: 38117462 DOI: 10.1007/s13246-023-01364-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
Detecting cold as well as hot tumors is vital for interpreting bone tumors on single-photon emission computed tomography (SPECT) images. This study aimed to visually and quantitatively demonstrate the detectability of cold tumors using xSPECT technology compared with that of hot tumors in the phantom study. Five tumors of different sizes and normal bone contained a mixture of 99mTc and K2HPO4 in a spine phantom. We acquired SPECT data using an xSPECT protocol and transverse images were reconstructed using xSPECT Bone (xB) and xSPECT Quant (xQ). Mean standardized uptake values (SUVmean) in volumes of interest (VOI) were calculated. Recovery coefficients (RCs) for each tumor site were calculated with reference to radioactive concentrations. The SUVmeans of the whole vertebral body for hot tumor bone image in cortical bone phantom reconstructed by with xB and xQ were 5.77 and 4.86 respectively. The SUVmean of xB was similar to the true value. The SUVmeans for xB and xQ reconstructed images of cold tumors were both approximately 0.16. The RC of the cold tumor on xQ images increased as the tumor diameter decreased, whereas that of xB remained almost constant regardless of the tumor diameter. In conclusion, the quantitative accuracy of detecting hot and cold tumors was higher in the xB image than in the xQ image. Moreover, the visual detectability of cold tumors was also excellent in xB images.
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Affiliation(s)
- Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
| | - Takahiro Konishi
- Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Japan
| | - Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Hiroto Yoneyama
- Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Japan
| | - Toshimune Ito
- Department of Radiological, Technology, Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - Koichi Okuda
- Department of Radiation Science, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Japan
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Kanazawa, Japan
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Mohseninia N, Zamani-Siahkali N, Harsini S, Divband G, Pirich C, Beheshti M. Bone Metastasis in Prostate Cancer: Bone Scan Versus PET Imaging. Semin Nucl Med 2024; 54:97-118. [PMID: 37596138 DOI: 10.1053/j.semnuclmed.2023.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 08/20/2023]
Abstract
Prostate cancer is the second most common cause of malignancy among men, with bone metastasis being a significant source of morbidity and mortality in advanced cases. Detecting and treating bone metastasis at an early stage is crucial to improve the quality of life and survival of prostate cancer patients. This objective strongly relies on imaging studies. While CT and MRI have their specific utilities, they also possess certain drawbacks. Bone scintigraphy, although cost-effective and widely available, presents high false-positive rates. The emergence of PET/CT and PET/MRI, with their ability to overcome the limitations of standard imaging methods, offers promising alternatives for the detection of bone metastasis. Various radiotracers targeting cell division activity or cancer-specific membrane proteins, as well as bone seeking agents, have been developed and tested. The use of positron-emitting isotopes such as fluorine-18 and gallium-68 for labeling allows for a reduced radiation dose and unaffected biological properties. Furthermore, the integration of artificial intelligence (AI) and radiomics techniques in medical imaging has shown significant advancements in reducing interobserver variability, improving accuracy, and saving time. This article provides an overview of the advantages and limitations of bone scan using SPECT and SPECT/CT and PET imaging methods with different radiopharmaceuticals and highlights recent developments in hybrid scanners, AI, and radiomics for the identification of prostate cancer bone metastasis using molecular imaging.
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Affiliation(s)
- Nasibeh Mohseninia
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Nazanin Zamani-Siahkali
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria; Department of Nuclear Medicine, Research center for Nuclear Medicine and Molecular Imaging, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Harsini
- Department of Molecular Oncology, BC Cancer Research Institute, Vancouver, BC, Canada
| | | | - Christian Pirich
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Mohsen Beheshti
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria.
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Du F, Wumener X, Zhang Y, Liu M, Li T, Huang S, Zhang M, Wu R, Liang Y. The diagnostic value of quantitative bone SPECT/CT in solitary undetermined bone lesions. Front Oncol 2023; 13:1205379. [PMID: 38023132 PMCID: PMC10665838 DOI: 10.3389/fonc.2023.1205379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To investigate the diagnostic value of the maximum standard uptake value (SUVmax) of quantitative single-photon emission computed tomography/computed tomography (SPECT/CT) in solitary undetermined bone lesions. Methods In Part I, retrospective study, 167 untreated patients with extra-skeletal malignant tumors by pathology were consecutively enrolled for staging with Tc-99m methyl-diphosphonate (99mTc-MDP) whole-body bone scan (WBS) and quantitative SPECT/CT, and a total of 396 bone lesions with abnormal radioactivity concentration in 167 patients were included from April 2019 to September 2020. The differences in SUVmax among the benign bone lesions, malignant bone lesions, and normal vertebrae were analyzed. The receiver operating characteristic (ROC) curve and cutoff value of SUVmax were obtained. Part II, prospective study, 49 solitary undetermined bone lesions in SPECT/CT in 49 untreated patients with extra-skeletal malignant tumors were enrolled from October 2020 to August 2022. The diagnostic efficacy of SUVmax in solitary undetermined bone lesions was assessed. The final diagnosis was based on follow-up imaging (CT, MRI, or 2-deoxy-2-[18F]fluoro-D-glucose-positron emission tomography/computed tomography) for at least 12 months. Results In Part I, a total of 156 malignant and 240 benign bone lesions was determined; the SUVmax of malignant lesions (26.49 ± 12.63) was significantly higher than those of benign lesions (13.92 ± 7.16) and normal vertebrae (6.97 ± 1.52) (P = 0.00). The diagnostic efficiency of the SUVmax of quantitative SPECT/CT revealed a sensitivity of 75.00% and a specificity of 81.70% at a cutoff value of 18.07. In Part II, 17 malignant and 32 benign lesions were determined. Using SUVmax ≥18.07 as a diagnostic criterion of malignancy, it has a sensitivity of 82.35%, a specificity of 93.75%, and an accuracy of 89.80%. Conclusion The SUVmax of quantitative SPECT/CT is valuable in evaluating solitary undetermined bone lesions. Using a cutoff SUVmax value of 18.07, quantitative SPECT/CT demonstrated high sensitivity, specificity, and accuracy in differentiating malignant from benign bone lesions.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ying Liang
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
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Wang H, Qiu J, Xie J, Lu W, Pan Y, Ma J, Jia M. Radiomics‑Clinical model based on 99mTc-MDP SPECT/CT for distinguishing between bone metastasis and benign bone disease in tumor patients. J Cancer Res Clin Oncol 2023; 149:13353-13361. [PMID: 37491635 DOI: 10.1007/s00432-023-05162-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/09/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND To establish a radiomics-clinical model based on 99mTc-MDP SPECT/CT for distinguishing between bone metastasis and benign bone disease in tumor patients. METHODS We retrospectively analyzed 256 patients (122 with bone metastasis and 134 with benign bone disease) and randomized them in the ratio of 6:2:2 into training, test and validation sets. All patients underwent 99mTc-labeled methylene diphosphonate (99mTc-MDP) SPECT/CT. We manually outlined the volumes of interest (VOIs) of lesions using ITK-SNAP from SPECT and CT images. In the training set, radiomics features were extracted using PyRadiomics and selected using Least Absolute Shrinkage and Selection Operator (LASSO) regression. Then, we established three radiomics models (CT, SPECT and SPECT-CT models) using support vector machine (SVM). In addition, a radiomics-clinical model was constructed using multivariable logistic regression analysis. The four models' performance was assessed using the area under the receiver operating characteristic curve (AUC). Using DeLong test to make comparisons between the ROC (receiver operating characteristic) curves of different models. The clinical utility of the models was evaluated using decision curve analysis (DCA). RESULTS The radiomics-clinical displayed excellent performance, and its AUC was 0.941 and 0.879 in the training and test sets. The DCA of radiomics-clinical model showed the highest clinical utility. CONCLUSIONS The radiomics-clinical nomogram for identifying bone metastasis and benign bone disease in tumor patients was suitable to assist in clinical decision.
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Affiliation(s)
- Huili Wang
- College of Preventive Medicine & Institute of Radiation Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250012, China
| | - Jianfeng Qiu
- School of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
| | - Jindong Xie
- College of Preventive Medicine & Institute of Radiation Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250012, China
| | - Weizhao Lu
- School of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
| | - Yuteng Pan
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250000, China
| | - Junchi Ma
- School of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China.
| | - Mingsheng Jia
- Department of Nuclear Medicine, The Second Affiliated Hospital of Shandong First Medical University, Taishan Street, No.706, Taian, 271000, China.
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Mutuleanu MD, Paun DL, Lazar AM, Petroiu C, Trifanescu OG, Anghel RM, Gherghe M. Quantitative vs. Qualitative SPECT-CT Diagnostic Accuracy in Bone Lesion Evaluation-A Review of the Literature. Diagnostics (Basel) 2023; 13:2971. [PMID: 37761338 PMCID: PMC10529093 DOI: 10.3390/diagnostics13182971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Considering the importance that quantitative molecular imaging has gained and the need for objective and reproducible image interpretation, the aim of the present review is to emphasize the benefits of performing a quantitative interpretation of single photon emission computed tomography-computed tomography (SPECT-CT) studies compared to qualitative interpretation methods in bone lesion evaluations while suggesting new directions for research on this topic. (2) Methods: By conducting comprehensive literature research, we performed an analysis of published data regarding the use of quantitative and qualitative SPECT-CT in the evaluation of bone metastases. (3) Results: Several studies have evaluated the diagnostic accuracy of quantitative and qualitative SPECT-CT in differentiating between benign and metastatic bone lesions. We collected the sensitivity and specificity for both quantitative and qualitative SPECT-CT; their values ranged between 74-92% and 81-93% for quantitative bone SPECT-CT and between 60-100% and 41-100% for qualitative bone SPECT-CT. (4) Conclusions: Both qualitative and quantitative SPECT-CT present an increased potential for better differentiating between benign and metastatic bone lesions, with the latter offering additional objective information, thus increasing diagnostic accuracy and enabling the possibility of performing treatment response evaluation through accurate measurements.
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Affiliation(s)
- Mario-Demian Mutuleanu
- Nuclear Medicine Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania; (A.M.L.); (C.P.)
| | - Diana Loreta Paun
- Endocrinology Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Endocrinology Department, National Institute of Endocrinology “C.I. Parhon”, 011863 Bucharest, Romania
| | - Alexandra Maria Lazar
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania; (A.M.L.); (C.P.)
- Carcinogenesis and Molecular Biology Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Cristina Petroiu
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania; (A.M.L.); (C.P.)
| | - Oana Gabriela Trifanescu
- Oncology Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Radiotherapy II Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Rodica Maricela Anghel
- Oncology Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Radiotherapy II Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Mirela Gherghe
- Nuclear Medicine Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania; (A.M.L.); (C.P.)
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Nakamura Y, Kangai Y, Sato S, Shibata S, Abe T, Mimura H, Inubushi M. [Impact of Residual Radioactivity Rate of 99mTc-macro Aggregated Albumin (MAA) in Syringes and Administration Routes with a Focus on Pediatric Nuclear Medicine Examinations]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023; 79:802-809. [PMID: 37357400 DOI: 10.6009/jjrt.2023-1352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the residual radioactivity in the syringe and route of administration of a low fluid volume 99mTc-macro aggregated albumin (MAA) intended for pediatric nuclear medicine examinations. METHOD We evaluated the residual characteristics, as the effect of elapsed time from drawing up of radiopharmaceuticals to plastic syringe to administration, and the effect of volume of 99mTcO4- solution to be labeled, the effect of rinsed times of plastic syringe, effect of dose of calculated by consensus guidelines for pediatric nuclear medicine and residual location in injection sets with 99mTc-MAA. Residual radioactivity was measured using planar images obtained by the gamma camera. RESULTS Residual radioactivity rate of 99mTc-MAA, 99mTc-MAG3, 123I-IMP showed 41.3±1.6%, 14.4±0.6%, 14.6±2.0%, respectively. 99mTc-MAA clearly showed a higher residual rate. Residual radioactivity rate increased with the extension of the elapsed time, and reached a high value of 41.3% in 30 minutes. Residual radioactivity rate was dependent on the different volume of 99mTcO4- to be labeled (4.0 ml and 8.0 ml). Residual radioactivity rate did not change when the number of rinsed was more than one. Residual rate was around 40% at all doses of calculated by consensus guidelines for pediatric nuclear medicine. CONCLUSION 99mTc-MAA showed the highest residual radioactivity rate among radiopharmaceuticals used in pediatric nuclear medicine examinations. The factor that most affected the residual radioactivity rate of 99mTc-MAA was the elapsed time from draw up to the plastic syringe to administration.
