Abstract
To perform quantitative measurement based on the standardized uptake value (SUV) of Tc-99m methylene diphosphonate (MDP) in the normal pelvis using a single-photon emission tomography (SPECT)/computed tomography (CT) scanner. This retrospective study was performed on 31 patients with cancer undergoing bone SPECT/CT scans with 99mTc-MDP. SUVmax and SUVmean of the normal pelvis were calculated based on the body weight. SUVmax and SUVmean of the bilateral anterior superior iliac spine, posterior superior iliac spine, facies auricularis ossis ilii, ischial tuberosity, and sacrum were also calculated. Furthermore, the correlation of SUVmax and SUVmean of all parts of pelvis with weight, height, and CT was assessed. The data for 31 patients (20 women and 11 men; mean age 58.97±9.12 years; age range 37-87 years) were collected. SUVmax and SUVmean changed from 1.65±0.40 to 3.8±1.0 and from 1.15±0.25 to 2.07±0.58, respectively. The coefficient of variation of SUVmax and SUVmean ranged from 0.22 to 0.31. SUVmax and SUVmean had no statistically significant difference between men and women. SUVmax and SUVmean also showed no significant correlation with weight and height. However, part of SUVmax and SUVmean showed a significant correlation with CT. In addition, SUVmax and SUVmean of the bilateral ischial tuberosity showed a significant correlation with CT values. Determination of the SUV value of the normal pelvis with 99m Tc-MDP SPECT/CT is feasible and highly reproducible. SUVs of the normal pelvis showed a relatively large variability. As a quantitative imaging biomarker, SUVs might require standardization with adequate reference data for the participant to minimize variability.
Highlights
The most commonly used tracer for imaging the skeleton in conventional nuclear medicine is technetium99m-labeled methylene diphosphonate (99mTc-MDP) bone scintigraphy, which is a cost-effective and useful tool and has variable diagnostic sensitivity with comparatively low specificity [1]
standardized uptake value (SUV) is defined as the tissue concentration of tracer as measured by a positron emission tomography (PET) scanner divided by the activity concentration injected divided usually by body weight [8,14,15]
The volumes of interest (VOIs) of bilateral anterior superior iliac spine, posterior superior iliac spine, facies auricularis ossis ilii, ischial tuberosity, and sacrum were plotted by manually adjusting the boundary of SPECT and the boundary of the spongy bone of pelvis on computed tomography (CT) images (Figure 1)
Summary
The most commonly used tracer for imaging the skeleton in conventional nuclear medicine is technetium99m-labeled methylene diphosphonate (99mTc-MDP) bone scintigraphy, which is a cost-effective and useful tool and has variable diagnostic sensitivity with comparatively low specificity [1]. Sullivan developed various quantitative imaging biomarkers (QIBs). Few of these QIBs are used routinely in clinical trials or clinical care [11,12]. Quantitative analyses have been performed for bone scans of vertebrae using the standardized uptake value (SUV) as QIB of SPECT/CT scans with 99mTc-MDP [8,13]. SUV is defined as the tissue concentration of tracer as measured by a positron emission tomography (PET) scanner divided by the activity concentration injected divided usually by body weight [8,14,15].
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