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Affiliation(s)
- Yuto Nakamura
- Department of Radiological Technology, Yamaguchi University Hospital
| | - Yoshiharu Kangai
- Department of Radiological Technology, Yamaguchi University Hospital
| | - Shun Sato
- Department of Radiological Technology, Kawasaki Medical School Hospital
| | - Shigeru Shibata
- Department of Radiological Technology, Kawasaki Medical School Hospital
| | - Toshinori Abe
- Department of Radiological Technology, Kawasaki Medical School Hospital
| | - Hiroaki Mimura
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare
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Hoog C, Verrecchia-Ramos E, Dejust S, Lalire P, Sezin G, Moubtakir A, El Farsaoui K, Caquot PA, Guendouzen S, Morland D, Papathanassiou D. Implementation of xSPECT, xSPECT bone and Broadquant from literature, clinical survey and innovative phantom study with task-based image quality assessment. Phys Med 2023; 112:102611. [PMID: 37329742 DOI: 10.1016/j.ejmp.2023.102611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 04/19/2023] [Accepted: 05/30/2023] [Indexed: 06/19/2023] Open
Abstract
OBJECTIVE From patient and phantom studies, we aimed to highlight an original implementation process and share a two-years experience clinical feedback on xSPECT (xS), xSPECT Bone (xB) and Broadquant quantification (Siemens) for 99mTc-bone and 177Lu-NET (neuroendocrine tumors) imaging. METHODS Firstly, we checked the relevance of implemented protocols and Broadquant module on the basis of literature and with a homogeneous phantom study respectively. Then, we described xS and xB behaviours with reconstruction parameters (10i-0mm to 40i-20mm) and optimized the protocols through a blinded survey (7 physicians). Finally, the preferred 99mTc-bone reconstruction was assessed through an IEC NEMA phantom including liquid bone spheres. Conventional SNR, CNR, spatial resolution, Q.%error, and recovery curves; and innovative NPS, TTF and detectability score d' were performed (ImQuest software). We also sought to review the adoption of these tools in clinical routine and showed the potential of quantitative xB in the context of theranostics (Xofigo®). RESULTS We showed the need of optimization of implemented reconstruction algorithms and pointed out a decay correction particularity with Broadquant. Preferred parameters were 1s-25i-8mm and 1s-25i-5mm for xS/xB-bone and xS-NET imaging respectively. The phantom study highlighted the different image quality especially for the enhanced spatial resolution xB algorithm (1/TTF10%=2.1 mm) and showed F3D and xB shared the best performances in terms of image quality and quantification. xS was generally less efficient. CONCLUSIONS Qualitative F3D still remains the clinical standard, xB and Broadquant offer challenging perspectives in theranostics. We introduced the potential of innovative metrics for image quality analysis and showed how CT tools should be adapted to fit nuclear medicine imaging.
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Affiliation(s)
| | | | | | - Paul Lalire
- Nuclear Medicine Department, Institut Godinot, Reims, France
| | - Ghali Sezin
- Nuclear Medicine Department, Institut Godinot, Reims, France
| | | | | | | | | | - David Morland
- Nuclear Medicine Department, Institut Godinot, Reims, France; UFR de médecine, université de Reims-Champagne Ardenne, 1, rue Cognacq-Jay, 51095 Reims cedex, France; CReSTIC Centre de recherche en sciences et technologies de l'information et de la communication, EA 3804, université de Reims-Champagne Ardenne, Moulin de la Housse, BP 1039, 51687 Reims Cedex 2, France
| | - Dimitri Papathanassiou
- Nuclear Medicine Department, Institut Godinot, Reims, France; UFR de médecine, université de Reims-Champagne Ardenne, 1, rue Cognacq-Jay, 51095 Reims cedex, France; CReSTIC Centre de recherche en sciences et technologies de l'information et de la communication, EA 3804, université de Reims-Champagne Ardenne, Moulin de la Housse, BP 1039, 51687 Reims Cedex 2, France
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Ichikawa H, Shibutani T, Matsutake Y, Kato T, Ikematsu R, Higashi R, Kamiya T, Shimada H, Onoguchi M. Comparison of the detectability of hot lesions on bone SPECT using six state-of-the-art SPECT/CT systems: a multicenter phantom study to optimize reconstruction parameters. Phys Eng Sci Med 2023; 46:839-849. [PMID: 37126151 DOI: 10.1007/s13246-023-01257-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/10/2023] [Indexed: 05/02/2023]
Abstract
Single-photon emission computed tomography with X-ray computed tomography (SPECT/CT) systems have diversified due to the remarkable developments made by each manufacturer. This study aimed to optimize the reconstruction parameters of six state-of-the-art SPECT/CT systems and compare their image quality of bone SPECT. SPECT images were acquired on SPECT/CT systems, including Symbia Intevo, Discovery NM/CT 670, Discovery NM/CT 870 CZT, Brightview XCT, and VERITON-CT. SIM2 bone phantom with tough lung phantoms on both sides of the spinal inserts that simulate the thorax was used for image quality assessment. SPECT images were obtained at individual workstations using an ordered subset expectation maximization method with three-dimensional resolution recovery, as well as CT attenuation and scatter correction, subset 2, iteration 12-84, and a full width at half maximum 10-mm Gaussian smooth filter. An automatic image analysis software dedicated to SIM2 bone phantom was used to assess the contrast-to-noise ratio (CNR), relative recovery coefficient, percentage of coefficient of variance, contrast, and detectability. The optimal parameters for each system were defined with superior detectability of spherical lesions and noise characteristics, as well as the highest CNR. All systems exhibited better image quality indexes using the optimal parameters than using the manufacturer's recommended parameters. The detectability of all systems was in agreement while using the optimal parameters. Detectability agreement can be achieved by optimizing the reconstruction parameters for different reconstruction algorithms, which can further improve the image quality. Therefore, future research should focus on optimal reconstruction parameters for SPECT alone.
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Affiliation(s)
- Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan
| | - Yuki Matsutake
- Department of Radiology, Kurume University Hospital, Kurume, Japan
| | - Toyohiro Kato
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Ryuji Ikematsu
- Department of Radiology, Kurume University Hospital, Kurume, Japan
| | - Riwa Higashi
- Department of Radiology, Aichi Medical University, Nagakute, Japan
| | - Takashi Kamiya
- Division of Radiology, Department of Medical Technology, Osaka University Hospital, Suita, Japan
| | - Hideki Shimada
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan.
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Single photon emission computed tomography/computed tomography imaging of gouty arthritis: A new voice. J Transl Int Med 2023. [DOI: 10.2478/jtim-2022-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
Abstract
Gouty arthritis, often referred to simply as gout, is a disorder of purine metabolism characterized by the deposition of monosodium urate monohydrate (MSU) crystals in multiple systems and organs, especially in joints and their surrounding soft tissue. Gout is a treatable chronic disease, and the main strategy for effective management is to reverse the deposition of MSU crystals by uric acid reduction, and to prevent gout attacks, tophi deposition and complications, and thereby improve the quality of life. However, the frequent association of gout with other conditions such as hypertension, obesity, cardiovascular disease, diabetes, dyslipidemia, chronic kidney disease (CKD) and kidney stones can complicate the treatment of gout and lead to premature death. Here, we review the use of medical imaging techniques for studying gouty arthritis with special interest in the potential role of single photon emission computed tomography (SPECT)/computed tomography (CT) in the clinical management of gout and complications (e.g., chronic kidney disease and cardiovascular disease).
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Lin L, Zheng R, Geng J, Wang X, Li M, Fan R, Zheng Y, Yang K. Skeletal standardized uptake values obtained using quantitative SPECT/CT for the detection of bone metastases in patients with lung adenocarcinoma. Front Med (Lausanne) 2023; 10:1119214. [PMID: 36817798 PMCID: PMC9931902 DOI: 10.3389/fmed.2023.1119214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Purpose To assess the utility of skeletal standardized uptake values (SUVs) obtained using quantitative single-photon emission computed tomography/computed tomography (SPECT/CT) in differentiating bone metastases from benign lesions, particularly in patients with lung adenocarcinoma. Methods Patients with lung adenocarcinoma who had undergone whole-body Tc-99m methyl-diphosphonate (99mTc-MDP) bone scans and received late phase SPECT/CT were retrospectively analyzed in this study. The maximum SUV (SUVmax); Hounsfield units (HUs); and volumes of osteoblastic, osteolytic, mixed, CT-negative metastatic and benign bone lesions, and normal vertebrae were compared. Receiver operating characteristic curves were used to determine the optimal cutoff SUVmax between metastatic and benign lesions as well as the cutoff SUVmax between CT-negative metastatic lesions and normal vertebrae. The linear correlation between SUVmax and HUs of metastatic lesions as well as that between SUVmax and the volume of all bone lesions were investigated. Results A total of 252 bone metastatic lesions, 140 benign bone lesions, and 199 normal vertebrae from 115 patients with lung adenocarcinoma were studied (48 males, 67 females, median age: 59 years). Metastatic lesions had a significantly higher SUVmax (23.85 ± 14.34) than benign lesions (9.67 ± 7.47) and normal vertebrae (6.19 ± 1.46; P < 0.0001). The SPECT/CT hotspot of patients with bone metastases could be distinguished from benign lesions using a cutoff SUVmax of 11.10, with a sensitivity of 87.70% and a specificity of 80.71%. The SUVmax of osteoblastic (29.16 ± 16.63) and mixed (26.62 ± 14.97) lesions was significantly greater than that of osteolytic (15.79 ± 5.57) and CT-negative (16.51 ± 6.93) lesions (P < 0.0001, P = 0.0003, and 0.002). SUVmax at the cutoff value of 8.135 could distinguish CT-negative bone metastases from normal vertebrae, with a sensitivity of 100.00% and a specificity of 91.96%. SUVmax showed a weak positive linear correlation with HUs in all bone metastases and the volume of all bone lesions. Conclusion SUVmax of quantitative SPECT/CT is a useful index for distinguishing benign bone lesions from bone metastases in patients with lung adenocarcinoma, particularly in the diagnosis of CT-negative bone metastases, but other factors that may affect SUVmax should be considered.
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Affiliation(s)
- Lin Lin
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rong Zheng
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,*Correspondence: Rong Zheng ✉
| | - Jianhua Geng
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuejuan Wang
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Xuejuan Wang ✉
| | - Meng Li
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rong Fan
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiqing Zheng
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ke Yang
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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11
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Kessler L, Fragoso Costa P, Kersting D, Jentzen W, Weber M, Lüdike P, Carpinteiro A, Oubari S, Hagenacker T, Thimm A, Rassaf T, Herrmann K, Papathanasiou M, Rischpler C. Quantitative 99mTc-DPD-SPECT/CT assessment of cardiac amyloidosis. J Nucl Cardiol 2023; 30:101-111. [PMID: 35562639 PMCID: PMC9984322 DOI: 10.1007/s12350-022-02960-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 02/06/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Transthyretin (ATTR) amyloidosis is responsible for the majority of cardiac amyloidosis (CA) cases and can be reliably diagnosed with bone scintigraphy and the visual Perugini score. We aimed to implement a quantification method of cardiac amyloid deposits in patients with suspected cardiac amyloidosis and to compare performance to visual scoring. METHODS AND MATERIALS 136 patients received 99mTc-DPD-bone scintigraphy including SPECT/CT of the thorax in case of suspicion of cardiac amyloidosis. Imaging phantom studies were performed to determine the scaling factor for standardized uptake value (SUV) quantification from SPECT/CT. Myocardial tracer uptake was quantified in a whole heart volume of interest. RESULTS Forty-five patients were diagnosed with CA. A strong relationship between cardiac SUVmax and Perugini score was found (Spearman r 0.75, p < 0.0001). Additionally, tracer uptake in bone decreased with increasing cardiac SUVmax and Perugini score (p < 0.0001). ROC analysis revealed good performance of the SUVmax for the detection of ATTR-CA with AUC of 0.96 ± 0.02 (p < 0.0001) with sensitivity 98.7% and specificity 87.2%. CONCLUSION We demonstrate an accessible and accurate quantitative SPECT approach in CA. Quantitative assessment of the cardiac tracer uptake may improve diagnostic accuracy and risk classification. This method may enable monitoring and assessment of therapy response in patients with ATTR amyloidosis.
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Affiliation(s)
- Lukas Kessler
- Department of Nuclear Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.
| | - Pedro Fragoso Costa
- Department of Nuclear Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - David Kersting
- Department of Nuclear Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Walter Jentzen
- Department of Nuclear Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Manuel Weber
- Department of Nuclear Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Peter Lüdike
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Alexander Carpinteiro
- Department of Hematology and Stem Cell Transplantation, West German Tumor Center, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
- Department of Molecular Biology, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Sara Oubari
- Department of Hematology and Stem Cell Transplantation, West German Tumor Center, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Tim Hagenacker
- Department of Neurology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Andreas Thimm
- Department of Neurology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Maria Papathanasiou
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
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12
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Sato T, Matsutomo N, Yamamoto T, Fukami M, Kono T. Evaluation of standardized uptake value on 131I-6β-iodomethyl-19-norcholesterol scintigraphy for diagnosis of primary aldosteronism and correspondence with adrenal venous sampling. Ann Nucl Med 2023; 37:89-98. [PMID: 36380175 DOI: 10.1007/s12149-022-01805-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Adrenal venous sampling (AVS) is a reliable method for lateralization of adrenal hormone secretion, which is important for discriminating between aldosterone-producing adenoma and bilateral adrenal hyperplasia, both of which cause primary aldosteronism (PA). The aim of this study was to evaluate the diagnostic accuracy of the maximum and mean standardized uptake values (SUVmax and SUVmean, respectively) of 131I-6β-iodomethyl-19-norcholesterol (NP-59) single-photon emission computed tomography (SPECT) for PA and its correspondence with AVS. METHODS Adrenal NP-59 scintigraphy was performed in 14 patients with suspected PA, and AVS was also performed in 7 of them. SUVmax and SUVmean of the adrenal lesions on the dominant side and their ratios to the values on the non-dominant side (SUVRmax and SUVRmean, respectively) were calculated on SPECT images using ordered-subset conjugate gradient minimization (OSCGM) and three-dimensional ordered-subset expectation maximization (3D-OSEM) reconstruction algorithms. RESULTS SUVmax and SUVmean on NP-59 SPECT images were significantly higher for aldosterone-producing adenoma than for bilateral adrenal hyperplasia or non-functioning adenoma and slightly superior to SUVRmax and SUVRmean (P = 0.0475 and P = 0.0447 vs. P = 0.124 and P = 0.132, respectively, with OSCGM). The respective areas under the receiver-operating characteristic curve for SUV and SUVR were 0.933 and 0.725 with OSCGM and 0.844 and 0.750 with 3D-OSEM, while SUVmax and SUVRmax had exactly the same diagnostic accuracy as SUVmean and SUVRmean. SUV and SUVR were associated with the diagnostic features on AVS and consistent with lateralization by AVS in most patients. CONCLUSION In this study, SUV on NP-59 SPECT helped in the diagnosis of PA and was consistent with the results of AVS in nearly all cases.
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Affiliation(s)
- Tomohiro Sato
- Department of Radiology, Chiba Aoba Municipal Hospital, 1273-2 Aoba-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-0852, Japan. .,Department of Medical Radiological Technology, Faculty of Health Sciences, Graduate School of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-Shi, Tokyo, 181-8612, Japan.
| | - Norikazu Matsutomo
- Department of Medical Radiological Technology, Faculty of Health Sciences, Graduate School of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-Shi, Tokyo, 181-8612, Japan.,Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-Shi, Tokyo, 181-8612, Japan
| | - Tomoaki Yamamoto
- Department of Medical Radiological Technology, Faculty of Health Sciences, Graduate School of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-Shi, Tokyo, 181-8612, Japan.,Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-Shi, Tokyo, 181-8612, Japan
| | - Mitsuha Fukami
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-Shi, Tokyo, 181-8612, Japan
| | - Takashi Kono
- Department of Internal Medicine, Chiba Aoba Municipal Hospital, 1273-2 Aoba-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-0852, Japan
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13
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Yamane T, Matsusaka Y, Fukushima K, Seto A, Matsunari I, Kuji I. Quantification of bone metabolic activity in the natural course of fractural lesions measured by quantitative SPECT/CT. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE & BIOLOGY 2023; 11:30-36. [PMID: 36619183 PMCID: PMC9803622 DOI: 10.22038/aojnmb.2022.63484.1446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/25/2022] [Accepted: 04/03/2022] [Indexed: 01/10/2023]
Abstract
Objectives While increased uptake at the bone fractural site gradually decreases over time on bone scans, the rate of change has not been quantitatively evaluated. The purpose of this study was to quantify the extent of bone metabolic changes in fractural lesions on bone SPECT/CT. Methods We reviewed bone scans acquired by dedicated SPECT/CT and chose those scans in which quantitative SPECT/CT of the same range was acquired twice or more. We set the region of interest on lesions of bone fracture and degeneration, and measured the maximum standardized uptake value (SUVmax). From the SUVmax of lesions and the interval between scans, a value for 30-day change in SUVmax was calculated as ∆SUVmax30d. The relationship between preSUVmax, SUVmax for the first scan of the comparison, and ∆SUVmax30d was evaluated utilizing a linear least-squares method. Furthermore, we assessed the ability to differentiate between fracture and degeneration using receiver operating characteristics (ROC) analysis and the Mann-Whitney U test. All cases were then categorized into five groups according to preSUVmax. Values of p <0.05 were considered statistically significant. Results We investigated 175 scans from 60 patients and analyzed scan combinations for 157 fractural lesions and 266 degenerative lesions. The relationship between preSUVmax of fractural lesions and ∆SUVmax30d was approximated as ∆SUVmax30d =-0.15×preSUVmax +1.35 (R 2=0.60, p<0.0001). Area under the curves for all cases, 30≤ preSUVmax, 20≤ preSUVmax <30, 15≤ preSUVmax <20, 10≤ preSUVmax <15, and preSUVmax <10 were 0.73, 0.89, 0.86, 0.80, 0.91, and 0.59, respectively. Median ∆SUVmax30d was significantly lower at fractural lesions than at degenerative lesions (-0.62 vs -0.04; p <0.0001). As for analyses of groups divided by preSUVmax, all median ∆SUVmax30d for fractural lesions were significantly lower than those of degenerative lesions except for the group with preSUVmax <10. Conclusion The increased uptake at the fractural bone lesion observed in the quantitative bone SPECT/CT gradually decreased at the rate of SUV 0.15 per month, which showed a different trend with degenerative change.
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Affiliation(s)
- Tomohiko Yamane
- Department of Molecular Imaging Research, Kobe City Medical Center General Hospital, Japan,Department of Nuclear Medicine, Saitama Medical University International Medical Center, Japan,Corresponding author: Tomohiko Yamane. Division of Molecular Imaging Research, Kobe City Medical Center General Hospital Minatojima-Minamimachi 2-1-1, Chuo-Ku, Kobe, 650-0047, Japan. Tel: +81-78-302-4321; E-mail:
| | - Yohji Matsusaka
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, Japan
| | - Kenji Fukushima
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, Japan,Department of Radiology and Nuclear Medicine, Fukushima Medical University, Japan
| | - Akira Seto
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, Japan
| | - Ichiro Matsunari
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University Hospital, Japan
| | - Ichiei Kuji
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, Japan
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14
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Ichikawa H, Shibutani T, Onoguchi M, Taniguchi Y. New index to assess the extent of bone disease in patients with prostate cancer using SPECT/CT. Ann Nucl Med 2022; 36:941-950. [PMID: 36048347 DOI: 10.1007/s12149-022-01783-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Assessing the extent of bone metastases in patients with prostate cancer is very important to predict patient prognosis. Therefore, the bone scan index (BSI), which is easy to use, has been used; however, the accuracy is not that high. In this study, we proposed a new index for the extent of bone disease using single-photon emission computed tomography with computed tomography (SPECT/CT) images and assessed the accuracy of calculation. METHODS In this study, a total of 46 bone scans from 12 patients with prostate cancer treated for bone metastases with Radium-223 were included. Whole-body planar images were obtained 150-180 min after an intravenous injection of 99mTc-methylene diphosphonate, and cervical-to-pelvic SPECT/CT was immediately obtained. The total bone volume (TBV) and regional metabolic bone volume (MBV) were defined as Hounsfield unit of > 120, standardized uptake value (SUV) of > 0.5, and SUV of > 5-8 in four levels, respectively. Bone metabolism volumetric index (BMVI) was calculated as the percentage of the total MBV divided by TBV. The variability of the TBV measurement was evaluated by the percentage coefficient of variance (%CV) of TBV within individual patients. We evaluated the correlation of TBV with age, height, weight, and body mass index and the correlation and agreement between BSI and BMVI. RESULTS The mean and %CV of TBV were 4661.7 cm3 and 2.8%, respectively, and TBV was strongly correlated with body weight. BMVI was significantly higher than BSI and correlated with alkaline phosphatase. For patients with progressive bone metastases, BSI was clearly underestimated, whereas BMVI was elevated. CONCLUSIONS Although assessed in a small number of cases, the new index for assessing the extent of bone disease using SPECT/CT imaging was highly value than BSI and was significantly correlated with alkaline phosphatase. Therefore, this study suggests that BMVI could improve the low sensitivity of BSI in patients with low extent of disease grade.
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Affiliation(s)
- Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 4418570, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan.
| | - Yuki Taniguchi
- Department of Radiology, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 4418570, Japan
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15
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Impact of patient body habitus on image quality and quantitative value in bone SPECT/CT. Ann Nucl Med 2022; 36:586-595. [PMID: 35543916 DOI: 10.1007/s12149-022-01746-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/19/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE The first edition of guidelines for standardization of bone single photon emission computed tomography (SPECT) imaging was published in 2017, and the optimization and standardization are widely promoted. To the purpose, clarification of the factors related to image quality and quantitative values and their influence are required. The present study aimed to clarify and optimize the influence of patient body habitus on image quality and quantitative values in bone SPECT/CT. METHODS National Electrical Manufacturers Association body phantom (S-size) and custom-made large body phantoms (M-size and L-size) that simulate the abdomens of Japanese patients weighing 60, 80, and 100 kg, were used. Each phantom was filled with 99mTc-solutions of 108 and 18 kBq/mL for the hot spheres and background, respectively. Dynamic SPECT acquisition was performed for 6000 s (150 s /rotation × 40 rotation). The data were divided into six projection data and reconstructed each acquisition time (150, 300, 450, 600, 750, 900 s, and single projection 6000 s). Image quality was evaluated for contrast (QH, 17 mm), background noise (NB, 17 mm), contrast-to-noise ratio (CNR), maximum standardized uptake value (SUVmax, 17 mm), and visual assessment for a 17 mm hot sphere. RESULTS Image quality in the 300 s acquisition showed that values of QH, 17 mm, CNR, and SUVmax, 17 mm decreased (-16.7%, -11.8%, and -11.3%) for M-size and (-28.2%, -30.1%, and -21.7%) for L-size compared with S-size, respectively. No significant difference was observed in NB, 17 mm values. M-size and L-size required 1.2 and 2.3 times longer acquisition, to achieve same CNR as S-size. In visual assessment, 17 mm hot sphere could not be detected only in the L-size. When the Japanese bone SPECT guidelines criteria were applied in 600 s, the sphere could be detected between all phantoms. CONCLUSIONS Patient body habitus significantly affects image quality and decreases the quantitative value in bone SPECT/CT. For the optimization, extend acquisition time according to the patient body habitus is effective for image quality. And for the standardization, it is important to achieve imaging conditions that meet the Japanese bone SPECT guidelines criteria to ensure adequate detectability.
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16
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Jin Z, Zhang F, Wang Y, Tian A, Zhang J, Chen M, Yu J. Single-Photon Emission Computed Tomography/Computed Tomography Image-Based Radiomics for Discriminating Vertebral Bone Metastases From Benign Bone Lesions in Patients With Tumors. Front Med (Lausanne) 2022; 8:792581. [PMID: 35059418 PMCID: PMC8764284 DOI: 10.3389/fmed.2021.792581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/22/2021] [Indexed: 12/31/2022] Open
Abstract
Purpose: The purpose of this study was to investigate the feasibility of Single-Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) image-based radiomics in differentiating bone metastases from benign bone lesions in patients with tumors. Methods: A total of 192 lesions from 132 patients (134 in the training group, 58 in the validation group) diagnosed with vertebral bone metastases or benign bone lesions were enrolled. All images were evaluated and diagnosed independently by two physicians with more than 20 years of diagnostic experience for qualitative classification, the images were imported into MaZda software in Bitmap (BMP) format for feature extraction. All radiomics features were selected by least absolute shrinkage and selection operator (LASSO) regression and 10-fold cross-validation algorithms after the process of normalization and correlation analysis. Based on these selected features, two models were established: The CT model and SPECT model (radiomics features were derived from CT and SPECT images, respectively). In addition, a combination model (ComModel) combined CT and SPECT features was developed in order to better evaluate the predictive performance of radiomics models. Subsequently, the diagnostic performance between each model was separately evaluated by a confusion matrix. Results: There were 12, 13, and 18 features contained within the CT, SPECT, and ComModel, respectively. The constructed radiomics models based on SPECT/CT images to discriminate between bone metastases and benign bone lesions not only had high diagnostic efficacy in the training group (AUC of 0.894, 0.914, 0.951 for CT model, SPECT model, and ComModel, respectively), but also performed well in the validation group (AUC; 0.844, 0.871, 0.926). The AUC value of the human experts was 0.849 and 0.839 in the training and validation groups, respectively. Furthermore, both SPECT model and ComModel show higher classification performance than human experts in the training group (P = 0.021 and P = 0.001, respectively) and the validation group (P = 0.037 and P = 0.007, respectively). All models showed better diagnostic accuracy than human experts in the training group and the validation group. Conclusion: Radiomics derived from SPECT/CT images could effectively discriminate between bone metastases and benign bone lesions. This technique may be a new non-invasive way to help prevent unnecessary delays in diagnosis and a potential contribution in disease staging and treatment planning.
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Affiliation(s)
- Zhicheng Jin
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Fang Zhang
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Yizhen Wang
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Aijuan Tian
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Jianan Zhang
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Meiyan Chen
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
| | - Jing Yu
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, China
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Quantitative Analysis of SPECT-CT Data in Metastatic Breast Cancer Patients-The Clinical Significance. Cancers (Basel) 2022; 14:cancers14020273. [PMID: 35053436 PMCID: PMC8773966 DOI: 10.3390/cancers14020273] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/24/2021] [Accepted: 01/02/2022] [Indexed: 01/13/2023] Open
Abstract
Simple Summary Breast cancer represents one of the most common cancers diagnosed in female patients, with up to 75% of the patients with stage IV breast cancer developing metastatic bone lesions. Early detection of bone metastasis and differentiating them from degenerative lesions using molecular imaging techniques, such as SPECT-CT, is important for therapeutic purposes and patient follow-up. This study was conducted to determine if the quantitative analysis of the data acquired by performing SPECT-CT scans can help in differentiating between metastatic lesions and degenerative bone disease. In 70 female patients, we identified the radiotracer uptake in metastatic and degenerative bone lesions and determined the diagnostic accuracy of the SPECT-CT quantitative analysis in differentiating between the two types of lesions. The results provided valuable information that can improve the diagnostic accuracy of metastatic bone lesions and treatment response evaluation in breast cancer patients. Abstract Purpose: To assess the potential added value of the SPECT-CT quantitative analysis in metastatic breast cancer lesions detection and differentiation from degenerative lesions. Methods: This prospective monocentric study was conducted on 70 female patients who underwent SPECT-CT bone scans using 99mTc–HDP that identified the presence of metastatic bone lesions and degenerative lesions in each patient. Once the lesions were identified, a quantitative analysis of radiotracer uptake was conducted. The highest one to five SUVmax values for both metastatic and degenerative bone lesions were identified in each patient and the data were then statistically analyzed. Results: The SUVmax value was significantly higher in metastatic bone lesions than in degenerative lesions (p < 0.001). The diagnostic accuracy of SPECT-CT quantitative data analysis revealed a sensitivity of 91.5% and a specificity of 93.3% at a cut-off value of the SUVmax of 16.6 g/mL. Conclusion: Quantitative analysis performed using SPECT-CT data can improve the diagnostic accuracy in differentiating between metastatic bone lesions and degenerative lesions, thus leading to appropriate treatment and better follow-up in metastatic breast cancer patients.
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Havel M, Dedek V, Kolacek M, Formanek M. Quantitative analysis in parathyroid adenoma scintigraphy. Nucl Med Commun 2022; 43:1-7. [PMID: 34406145 DOI: 10.1097/mnm.0000000000001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Surgery is the only curative treatment for primary hyperparathyroidism. Parathyroid scintigraphy is one method used to preoperatively localize the lesion. We examined time-related changes in radiopharmaceutical uptake in parathyroid adenomas (PTAs) and thyroid gland by quantitative single-photon-emission computed tomography (SPECT) imaging to assess differences between rapid and delayed washout patterns. PATIENTS AND METHODS The study group consisted of 35 histologically verified PTAs after radio-guided surgery extirpation in 33 patients with primary hyperparathyroidism. Patients underwent a three-phase SPECT/CT study of the neck and upper thorax post 99mTc-methoxyisobutylisonitrile (MIBI) injection. Images were reconstructed using a proprietary ordered-subset-conjugate-gradient-maximization algorithm (Siemens xSPECT Quant). PTAs were divided into those with a rapid (group A) and those with a slow (group B) washout pattern. SUVmax values of PTAs and thyroid gland tissue at 10, 90 and 180 min post 99mTc-MIBI injection were recorded and statistically assessed. Retention indexes related to the early examination were calculated for PTA and thyroid gland (RI-PTA and RI-TG). RESULTS There were 11 PTAs in group A and 24 in group B. Significant between-group differences in PTA SUVmax and PTA/thyroid gland ratios were observed only at 180 min postinjection (P = 0.0297, P = 0.0222, respectively). RI-PTAs differed significantly at 90 and 180 min postinjection (P = 0.0298, P = 0.0431). No differences in PTA volumes, thyroid gland SUVmax values or RI-TG were observed between the groups. CONCLUSION PTAs with rapid and slow washout patterns have different characteristics on quantitative analysis in later phases. No significant differences in directly measurable quantitative values (SUVmax, PTA/thyroid gland ratio) at the early stages of multi-phase examination were observed.
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Affiliation(s)
| | | | | | - Martin Formanek
- Department of Otorhinolaryngology, University Hospital Ostrava and Medical Faculty, University Ostrava, Ostrava, Czech Republic
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Konishi T. [[SPECT] 4. Introductions of SPECT Reconstruction Algorithm Using the Conjugated Gradient Method and Metal Artifact Reduction Technologies in the Latest SPECT System]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:895-901. [PMID: 35989260 DOI: 10.6009/jjrt.2022-2075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Imbert L, Bahloul A, Verger A, Marie PY. 360° CZT gamma cameras for nuclear medicine and molecular imaging. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00087-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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21
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Yamane T, Takahashi M, Matsusaka Y, Fukushima K, Seto A, Kuji I, Matsunari I. Satisfied quantitative value can be acquired by short-time bone SPECT/CT using a whole-body cadmium-zinc-telluride gamma camera. Sci Rep 2021; 11:24320. [PMID: 34934145 PMCID: PMC8692318 DOI: 10.1038/s41598-021-03853-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 12/10/2021] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to evaluate the quantitative values of short-time scan (STS) of metastatic lesions compared with a standard scan (SS) when acquired by whole-body bone SPECT/CT with cadmium-zinc-telluride (CZT) detectors. We retrospectively reviewed 13 patients with bone metastases from prostate cancer, who underwent SPECT/CT performed on whole-body CZT gamma cameras. STSs were obtained using 75, 50, 25, 10, and 5% of the list-mode data for SS, respectively. Regions of interest (ROIs) were set on the increased uptake areas diagnosed as metastases. Intraclass correlation coefficients (ICCs) of standardized uptake values (SUVs) for the ROIs were calculated between the SS and each STS, and ICC ≥ 0.8 was set as a perfect correlation. Moreover, the repeatability coefficient (RC) was calculated, and RC ≤ 20% was defined as acceptable. A total of 152 metastatic lesions were included in the analysis. The ICCs between the SS vs. 75%-STS, 50%-STS, 25%-STS, 10%-STS, and 5%-STS were 0.999, 0.997, 0.994, 0.983, and 0.955, respectively. The RCs of the SS vs. 75%-STS, 50%-STS, 25%-STS, 10%-STS, and 5%-STS were 7.9, 12.4, 19.8, 30.8, and 41.3%, respectively. When evaluating the quality of CZT bone SPECT/CT acquired by a standard protocol, 25%-STS may provide adequate quantitative values.
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Affiliation(s)
- Tomohiko Yamane
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University Hospital, 38 Moro-Hongo, Moroyama, 350-0495, Japan.
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-0491, Japan.
| | - Masafumi Takahashi
- Department of Central Radiological Technology, Saitama Medical University Hospital, 38 Moro-Hongo, Moroyama, 350-0495, Japan
| | - Yohji Matsusaka
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-0491, Japan
| | - Kenji Fukushima
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-0491, Japan
| | - Akira Seto
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-0491, Japan
| | - Ichiei Kuji
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-0491, Japan
| | - Ichiro Matsunari
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University Hospital, 38 Moro-Hongo, Moroyama, 350-0495, Japan
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Ye YX, Guan J, Chen XY, Yu YW, Xu ZM, Zeng SMZ, Wang ZC, Wang BZ, Jiao QC, Zhu HL. A new fluorescently labeled bisphosphonate for theranostics in tumor bone metastasis. Talanta 2021; 235:122796. [PMID: 34517654 DOI: 10.1016/j.talanta.2021.122796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
Bone metastasis of malignant solid tumors has become one of the most serious complications, especially in breast cancer, which was particularly challenging for early detection and treatment in clinical practice. In this work, we reported a new fluorescently labeled bisphosphonate for bone metastasis detection of breast cancer. The designed probes were based on Rhodamine B and bisphosphonate as recognition group, which can specifically target hydroxyapatite (HA) existed in bone tissue. After the osteoclasts were adsorbed on the bone surface, the surrounding microenvironment was acidified, causing the HA to locally dissolve. The probe bound to the HA was then released, and realized the fluorescence turn on under acidic conditions. In vitro experiments showed that G0 was more excellent than G2 owing to shorter connecting arm. Subsequently, we proved that G0 could combine with HA rapidly and exhibit excellent response in solid state. More importantly, we established a model of bone metastasis with MDA-MB-231 cells which was similar to the clinical cases and evaluated the theranostics value of G0 prospectively, which provide the potential application prospect in clinical.
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Affiliation(s)
- Ya-Xi Ye
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing, 210023, PR China
| | - Jing Guan
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing, 210023, PR China
| | - Xin-Yue Chen
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing, 210023, PR China
| | - Ya-Wen Yu
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing, 210023, PR China
| | - Zhu-Min Xu
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing, 210023, PR China
| | - Shang-Ming-Zhu Zeng
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing, 210023, PR China
| | - Zhong-Chang Wang
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing, 210023, PR China; Institute of Artificial Intelligence Biomedicine, Nanjing University, Nanjing, 210023, PR China
| | - Bao-Zhong Wang
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing, 210023, PR China.
| | - Qing-Cai Jiao
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing, 210023, PR China.
| | - Hai-Liang Zhu
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing, 210023, PR China.
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Optimization of cross-calibration factor for quantitative bone SPECT without attenuation and scatter correction in the lumbar spine: head-to-head comparison with attenuation and scatter correction. Nucl Med Commun 2021; 42:1404-1416. [PMID: 34456319 DOI: 10.1097/mnm.0000000000001480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Quantitative single-photon emission computed tomography (SPECT) with computed tomography (SPECT/CT) is known to improve diagnostic performance. Although SPECT-alone systems are used widely, accurate quantitative SPECT using these systems is challenging. This study aimed to improve the accuracy of quantitative bone SPECT of the lumbar spine with the SPECT-alone system. METHODS The cross-calibration factor (CCF) was measured using three kinds of phantoms and the optimal values were determined. The recovery coefficient with and without attenuation and scatter correction (ACSC) were compared. Bone SPECT/CT was performed on 93 consecutive patients with prostate cancer, and the standardized uptake values (SUVs) were compared using the respective CCFs. The first 60 patients were classified according to body weight, and the correlation coefficient between SUVs with and without ACSC were calculated; the slopes were defined as body weight-based coefficients (BWCs). In the remaining 33 patients, the SUV was adjusted according to BWC, and the accuracy of the adjustment was verified. RESULTS The quantitative SPECT values obtained from the CCF using SIM2 bone phantom showed nearly accurate radioactivity concentrations, even without ACSC. The recovery coefficients with and without ACSC were similar. Unadjusted SUVs with and without ACSC were strongly correlated; however, SUVs without ACSC were significantly higher than those with ACSC (P < 0.0001). The mean difference between the SUVs with and without ACSC disappeared when the SUVs without ACSC were adjusted by BWC (P = 0.9814). CONCLUSIONS Our cross-calibration method for quantitative bone SPECT enables interpretation with a harmonized SUV even in SPECT-alone systems.
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Feasibility of ultra-high-speed acquisition in xSPECT bone algorithm: a phantom study with advanced bone SPECT-specific phantom. Ann Nucl Med 2021; 36:183-190. [PMID: 34731435 DOI: 10.1007/s12149-021-01689-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Although xSPECT Bone (xB) provides quantitative single-photon emission computed tomography (SPECT) high-resolution images, patients' burden remains high due to long acquisition time; therefore, this study aimed to investigate the feasibility of shortening the xB acquisition time using a custom-designed phantom. METHODS A custom-designed xSPECT bone-specific (xSB) phantom with simulated cortical and spongious bones was developed based on the thoracic bone phantom. Both standard- and ultra-high-speed (UHS) xB acquisitions were performed in a male patient with lung cancer. In this phantom study, SPECT was acquired for 3, 6, 9, 12, and 30 min. The clinical SPECT acquisition time per rotation was 9 and 3 min for standard and UHS, respectively. SPECT images were reconstructed using ordered subset expectation maximization with three-dimensional resolution recovery (Flash3D; F3D) and xB algorithms. Quantitative SPECT value (QSV) and coefficient of variation (CV) were measured using the volume of interests (VOIs) placed at the center of the vertebral body and hot sphere. A linear profile was plotted on the spinous process at the center of the xSB phantom; then, the full width at half maximum (FWHM) was measured. The standardized uptake value (SUV) and standard deviation from the first thoracic to the fifth lumbar vertebrae in clinical standard- and UHS-xB images were measured using a 1-cm3 VOI. RESULTS The QSV of F3D images was underestimated even in large regions, whereas those of xB images were close to actual radioactivity concentration. The CV was similar or lower for xB images than that for F3D images but was not decreased with increasing acquisition time for both reconstruction images. The FWHM of xB images was lower than those of F3D images at all acquisition times. The mean SUV values from the first thoracic to fifth lumbar vertebrae for standard- and UHS-xB images were 6.73 ± 0.64 and 6.19 ± 0.87, respectively, showing a strong positive correlation. CONCLUSIONS Results of this phantom study suggest that xB imaging can be obtained in only one-third of the acquisition time without compromising the image quality. The SUV of UHS-xB images can be similar to that of standard-xB images in terms of clinical interpretation.
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25
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Nautiyal A, Jha AK, Mithun S, Sawant V, Jadhav R, Khairnar K, Rangarajan V. Normal Skeletal Standardized Uptake Values Obtained from Quantitative Single-Photon Emission Computed Tomography/Computed Tomography: Time-Dependent Study on Breast Cancer Patients. Indian J Nucl Med 2021; 36:398-411. [PMID: 35125758 PMCID: PMC8771070 DOI: 10.4103/ijnm.ijnm_47_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/14/2021] [Accepted: 08/31/2021] [Indexed: 11/09/2022] Open
Abstract
Aim: To estimate the standard uptake values (SUVs) of Tc-99m methylene-diphosphonate (Tc-99m MDP) from normal skeletal sites in breast cancer patients using quantitative single-photon emission computed tomography (SPECT). Materials and Methods: A total of 60 breast cancer patients who underwent Tc-99m MDP SPECT/CT study at different postinjection acquisition times were included in this study. Based on postinjection acquisition time, patients were divided into four study groups (n_15 each), i.e. Ist (2 h), IInd (3 h), IIIrd (4 h), and IVth (5 h). Image quantification (SUVmax and SUVmean) was performed using Q.Metrix software. Delineation of volume of interest was shaped around different bones of the skeletal system. Results: The highest normal SUVmax and SUVmean values were observed in lumber and thoracic vertebra (8.89 ± 2.26 and 2.89 ± 0.58) for Group I and in pelvis and thoracic (9.6 ± 1.32 and 3.04 ± 0.64), (10.93 ± 3.91 and 3.65 ± 0.97), (11.33 ± 2.67 and 3.65 ± 0.22) for Group II, III and IV, respectively. Lowest normal SUVmax and SUVmean values were observed in humerus and ribs (3.22 ± 0.67 and 0.97 ± 0.18), (5.16 ± 1.82 and 1.18 ± 0.16) for Group I, IV, and in humerus (3.17 ± 0.58 and 0.85 ± 0.26), (3.98 ± 1.12 and 1.04 ± 0.28) for Group II and III, respectively. Significant difference (P < 0.05) noted in SUVmax for sternum, cervical, humerus, ribs, and pelvis with respect to time. However, significant difference (P < 0.05) noted in SUVmean for all skeletal sites with respect to time. Conclusions: Our study shows variability in normal SUV values for different skeletal sites in breast cancer patients. Vertebral bodies and pelvis contribute highest SUV values. Time dependency of SUVs emphasizes the usefulness of routinely acquired images at the same time after Tc-99m MDP injection, especially in follow-up studies.
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Affiliation(s)
- Amit Nautiyal
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ashish Kumar Jha
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sneha Mithun
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Viraj Sawant
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Raveena Jadhav
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Kranti Khairnar
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
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The value of skeletal standardized uptake values obtained by quantitative single-photon emission computed tomography-computed tomography in differential diagnosis of bone metastases. Nucl Med Commun 2021; 42:63-67. [PMID: 33044406 DOI: 10.1097/mnm.0000000000001311] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to explore the value of skeletal standardized uptake value (SUV) obtained by quantitative single-photon emission computed tomography-computed tomography (SPECT/CT) in differential diagnosis of bone metastases from benign lesions. MATERIALS AND METHODS Retrospective analysis has been conducted to 51 patients with extraskeletal malignant tumors who underwent whole-body bone scan with quantitative SPECT/CT imaging, and there are no more than three hotspots that were visually detected in the SPECT/CT imaging range. Fifty-one patients were enrolled, including 28 men and 23 women with an average age of 58.8 ± 9.5 (37-77) years. A total of 88 hotspots, including 40 benign lesions and 48 metastatic lesions, and corresponding normal sites were obtained. The region of interest (ROI) of the hotspots was sketched. The ROI of the normal bone of the spinal vertebral body adjacent to the lesions or normal bone of the symmetric side of the lesions of other locations was delineated to obtain the maximum SUV (SUVmax) and the average SUV (SUVave). RESULTS The SUVmax value of all lesions was 20.73 ± 14.01 (3.90-92.61), and the SUVmax value of the corresponding normal parts was 5.88 ± 2.36 (2.08-12.52). The difference between the two groups was statistically significant (t = 10.343, P < 0.01). The SUVave of all lesions was 8.42 ± 4.81 (37-77), and the SUVave of the corresponding normal sites was 3.10 ± 1.51 (0.65-7.54). The difference between the two groups was statistically significant (t = 11.342, P < 0.01). The SUVmax of metastases was 24.77 ± 16.32 (3.90-92.61), and the SUVmax of benign lesions was 15.89 ± 8.51 (4.68-42.32). The difference between the two groups was statistically significant (t = 3.273, P = 0.002). The SUVave of metastases was 9.09 ± 5.59 (0.81-29.08), and the SUVave of benign lesions was 7.61 ± 3.57 (1.66-17.48). There was no significant difference between the two groups (t = 1.44, P = 0.154). The area under the curve (AUC) values of the SUVmax curves was greater than that of the SUVave curve. AUCs of the SUVmax and SUVave were 0.687 (P = 0.03) and 0.576 (P = 0.223), respectively. SUVmax had greater accuracy for discriminating bone metastasis from benign lesions. Hotspots of the patients with malignant neoplasms in bone SPECT/CT may be discriminated using SUVmax with certain accuracy, and the optimal cutoff value was 17.705. CONCLUSION The SUVmax of bone metastases was significantly larger than that of benign lesions, and there was no significant difference in SUVave between the two groups. Therefore, the SUVmax has a certain value for the differential diagnosis of metastases from benign lesions.
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Ishihara M, Kato Y, Onoguchi M, Shibutani T. An alternative method for radioactivity measurement in quantitative bone SPECT/CT imaging. Sci Prog 2021; 104:368504211028363. [PMID: 34231449 PMCID: PMC10450721 DOI: 10.1177/00368504211028363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bone scintigraphy with combined single-photon emission computed tomography (SPECT) and computed tomography (CT) has become widely used for the detection of bone metastases. However, calculation of the semi-quantitative standardized uptake value (SUV) requires measurement of the pre- and post-injection radioactivity of the radiopharmaceutical. This study aimed to compare measured and fixed input radioactivity values for quantitative SPECT/CT bone imaging to examine whether the fixed measurement method of radiopharmaceutical radioactivity could be used as an alternative method. Four different methods were used to quantify the Tc-99m hydroxymethylene diphosphonate input radioactivity: (A) measured pre- and post-injection radioactivity values; (B) measured pre-injection and fixed post-injection radioactivity values; (C) fixed pre-injection and measured post-injection radioactivity values; (D) fixed pre- and post-injection radioactivity values. All SPECT/CT acquisitions were analyzed using bone SPECT analysis software, and the semi-quantitative parameters (SUVpeak and SUVmean) were recorded and compared for each analytical method. Two semi-quantitative parameters showed significant differences between analytical methods A and B, A and D, and C and D. However, an additional subgroup analysis performed on patients whose median post-injection measured radioactivity value was <1.5 MBq showed no significant differences in parameters between all analytical methods. Measurement of the radiopharmaceutical radioactivity can be an alternative method because it reduces the volume of radioactivity post-injection. The simplified fixed measurement method of radiopharmaceutical radioactivity can be used as an alternative method in cases when measuring the radioactivity in quantitative bone SPECT/CT imaging is missed.
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Affiliation(s)
- Masaru Ishihara
- Department of Radiology, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, Hyogo, Japan
| | - Yasuaki Kato
- Department of Radiology, Hyogo Prefectural Awaji Medical Center, Sumoto, Hyogo, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
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28
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Automatic quantification package (Hone Graph) for phantom-based image quality assessment in bone SPECT: computerized automatic classification of detectability. Ann Nucl Med 2021; 35:937-946. [PMID: 34028702 DOI: 10.1007/s12149-021-01631-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/12/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE We previously developed a custom-design thoracic bone scintigraphy-specific phantom ("SIM2 bone phantom") to assess image quality in bone single-photon emission computed tomography (SPECT). We aimed to develop an automatic assessment system for imaging technology in bone SPECT and demonstrate the validity of this system. METHODS Four spherical lesions of 13-, 17-, 22-, and 28-mm diameters in the vertebrae of SIM2 bone phantom simulating the thorax were filled with radioactivity (target-to-background ratio: 4). Dynamic SPECT acquisitions were performed for 15 min; reconstructions were performed using ordered subset expectation maximization at 3-15-min timepoints. Consequently, 216 lesions (54 SPECT images) were obtained: 120 and 96 lesions were used for software development and validation, respectively. The developed software used statistical parametric mapping to rigidly register and automatically calculate quantitative indexes (contrast-to-noise ratio, % coefficient of variance, % detectability equivalence volume, recovery coefficient, target-to-normal bone ratio, and full width at half maximum). A detectability score (DS) was used to define the four observation types (4, excellent; 3, adequate; 2, average; 1, poor) to score hot spherical lesions. The gold standard for DSs was independently classified by three experienced board-certified nuclear medicine technologists using the four observation types; thereafter, a consensus regarding the gold standard for DSs was reached. Using 120 lesions for development, decision tree analysis was performed to determine DS based on the quantitative indexes. We verified the validation of the quantitative indexes and their threshold values for automatic classification using 96 lesions for validation. RESULTS The trends in the automatically calculated quantitative indices were consistent. Decision tree analysis produced four terminal groups; two quantitative indexes (% detectability equivalence volume and contrast-to-noise ratio) were used to classify DS. The automatically classified DSs exhibited an almost perfect agreement with the gold standard. The percentage agreement and kappa coefficient were 91.7% and 0.93, respectively, in 96 lesions for validation. CONCLUSIONS The developed software automatically classified the detectability of hot lesions in the SIM2 bone phantom using the automatically calculated quantitative indexes, suggesting that this software could provide a means to automatically perform detectability analysis after data input that is excellent in reproducibility and accuracy.
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Kitajima K, Tsuchitani T, Takahashi Y, Minami T, Yokoi T, Nakamura A, Hashimoto M, Kuribayashi K, Kijima T, Hasegawa S, Yamakado K. Usefulness of Quantitative Bone Single-Photon Emission Computed Tomography/Computed Tomography for Evaluating the Treatment Response of Bone Metastasis in a Lung Cancer Patient. Case Rep Oncol 2021; 14:391-396. [PMID: 33776734 PMCID: PMC7983545 DOI: 10.1159/000513907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 11/19/2022] Open
Abstract
We report a case of bone metastasis arising from lung cancer, including quantitative values obtained with bone single-photon emission computed tomography/computed tomography (SPECT/CT), which were useful to evaluate the treatment response. The first bone SPECT/CT during pembrolizumab therapy for lung cancer recurrence showed intense <sup>99m</sup>Tc-HMDP uptake of the right femur head and mild uptake of the left ribs. After the palliative radiotherapy for the right femur head metastasis and chemotherapy, the second bone SPECT/CT showed a decrease in focal uptake of the right femur hip and increasing uptake of the left ribs. There was also new uptake appearance in the sternum, right rib, spine (Th2, Th9, Th12, L4, S1), and bilateral pelvic bone (left ilium, acetabular cartridge, femur, right ilium and ischium). The change of maximum standardized uptake values (SUVmax) for the right femur head and left third and eighth rib bony metastases were −72.6% (from 22.96 to 6.28), +407.7% (from 2.97 to 15.08), and +229.2% (from 2.60 to 8.56), respectively. The change of whole-lesion metabolic bone volume and total bone uptake was +235.4% (from 22.75 to 76.3 cm<sup>3</sup>) and +219.1% (from 205.0 to 654.09), respectively. Two quantitative bone SPECT/CT images clearly showed the good response of femur head metastasis due to radiotherapy, and progression of other bone metastases regardless of chemotherapy.
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Affiliation(s)
| | - Tatsuya Tsuchitani
- Department of Radiological Technology, Hyogo College of Medicine College Hospital, Hyogo, Japan
| | - Yoshiyuki Takahashi
- Department of Radiological Technology, Hyogo College of Medicine College Hospital, Hyogo, Japan
| | - Toshiyuki Minami
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Takashi Yokoi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Akifumi Nakamura
- Department of Thoracic Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Masaki Hashimoto
- Department of Thoracic Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Kozo Kuribayashi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Takashi Kijima
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Seiki Hasegawa
- Department of Thoracic Surgery, Hyogo College of Medicine, Hyogo, Japan
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Qi N, Meng Q, You Z, Chen H, Shou Y, Zhao J. Standardized uptake values of 99mTc-MDP in normal vertebrae assessed using quantitative SPECT/CT for differentiation diagnosis of benign and malignant bone lesions. BMC Med Imaging 2021; 21:39. [PMID: 33639883 PMCID: PMC7913396 DOI: 10.1186/s12880-021-00569-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/16/2021] [Indexed: 11/10/2022] Open
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.
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Affiliation(s)
- Na Qi
- Department of Nuclear Medicine, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China
| | - Qingyuan Meng
- Department of Nuclear Medicine, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China
| | - Zhiwen You
- Department of Nuclear Medicine, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China
| | - Huiqian Chen
- Department of Nuclear Medicine, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China
| | - Yi Shou
- Department of Nuclear Medicine, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China
| | - Jun Zhao
- Department of Nuclear Medicine, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China.
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Bando R, Otsuka H, Otani T, Matsuda N, Azane S, Kunikane Y, Otomi Y, Sako W, Izumi Y, Harada M. A new quantitative index in the diagnosis of Parkinson syndrome by dopamine transporter single-photon emission computed tomography. Ann Nucl Med 2021; 35:504-513. [PMID: 33630226 DOI: 10.1007/s12149-021-01592-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/28/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Dopamine transporter single-photon emission computed tomography (DAT SPECT) has been widely used to diagnose Parkinson syndrome. Using the standardized uptake value (SUV) of DAT SPECT, we propose "functional dopamine transporter volume (f-DTV)" as a new quantitative index to evaluate the three-dimensional volume of functional dopamine transporters and assess its diagnostic ability in differentiating dopaminergic neurodegenerative diseases (dNDD) from non-dNDD. METHODS Seventy-nine patients were enrolled (42 dNDD, 37 non-dNDD; 38 men; age 24-88 years). We analyzed seven quantitative indices. The specific binding ratio (SBR) was calculated using a program specialized for DAT SPECT (SBR_Bolt). The SUVmax, SUVpeak, and SUVmean were calculated using a quantification program for bone SPECT. SBR_SUV was calculated by dividing striatal SUVmean by the average of background SUVmean. The cutoff value of the active dopamine transporter level was examined using three methods (threshold of 40% of SUVmax, SUV 2, and SUV 3) to calculate the active dopamine transporter volume (ADV). The f-DTV was calculated by multiplying ADV and SUVmean. We assessed the correlations between SBR_Bolt and SBR_SUV, and compared the mean value of each index between the dNDD and non-dNDD groups. The abilities of SBR_Bolt, SBR_SUV, SUVmax, SUVpeak, SUVmean, ADV, and f-DTV in differentiating dNDD from non-dNDD were determined by the area under the receiver operating curve (AUC) generated by the receiver operating characteristics analysis. RESULTS The SBR_Bolt and SBR_SUV highly correlated with each other (r = 0.71). The cutoff value of the active dopamine transporter level was determined as SUV 3. All seven quantitative indices showed lower values in the dNDD group than in the non-dNDD group, and the difference between the two groups was statistically significant (p < 0.05). Sensitivity, specificity, and AUC of f-DTV were slightly lower than those of SBR_Bolt (71%, 79%, and 0.81, respectively, for f-DTV, and 81%, 84%, 0.88, respectively, for SBR_Bolt). The difference in AUC between f-DTV and SBR_Bolt was not statistically significant. CONCLUSIONS This study demonstrates the utility of f-DTV as a novel quantitative index for evaluating the three-dimensional volume of functional dopamine transporters, and that f-DTV has almost the same diagnostic ability to differentiate dNDD from non-dNDD using DAT SPECT.
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Affiliation(s)
- Ryota Bando
- Department of Radiology, Tokushima University Hospital, Kuramoto-cho 3-18-15, Tokushima, 770-8503, Japan
| | - Hideki Otsuka
- Department of Medical Imaging/Nuclear Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
| | - Tamaki Otani
- Advance Radiation Research, Education and Management Center, Tokushima University, Tokushima, Japan
| | - Noritake Matsuda
- Department of Radiology, Tokushima University Hospital, Kuramoto-cho 3-18-15, Tokushima, 770-8503, Japan
| | - Shota Azane
- Department of Radiology, Tokushima University Hospital, Kuramoto-cho 3-18-15, Tokushima, 770-8503, Japan
| | - Yamato Kunikane
- Department of Radiology, Tokushima University Hospital, Kuramoto-cho 3-18-15, Tokushima, 770-8503, Japan
| | - Yoichi Otomi
- Department of Radiology and Radiation Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Wataru Sako
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yuishin Izumi
- Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masafumi Harada
- Department of Radiology and Radiation Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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Two-versus three-dimensional regions of interest for quantifying SPECT-CT images. Phys Eng Sci Med 2021; 44:365-375. [PMID: 33620700 DOI: 10.1007/s13246-021-00983-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/08/2021] [Indexed: 10/22/2022]
Abstract
The aim of this study was to investigate the relationship of quantitative parameters between the two-dimensional region of interest (ROI) and the three-dimensional volume of interest (VOI) for accumulation of radiopharmaceutical. Single-photon emission computed tomography combined with computed tomography (SPECT/CT) images of the NEMA/IEC phantom were acquired. The ROIs and VOIs were automatically set to the sphere and background in the phantom. We defined as two-dimensional analysis (2D analysis) that which used ROIs set on the center section of the sphere, and as three-dimensional analysis (3D analysis) that which used VOIs set on the center of gravity of the sphere. Dose linearity (DL), the recovery coefficient (RC), the contrast-to-noise ratio (CNR), and standardized uptake value (SUV) were evaluated. Each index value was compared between both analyses. DL was almost 1 under both conditions. RC showed a similar tendency with 2D and 3D analyses. The CNR for 3D analysis was smaller than for 2D analysis. The maximum SUV was almost equal with both analyses. The mean SUV with 3D analysis was underestimated by 4.83% on average compared with 2D analysis. For the same accumulation, a difference may occur in the quantitative index between 2 and 3D analyses. In particular, the quantitative parameters based on the average value tends to be smaller with 3D analysis than 2D analysis. The quantitative parameters in 2D analysis showed dependence upon the cross section used for setting the ROI, whereas 3D analysis showed less dependence on the position of the VOI.
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Metal artifact reduction for improving quantitative SPECT/CT imaging. Ann Nucl Med 2021; 35:291-298. [PMID: 33460009 DOI: 10.1007/s12149-020-01560-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effect of the metal artifact reduction (MAR) method on quantitative single-photon emission computed tomography (SPECT)/computed tomography (CT) to reveal the usefulness of MAR in patients with metal implants. METHODS We performed a phantom experiment simulating patients with artificial hip prostheses using SPECT/CT equipped with the iterative MAR (iMAR). The phantom was filled with Tc-99m solution (29.5 kBq/mL). For the CT scan conditions, tube current time products were applied to obtain volume CT dose indexes (CTDIvols) of 1.4, 2.8, and 5.6 mGy. Six types of quantitative SPECT images were reconstructed using data from different doses of CT processed with and without iMAR for CT attenuation correction. Thirty circular regions of interest (ROIs) were placed in each of the dark-band artifact areas, the white-streak artifact areas, and the non-artifact areas. We calculated radioactivity concentrations from quantitative SPECT images with and without iMAR to evaluate the quantitative accuracy. The differences of the effect of iMAR with different CT doses were also evaluated. RESULTS The results obtained using CT data with a CTDIvol of 2.8 mGy are described below. For quantitative SPECT data without iMAR, we observed the underestimation of radioactivity concentration in the dark-band artifact areas and overestimation in the white-streak artifact areas. We observed quantification errors ranging from - 41.1% to + 20.0% without iMAR, depending on the ROI localization. When iMAR was used, these errors were reduced to a range of - 22.8% to + 14.2%. The mean absolute error from the true value in the artifact regions was also significantly reduced from 4.00 to 1.74 kBq/mL. In the non-artifact areas, the radioactivity concentrations obtained from the quantitative SPECT data with and without iMAR were equivalent to the true value and did not differ significantly between the two conditions. Similar results were observed for procedures with CTDIvols of 1.4 and 5.6 mGy. CONCLUSIONS This study indicated that iMAR could improve the quantitative accuracy of SPECT/CT independent of the CT dose. iMAR can serve as a practicable technique for quantitative SPECT/CT in patients with metal implants.
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Okuda K, Hasegawa D, Kamiya T, Ichikawa H, Umeda T, Ohkubo T, Miwa K. Multicenter Study of Quantitative SPECT: Reproducibility of 99mTc Quantitation Using a Conjugated-Gradient Minimization Reconstruction Algorithm. J Nucl Med Technol 2021; 49:138-142. [PMID: 33419954 DOI: 10.2967/jnmt.120.256131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/03/2021] [Indexed: 11/16/2022] Open
Abstract
This multicenter study aimed to determine the reproducibility of quantitative SPECT images reconstructed using a commercially available method of ordered-subset conjugate-gradient minimization. Methods: A common cylindric phantom containing a 100 kBq/mL concentration of 99mTc-pertechnetate solution in a volume of 7 L was scanned under standard imaging conditions at 6 institutions using the local clinical protocol of each. Interinstitutional variation among the quantitative SPECT images was evaluated using the coefficient of variation. Dose calibrator accuracy was also investigated by measuring the same lot of commercially available 99mTc vials at each institution. Results: The respective radioactivity concentrations under standard and clinical conditions ranged from 95.71 ± 0.60 (mean ± SD) to 108.35 ± 0.36 kBq/mL and from 96.78 ± 0.64 to 108.49 ± 0.11 kBq/mL, respectively. Interinstitutional variation in radioactivity concentration was 4.20%. The bias in the radioactivity concentrations in SPECT images was associated with the accuracy of the dose calibrator at each institution. Conclusion: The reproducibility of the commercially available quantitative SPECT reconstruction method is high and comparable to that of PET, for comparatively large (∼7 L), homogeneous objects.
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Affiliation(s)
- Kyohei Okuda
- Department of Clinical Radiology, Tottori University Hospital, Yonago, Japan
| | - Daisuke Hasegawa
- Department of Radiology, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Takashi Kamiya
- Division of Radiology, Department of Medical Technology, Osaka University Hospital, Suita, Japan
| | - Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Takuro Umeda
- Department of Nuclear Medicine, Cancer Institution Hospital of Japan Foundation for Cancer Research, Tokyo, Japan
| | - Takushi Ohkubo
- Central Division of Radiology, Toho University Omori Medical Center, Tokyo, Japan; and
| | - Kenta Miwa
- School of Health Science, International University of Health and Welfare, Ohtawara, Japan
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Test-retest repeatability of quantitative bone SPECT/CT. Ann Nucl Med 2021; 35:338-346. [PMID: 33400148 DOI: 10.1007/s12149-020-01568-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Technological innovations in single-photon emission computed tomography (SPECT) have enabled a more accurate quantitative evaluation of the uptake, and the standardized uptake value (SUV) can be measured as a semi-quantitative value, as in positron emission tomography. Nevertheless, the reliability of the SUV of bone SPECT has not been well established. The purpose of this study is to evaluate the test-retest repeatability of the SUV of bone SPECT/CT in clinical settings. METHODS This prospective study recruited patients with prostate cancer planning to receive bone SPECT/CT for the evaluation of bone abnormality between August 2017 and September 2019. Bone images were acquired twice by an integrated SPECT/CT scanner (Symbia Intevo, Siemens) within a 4- to 10-day interval. The maximum SUV (SUVmax) and peak SUV (SUVpeak) were calculated for the volumes of interests on the normal bone areas, degeneration/fracture lesions, and metastatic lesions. To determine repeatability, we calculated statistical indicators, including intraclass correlation coefficient (ICC), repeatability coefficient (RC), and mean absolute percentage difference (MAPD). For the ICC, the 95% confidential interval (CI) was also calculated, and an ICC of ≥ 0.8 was defined as an almost perfect correlation. RESULTS Twelve male patients were enrolled in the study (58-86 years; median, 71 years), and a total of 229 volumes of the interest were included in the analyses. The ICCs were 0.968 [95% CI (0.959, 0.975)] for SUVmax and 0.976 [95% CI (0.969, 0.981)] for SUVpeak. The RCs of the relative difference were 30.7% for SUVmax and 27.6% for SUVpeak, and the MAPDs (± standardized deviation) of all lesions were 12.3 ± 9.9% for SUVmax and 11.5 ± 8.3% for SUVpeak. The RCs and the MAPDs showed comparable value with the previous report regarding repeatability studies on PET. CONCLUSION An almost perfect correlation was demonstrated by repeated SUVmax and SUVpeak measured by quantitative integrated SPECT/CT. The quantitative values could be reliable indicators in patient management.
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Rohani MFM, Yonan SNM, Tagiling N, Zainon WMNW, Udin Y, Nawi NM. Standardized Uptake Value from Semiquantitative Bone Single-Photon Emission Computed Tomography/Computed Tomography in Normal Thoracic and Lumbar Vertebrae of Breast Cancer Patients. Asian Spine J 2020; 14:629-638. [PMID: 32213791 PMCID: PMC7595810 DOI: 10.31616/asj.2019.0308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/29/2019] [Accepted: 11/04/2019] [Indexed: 11/28/2022] Open
Abstract
STUDY DESIGN Retrospective study. PURPOSE This study aims to semiquantitatively evaluate the standardized uptake value (SUV) of 99mTc-methylene diphosphonate (MDP) radionuclide tracer in the normal vertebrae of breast cancer patients using an integrated single-photon emission computed tomography (SPECT)/computed tomography (CT) scanner. OVERVIEW OF LITERATURE Molecular imaging techniques using gamma cameras and stand-alone SPECT have traditionally been utilized to evaluate metastatic bone diseases. However, these methods lack quantitative analysis capabilities, impeding accurate uptake characterization. METHODS A total of 30 randomly selected female breast cancer patients were enrolled in this study. The SUV mean (SUVmean) and SUV maximum (SUVmax) values for 286 normal vertebrae at the thoracic and lumbar levels were calculated based on the patients' body weight (BW), body surface area (BSA), and lean body mass (LBM). Additionally, 106 degenerative joint disease (DJD) lesions of the spine were also characterized, and both their BW SUVmean and SUVmax values were obtained. A receiver operating characteristic (ROC) curve analysis was then performed to determine the cutoff value of SUV for differentiating DJD from normal vertebrae. RESULTS The mean±standard deviations for the SUVmean and SUVmax in the normal vertebrae displayed a relatively wide variability: 3.92±0.27 and 6.51±0.72 for BW, 1.05±0.07 and 1.75±0.17 for BSA, and 2.70±0.19 and 4.50±0.44 for LBM, respectively. Generally, the SUVmean had a lower coefficient of variation than the SUVmax. For DJD, the mean±standard deviation for the BW SUVmean and SUVmax was 5.26±3.24 and 7.50±4.34, respectively. Based on the ROC curve, no optimal cutoff value was found to differentiate DJD from normal vertebrae. CONCLUSIONS In this study, the SUV of 99mTc-MDP was successfully determined using SPECT/CT. This research provides an approach that could potentially aid in the clinical quantification of radionuclide uptake in normal vertebrae for the management of breast cancer patients.
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Affiliation(s)
- Mohd Fazrin Mohd Rohani
- Department of Nuclear Medicine, School of Medical Sciences, Universiti Sains Malaysia (Health Campus), Kubang Kerian, Malaysia
- Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Siti Nurshahirah Mohd Yonan
- Medical Radiation Program, School of Health Sciences, Universiti Sains Malaysia (Health Campus), Kubang Kerian, Malaysia
| | - Nashrulhaq Tagiling
- Department of Nuclear Medicine, School of Medical Sciences, Universiti Sains Malaysia (Health Campus), Kubang Kerian, Malaysia
| | | | - Yusri Udin
- Department of Nuclear Medicine, School of Medical Sciences, Universiti Sains Malaysia (Health Campus), Kubang Kerian, Malaysia
| | - Norazlina Mat Nawi
- Department of Nuclear Medicine, School of Medical Sciences, Universiti Sains Malaysia (Health Campus), Kubang Kerian, Malaysia
- Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Miyaji N, Miwa K, Tokiwa A, Ichikawa H, Terauchi T, Koizumi M, Onoguchi M. Phantom and clinical evaluation of bone SPECT/CT image reconstruction with xSPECT algorithm. EJNMMI Res 2020; 10:71. [PMID: 32601770 PMCID: PMC7324467 DOI: 10.1186/s13550-020-00659-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/10/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Two novel methods of image reconstruction, xSPECT Quant (xQ) and xSPECT Bone (xB), that use an ordered subset conjugate gradient minimizer (OSCGM) for SPECT/CT reconstruction have been proposed. The present study compares the performance characteristics of xQ, xB, and conventional Flash3D (F3D) reconstruction using images derived from phantoms and patients. METHODS A custom-designed body phantom for bone SPECT was scanned using a Symbia Intevo (Siemens Healthineers), and reconstructed xSPECT images were evaluated. The phantom experiments proceeded twice with different activity concentrations and sphere sizes. A phantom with 28-mm spheres containing a 99mTc-background and tumor-to-normal bone ratios (TBR) of 1, 2, 4, and 10 were generated, and convergence property against various TBR was evaluated across 96 iterations. A phantom with four spheres (13-, 17-, 22-, and 28-mm diameters), containing a 99mTc-background at TBR4, was also generated. The full width at half maximum of an imaged spinous process (10 mm), coefficients of variance (CV), contrast-to-noise ratio (CNR), and recovery coefficients (RC) were evaluated after reconstructing images of a spine using Flash 3D (F3D), xQ, and xB. We retrospectively analyzed images from 20 patients with suspected bone metastases (male, n = 13) which were acquired using [99mTc]Tc-(H)MDP SPECT/CT, then CV and standardized uptake values (SUV) at the 4th vertebral body (L4) were compared after xQ and xB reconstruction in a clinical setup. RESULTS Mean activity concentrations with various TBR converged according to increasing numbers of iterations. The spatial resolution of xB was considerably superior to xQ and F3D, and it approached almost the actual size regardless of the iteration numbers during reconstruction. The CV and RC were better for xQ and xB than for F3D. The CNR peaked at 24 iterations for xQ and 48 iterations for F3D and xB, respectively. The RC between xQ and xB significantly differed at lower numbers of iterations but were almost equivalent at higher numbers of iterations. The reconstructed xQ and xB images of the clinical patients showed a significant difference in the SUVmax and SUVpeak. CONCLUSIONS The reconstructed xQ and xB images were more accurate than those reconstructed conventionally using F3D. The xB for bone SPECT imaging offered essentially unchanged spatial resolution even when the numbers of iterations did not converge. The xB reconstruction further enhanced SPECT image quality using CT data. Our findings provide important information for understanding the performance characteristics of the novel xQ and xB algorithms.
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Affiliation(s)
- Noriaki Miyaji
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550 Japan
- Department of Quantum Medical Technology, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 Japan
| | - Kenta Miwa
- Department of Radiological Sciences, School of Health Science, International University of Health and Welfare, 2600-1 Kitakanemaru, Ohtawara, Tochigi, 324-8501 Japan
| | - Ayaka Tokiwa
- Department of Radiological Sciences, School of Health Science, International University of Health and Welfare, 2600-1 Kitakanemaru, Ohtawara, Tochigi, 324-8501 Japan
| | - Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital, 50, Aza Hachiken Nishi, Aotake–Cho, Toyohashi, Aichi 441-8570 Japan
| | - Takashi Terauchi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550 Japan
| | - Mitsuru Koizumi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550 Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 Japan
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Evaluation of bone metastasis burden as an imaging biomarker by quantitative single-photon emission computed tomography/computed tomography for assessing prostate cancer with bone metastasis: a phantom and clinical study. Radiol Phys Technol 2020; 13:219-229. [PMID: 32535819 DOI: 10.1007/s12194-020-00571-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 12/21/2022]
Abstract
Metabolic bone volume (MBV), standardized uptake value (SUV), and total bone uptake (TBU) are new imaging biomarkers for quantitative bone single-photon emission computed tomography/computed tomography. The purpose of this study was to validate the quantitative accuracy and utility of MBV, SUVmean, and TBU for the assessment of bone metastases in prostate cancer. We used a bone-specific phantom with four hot spheres (φ = 13, 17, 22, 28 mm) filled with different Tc-99 m activities to simulate uptake ratios of 3 and 7, corresponding to normal and metastatic values. We calculated the error ratio (%Error) by comparing MBV, SUVmean, and TBU with true values for various parameters, including bone lesion size, uptake ratio, and SUV cut-off level. Differences for MBV, SUVmean, TBU, and bone scan index (BSI) were calculated to verify their utility in assessing bone metastases. Receiver-operating characteristic curve (ROC) analysis was performed to calculate the area under the curve (AUC) for each biomarker. MBV, SUVmean, and TBU were affected by lesion size, uptake ratio, and SUV cut-off level; however, TBU demonstrated the most stable %Error. The TBU %Error was within 15% in spheres 17 mm or larger when the SUV cut-off level was 7, regardless of the uptake ratio. The ROC analyses revealed the AUCs of BSI (0.977) and TBU (0.968). Additionally, TBU was able to assess bone metastasis when BSI provided false-negative results, but TBU also provided false-positive results by degenerative changes. The synergy between TBU and BSI could potentially improve diagnostic accuracy.
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Dittmann H, Kaltenbach S, Weissinger M, Fiz F, Martus P, Pritzkow M, Kupferschlaeger J, la Fougère C. The Prognostic Value of Quantitative Bone SPECT/CT Before 223Ra Treatment in Metastatic Castration-Resistant Prostate Cancer. J Nucl Med 2020; 62:48-54. [PMID: 32444369 DOI: 10.2967/jnumed.119.240408] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/22/2020] [Indexed: 12/31/2022] Open
Abstract
Radiolabeled bisphosphonates such as 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (99mTc-DPD) typically show intense uptake in skeletal metastases from metastatic castration-resistant prostate cancer (mCRPC). Extensive bone involvement is regarded as a risk factor for mCRPC patients treated with 223Ra-dichloride (223Ra). The aim of this study was to quantify 99mTc-DPD uptake by means of SPECT/CT before 223Ra and compare the results with the feasibility of treatment and overall survival (OS). Methods: Sixty consecutive mCRPC patients were prospectively included in this study. SPECT/CT of the central skeleton covering the skull to the mid-femoral level was performed before the first cycle of 223Ra. The bone compartment was defined by means of low-dose CT. Emission data were corrected for scatter, attenuation, and decay supplemented by resolution recovery using dedicated software. The Kaplan-Meier estimator, U test, and Cox regression analysis were used for statistics. Results: Total 99mTc-DPD uptake of the central skeleton varied between 11% and 56% of injected dose (%ID) or between 1.8 and 10.5 %ID/1,000 mL of bone volume (%ID/L). SUVmean ranged from 1.9 to 7.4, whereas the SUVmax range was 18-248. Patients unable to complete 223Ra treatment because of progression and/or cytopenia (n = 23) showed significantly higher uptake (31.9 vs. 25.4 %ID and 6.0 vs. 4.7 %ID/L; P < 0.02). OS after 223Ra (median, 15.2 mo) was reduced to 7.3 mo in cases of skeletal uptake that was 26 %ID or higher, as compared with 30.8 mo if lower than 26 %ID (P = 0.008). Similar results were obtained for %ID/L and SUVmean SUVmax did not correlate with survival. %ID/L was identified as an independent prognostic factor for OS (hazard ratio, 1.381 per unit), along with number of previous treatment lines. Conclusion: Quantitative SPECT/CT of bone scans performed at baseline is prognostic for survival in mCRPC patients treated with 223Ra.
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Affiliation(s)
- Helmut Dittmann
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany
| | - Sabine Kaltenbach
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany
| | - Matthias Weissinger
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany
| | - Francesco Fiz
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, University of Tuebingen, Tuebingen, Germany; and
| | - Maren Pritzkow
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany
| | - Juergen Kupferschlaeger
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany
| | - Christian la Fougère
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany.,iFIT Cluster of Excellence, University of Tuebingen, Tuebingen, Germany
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Abstract
The continuous development of SPECT over the past 50 years has led to improved image quality and increased diagnostic confidence. The most influential developments include the realization of hybrid SPECT/CT devices, as well as the implementation of attenuation correction and iterative image reconstruction techniques. These developments have led to a preference for SPECT/CT devices over SPECT-only systems and to the widespread adoption of the former, strengthening the role of SPECT/CT as the workhorse of Nuclear Medicine imaging. New trends in the ongoing development of SPECT/CT are diverse. For example, whole-body SPECT/CT images, consisting of acquisitions from multiple consecutive bed positions in the manner of PET/CT, are increasingly performed. Additionally, in recent years, some interesting approaches in detector technology have found their way into commercial products. For example, some SPECT cameras dedicated to specific organs employ semiconductor detectors made of cadmium telluride or cadmium zinc telluride, which have been shown to increase the obtainable image quality by offering a higher sensitivity and energy resolution. However, the advent of quantitative SPECT/CT which, like PET, can quantify the amount of tracer in terms of Bq/mL or as a standardized uptake value could be regarded as most important development. It is a major innovation that will lead to increased diagnostic accuracy and confidence, especially in longitudinal studies and in the monitoring of treatment response. The current work comprises two main aspects. At first, physical and technical fundamentals of SPECT image formation are described and necessary prerequisites of quantitative SPECT/CT are reviewed. Additionally, the typically achievable quantitative accuracy based on reports from the literature is given. Second, an extensive list of studies reporting on clinical applications of quantitative SPECT/CT is provided and reviewed.
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Affiliation(s)
- Philipp Ritt
- Clinic of Nuclear Medicine, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.
| | - Torsten Kuwert
- Clinic of Nuclear Medicine, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
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Yamamoto Y. [12.Uncertainty in Quantitative Bone Scintigraphy]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2020; 76:620-625. [PMID: 32565521 DOI: 10.6009/jjrt.2020_jsrt_76.6.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Quantitative bone SPECT/CT: high specificity for identification of prostate cancer bone metastases. BMC Musculoskelet Disord 2019; 20:619. [PMID: 31878904 PMCID: PMC6933900 DOI: 10.1186/s12891-019-3001-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/11/2019] [Indexed: 12/21/2022] Open
Abstract
Purpose Bone scintigraphy with 99mTc-labeled diphosphonates can identify prostate cancer bone metastases with high sensitivity, but relatively low specificity, because benign conditions such as osteoarthritis can also trigger osteoblastic reactions. We aimed to investigate the diagnostic performance of 99mTc-2,3-dicarboxy propane-1,1-diphosphonate (99mTc-DPD) uptake quantification by single-photon emission computed tomography coupled with computed tomography (SPECT/CT) for distinguishing prostate cancer bone metastases from spinal and pelvic osteoarthritic lesions. Methods We retrospectively assessed 26 bone scans from 26 patients with known prostate cancer bone metastases and 13 control patients with benign spinal and pelvic osteoarthritic changes without known neoplastic disease. Quantitative SPECT/CT (xSPECT, Siemens Symbia Intevo, Erlangen, Germany) was performed and standardized uptake values (SUVs) were quantified with measurements of SUVmax and SUVmean (g/mL) in all bone metastases for the prostate cancer group and in spinal and pelvic osteoarthritic changes for the control group. We used receiver operating characteristics (ROC) curves to determine the optimum SUVmax cutoff value to distinguish between bone metastases and benign spinal and pelvic lesions. Results In total, 264 prostate cancer bone metastases were analyzed, showing a mean SUVmax and SUVmean of 34.6 ± 24.6 and 20.8 ± 14.7 g/mL, respectively. In 24 spinal and pelvic osteoarthritic lesions, mean SUVmax and SUVmean were 14.2 ± 3.8 and 8.9 ± 2.2 g/mL, respectively. SUVmax and SUVmean were both significantly different between the bone metastases and osteoarthritic groups (p ≤ 0.0001). Using a SUVmax cutoff of 19.5 g/mL for prostate cancer bone metastases in the spine and pelvis, sensitivity, specificity, positive and negative predictive values were 87, 92, 99 and 49%, respectively. Conclusion This study showed significant differences in quantitative 99mTc-DPD uptake on bone SPECT/CT between prostate cancer bone metastases and spinal and pelvic osteoarthritic changes, with higher SUVmax and SUVmean in metastases. Using a SUVmax cutoff of 19.5 g/mL, high specificity and positive predictive value for metastases identification in the spine and pelvis were found, thus increasing accuracy of bone scintigraphy.
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Huang K, Feng Y, Liu D, Liang W, Li L. Quantification evaluation of 99mTc-MDP concentration in the lumbar spine with SPECT/CT: compare with bone mineral density. Ann Nucl Med 2019; 34:136-143. [PMID: 31768820 DOI: 10.1007/s12149-019-01425-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 11/18/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Despite recent technological advances allowing for quantitative single-photon emission computed tomography (SPECT), quantitative SPECT has not been widely used in the clinical practice of osteoporosis. The aim of this study is to evaluate the feasibility of quantitative bone SPECT/CT for measuring lumbar standard uptake value (SUV) in patients with different bone-mineral density (BMD), and investigate the correlation between SUV measured with 99mTc-methylene diphosphonate (MDP) SPECT/CT and BMD assessment by dual-energy X-ray absorptiometry (DXA). METHODS A retrospective analysis of 62 cases 99mTc-MDP whole-body bone imaging and local lumbar SPECT/CT tomography were performed. According to the results of dual-energy X-ray bone density examination, they were divided into normal group, osteopenic group, and osteoporosis group. The raw SPECT data were reconstructed using flash3D which includes attenuation correction, scatter compensation, and collimator resolution recovery, SPECT images from this algorithm were calibrated for SUV analysis. Comparing difference of lumbar SUV in different BMD subjects, and investigating the correlation between lumbar SUV and BMD. Data were analyzed by one-way ANOVA and Pearson regression analysis using SPSS 17.0 software. RESULTS The maximum SUV (SUVmax) and mean SUV (SUVmean) of L1-L4 vertebral in 62 subjects were 7.39 ± 1.84 and 4.90 ± 1.27, respectively. The average BMD was 0.85 ± 0.15 (g/cm2), and the average CT value was 145.88 ± 53.99 (HU). The SUVmax, SUVmean, BMD, and CT values of the lumbar spine were statistically significantly different among the three groups (F = 24.089, 30.501, 94.847, 30.241, all p < 0.001), and the osteopenic group was significantly lower than the normal group (all p < 0.001), the osteoporosis group was significantly lower than the normal group and the osteopenic group (all p < 0.001). Lumbar SUVmax, SUVmean, and BMD were significantly negatively correlated with age (r = - 0.328 to - 0.442, all p < 0.05), and positively correlated with body weight and CT value (r = 0.299-0.737, all p < 0.05), but no significant correlation with height (r = 0.006-0.175, all p > 0.05). Lumbar SUVmax and SUVmean increased significantly with the increase of BMD (r = 0.638, 0.632, p < 0.001). CONCLUSION The SUV of lumbar spine in 99mTc-MDP bone SPECT/CT was significantly different among subjects with different BMD, and the SUV was positively correlated with BMD. These findings justify that quantitative bone SPECT/CT is an applicable tool for clinical quantification of bone metabolism in osteoporosis patients.
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Affiliation(s)
- Kemin Huang
- Department of Nuclear Medicine, The First People's Hospital of Foshan, Foshan, 528000, Guangdong, China
| | - Yanlin Feng
- Department of Nuclear Medicine, The First People's Hospital of Foshan, Foshan, 528000, Guangdong, China.
| | - Dejun Liu
- Department of Nuclear Medicine, The First People's Hospital of Foshan, Foshan, 528000, Guangdong, China
| | - Weitang Liang
- Department of Nuclear Medicine, The First People's Hospital of Foshan, Foshan, 528000, Guangdong, China
| | - Lin Li
- Department of Nuclear Medicine, The First People's Hospital of Foshan, Foshan, 528000, Guangdong, China
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De Schepper S, Ritt P, Van den Wyngaert T, Kuwert T. Quantitative radionuclide imaging of bone metastases. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2019; 63:129-135. [DOI: 10.23736/s1824-4785.19.03204-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ross JC, Vilić D, Sanderson T, Vöö S, Dickson J. Does quantification have a role to play in the future of bone SPECT? Eur J Hybrid Imaging 2019; 3:8. [PMID: 34191209 PMCID: PMC8218028 DOI: 10.1186/s41824-019-0054-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/01/2019] [Indexed: 12/26/2022] Open
Abstract
Routinely, there is a visual basis to nuclear medicine reporting: a reporter subjectively places a patient's condition into one of multiple discrete classes based on what they see. The addition of a quantitative result, such as a standardised uptake value (SUV), would provide a numerical insight into the nature of uptake, delivering greater objectivity, and perhaps improved patient management.For bone scintigraphy in particular quantification could increase the accuracy of diagnosis by helping to differentiate normal from abnormal uptake. Access to quantitative data might also enhance our ability to characterise lesions, stratify and monitor patients' conditions, and perform reliable dosimetry for radionuclide therapies. But is there enough evidence to suggest that we, as a community, should be making more effort to implement quantitative bone SPECT in routine clinical practice?We carried out multiple queries through the PubMed search engine to facilitate a cross-sectional review of the current status of bone SPECT quantification. Highly cited papers were assessed in more focus to scrutinise their conclusions.An increasing number of authors are reporting findings in terms of metrics such as SUVmax. Although interest in the field in general remains high, the rate of clinical implementation of quantitative bone SPECT remains slow and there is a significant amount of validation required before we get carried away.
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Affiliation(s)
- James C. Ross
- Institute of Nuclear Medicine T05, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Dijana Vilić
- Radiological Sciences Unit, Imperial College Healthcare NHS Trust, London, UK
| | - Tom Sanderson
- Institute of Nuclear Medicine T05, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - Stefan Vöö
- Institute of Nuclear Medicine T05, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
| | - John Dickson
- Institute of Nuclear Medicine T05, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU UK
- Institute of Nuclear Medicine, University College London, London, UK
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Yamane T, Kondo A, Takahashi M, Miyazaki Y, Ehara T, Koga K, Kuji I, Matsunari I. Ultrafast bone scintigraphy scan for detecting bone metastasis using a CZT whole-body gamma camera. Eur J Nucl Med Mol Imaging 2019; 46:1672-1677. [DOI: 10.1007/s00259-019-04329-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/02/2019] [Indexed: 01/12/2023]
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Lee WW. Clinical Applications of Technetium-99m Quantitative Single-Photon Emission Computed Tomography/Computed Tomography. Nucl Med Mol Imaging 2019; 53:172-181. [PMID: 31231437 DOI: 10.1007/s13139-019-00588-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 12/16/2022] Open
Abstract
Single-photon emission computed tomography/computed tomography (SPECT/CT) is an already established nuclear imaging modality. Co-registration of functional information (SPECT) with anatomical images (CT) paved the way to the wider application of SPECT. Recent advancements in quantitative SPECT/CT have made it possible to incorporate quantitative parameters, such as standardized uptake value (SUV) or %injected dose (%ID), in gamma camera imaging. This is indeed a paradigm shift in gamma camera imaging from qualitative to quantitative evaluation. In fact, such quantitative approaches of nuclear imaging have only been accomplished for positron emission tomography (PET) technology. Attenuation correction, scatter correction, and resolution recovery are the three main features that enabled quantitative SPECT/CT. Further technical improvements are being achieved for partial-volume correction, motion correction, and dead-time correction. The reported clinical applications for quantitative SPECT/CT are mainly related to Tc-99m-labeled radiopharmaceuticals: Tc-99m diphosphonate for bone/joint diseases, Tc-99m pertechnetate for thyroid function, and Tc-99m diethylenetriaminepentaacetic acid for measurement of glomerular filtration rate. Dosimetry before trans-arterial radio-embolization is also a promising application for Tc-99m macro-aggregated albumin. In this review, clinical applications of Tc-99m quantitative SPECT/CT will be discussed.
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Affiliation(s)
- Won Woo Lee
- 1Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Seoul, 13620 South Korea
- 2Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea
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Spatial dependence of activity concentration recovery for a conjugate gradient (Siemens xSPECT) algorithm using manufacturer-defined reconstruction presets. Nucl Med Commun 2019; 40:287-293. [PMID: 30763291 DOI: 10.1097/mnm.0000000000000960] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Siemens absolute quantitative reconstruction, xSPECT, is available with manufacturer-defined reconstruction presets to assist with optimization. This phantom study evaluates the impact of these presets on the spatial dependence of activity concentration recovery (ACR). Single-photon emission computed tomography/computed tomography scans of a 5 : 1 and 10 : 1 (sphere : background) contrast NEMA phantom were performed on a Siemens Intevo 6. Three sphere position configurations, achieved by rotating the sphere mount through 0°, 120° and 240°, were used and three replicate images of each configuration were acquired. xSPECT reconstruction was performed using 'Fast', 'Standard' and 'Best' presets. Maximum voxel and A50 threshold ACR were measured in each sphere. The average ACR per sphere was calculated across replicates. Percentage variation of ACR, about this average, for each sphere within a given configuration across replicates and also alternative configurations was calculated. Within a given sphere configuration, percentage variation for maximum voxel ACR in like-for-like spheres across replicates was within 11% for all three presets across all sphere sizes, and within 3% for 10 : 1 and 9% for 5 : 1 contrast in the three largest spheres. Substantial variation of ACR was observed when comparing like-for-like spheres in different configurations. In the three largest spheres, variation in maximum ACR of up to 35 and 32% was measured for 10 : 1 and 5 : 1 contrast, respectively. Variation in activity concentration may be substantially greater than perceived from using a single phantom configuration. The spatial dependence observed using the manufacturer presets highlights the need for evaluation of user-defined reconstruction parameters.
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Arvola S, Jambor I, Kuisma A, Kemppainen J, Kajander S, Seppänen M, Noponen T. Comparison of standardized uptake values between 99mTc-HDP SPECT/CT and 18F-NaF PET/CT in bone metastases of breast and prostate cancer. EJNMMI Res 2019; 9:6. [PMID: 30680469 PMCID: PMC6346696 DOI: 10.1186/s13550-019-0475-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 01/15/2019] [Indexed: 11/25/2022] Open
Abstract
Background Despite recent technological advances allowing for quantitative single-photon emission computed tomography (SPECT), quantitative SPECT has not been widely used in the clinical practice. The aim of this study is to evaluate the feasibility of quantitative SPECT for measuring metastatic bone uptake in breast and prostate cancer by comparing standard uptake values (SUVs) measured with 99mTc-HDP SPECT/CT and 18F-NaF PET/CT. Methods Twenty-six breast and 27 prostate cancer patients at high risk of bone metastases underwent both 99mTc-HDP SPECT/CT and 18F-NaF PET/CT within 14 days of each other. The SPECT and PET data were reconstructed using ordered-subset expectation-maximization algorithms achieving quantitative images. Metastatic and benign skeletal lesions visible in both data sets were identified, and their maximum, peak, and mean SUVs (SUVmax, SUVpeak, and SUVmean) were determined. SUV ratios (SUVRs) between the lesions and adjacent normal appearing bone were also calculated. Linear regression was used to evaluate the correlations between the SUVs of SPECT and PET and Bland-Altman plots to evaluate the differences between the SUVs and SUVRs of SPECT and PET. Results A total of 231 skeletal lesions, 129 metastatic and 102 benign, were analyzed. All three SUV measures correlated very strongly between SPECT and PET (R2 ≥ 0.80, p < 0.001) when all lesions were included, and the PET SUVs were significantly higher than SPECT SUVs (p < 0.001). The median differences were 21%, 12%, and 19% for SUVmax, SUVpeak, and SUVmean, respectively. On the other hand, the SUVRs were similar between SPECT and PET with median differences of 2%, − 9%, and 2% for SUVRmax, SUVRpeak, and SUVRmean, respectively. Conclusion The strong correlation between SUVs and similar SUVRs of 99mTc-HDP SPECT/CT and 18F-NaF PET/CT demonstrate that SPECT is an applicable tool for clinical quantification of bone metabolism in osseous metastases in breast and prostate cancer patients.
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Affiliation(s)
- Samuli Arvola
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
| | - Ivan Jambor
- Department of Diagnostic Radiology, University of Turku, Turku, Finland
| | - Anna Kuisma
- Department of Oncology and Radiotherapy, University of Turku, Turku, Finland
| | | | | | - Marko Seppänen
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.,Turku PET Centre, Turku, Finland
| | - Tommi Noponen
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.,Department of Medical Physics, Turku University Hospital, Turku, Finland
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Kita A, Sugimoto K, Kosaka N, Onoguchi M, Shibutani T, Adachi T. [Simplification of Activity Measurement during Quantitative Value Estimation in Bone SPECT]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2019; 75:1158-1164. [PMID: 31631109 DOI: 10.6009/jjrt.2019_jsrt_75.10.1158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE To calculate the quantitative values in bone single-photon emission computed tomography, it is necessary to measure the amount of syringe radiation before and after the administration of a radiopharmaceutical. We proposed a method to omit the measurement of radioactivity. In this study, we clarified the effects of adopting this method and calculated its influence on quantitative values in a clinical setting. METHODS We derived a relational expression of the administration time and dose of radioactivity from the measured value and the administration time of the syringe dose before and after the administration in each patient. Next, we determined the differences for radioactivity calculated from this relational expression (estimated dose) and actual administered radioactivity (actual dose). Furthermore, we calculated the differences in the quantitative values of a normal region (the fourth lumbar vertebra) on adopting these data. RESULTS No significant differences between the estimated dose and actual dose were noted. Additionally, no significant differences in the quantitative values were observed. CONCLUSION Our findings suggest that adoption of the estimated dose does not affect the quantitative value. When the estimated dose is adopted, it can be administered with an accuracy of 0.80%. Thus, it is possible to omit the actual measurement of radioactivity by using our proposed method.
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Affiliation(s)
- Akinobu Kita
- Radiological Center, University of Fukui Hospital
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University
| | | | - Nobuyuki Kosaka
- Department of Radiology, Faculty of Medical Sciences, University of Fukui
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Toshiki Adachi
- Radiological Center, University of Fukui Hospital (Current address: Niigata University of Health and Welfare)
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