A retrospective study of SPECT/CT scans using SUV measurement of the normal pelvis with Tc-99m methylene diphosphonate

Abstract

OBJECTIVE:

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.

MATERIAL AND METHODS:

This retrospective study was performed on 31 patients with cancer undergoing bone SPECT/CT scans with ^99mTc-MDP. SUV_max and SUV_mean of the normal pelvis were calculated based on the body weight. SUV_max and SUV_mean 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 SUV_max and SUV_mean of all parts of pelvis with weight, height, and CT was assessed.

RESULTS:

The data for 31 patients (20 women and 11 men; mean age 58.97±9.12 years; age range 37–87 years) were collected. SUV_max and SUV_mean 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 SUV_max and SUV_mean ranged from 0.22 to 0.31. SUV_max and SUV_mean had no statistically significant difference between men and women. SUV_max and SUV_mean also showed no significant correlation with weight and height. However, part of SUV_max and SUV_mean showed a significant correlation with CT. In addition, SUV_max and SUV_mean of the bilateral ischial tuberosity showed a significant correlation with CT values.

CONCLUSIONS:

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.

Keywords

Bone pelvis SPECT/CT SUV

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References

Kuji

, Yamane

, Seto

, Yasumizu

, Shirotake

, et al, Skeletal standardized uptake values obtained by quantitative SPECT/CT as an osteoblastic biomarker for the discrimination of active bone metastasis in prostate cancer, Eur J Hybrid Imaging 1 (2017), 2.

Suh

M.S.

, Lee

W.W.

, Kim

Y.K.

, Yun

P.Y.

, Kim

S.E.

, Maximum Standardized Uptake Value of (99m)Tc Hydroxymethylene Diphosphonate SPECT/CT for the Evaluation of Temporomandibular Joint Disorder, Radiology 280 (2016), 890–896.

, Sivrikoz

M.C.

, Entok

, Vardareli

, Discordant findings in patients with non-small-cell lung cancer: Absolutely normal bone scans versus disseminated bone metastases on positron-emission tomography/computed tomography, Eur J Cardiothorac Surg 37 (2010), 792–796.

Doddala

S.M.

, Suryadevara

, Chinta

S.K.

, Madisetty

A.L.

, Incidence and pattern of bone metastases at presentation in Indian carcinoma breast patients, Indian J Cancer 53 (2016), 360–362.

Spinelli

M.S.

, Ziranu

, Piccioli

, Maccauro

, Surgical treatment of acetabular metastasis, Eur Rev Med Pharmacol Sci 20 (2016), 3005–3010.

Tsuya

, Kurata

, Tamura

, Fukuoka

, Skeletal metastases in non-small cell lung cancer: A retrospective study, Lung Cancer 57 (2007), 229–232.

Jacobs

S.C.

, Spread of prostatic cancer to bone, Urology 21 (1983), 337–344.

Chen

X.Y.

, Lan

, Zhou

, Chen

W.Z.

, Hu

et al, Risk factors for bone metastasis from renal cell cancer, J Bone Oncol 9 (2017), 29–33.

Lin

J.D.

, Hsueh

, Chao

T.C.

, Long-Term Follow-Up of the Therapeutic Outcomes for Papillary Thyroid Carcinoma With Distant Metastasis, Medicine (Baltimore) 94 (2015), e1063.

10.

Kaneta

, Ogawa

, Daisaki

, Nawata

, Yoshida

et al, SUV measurement of normal vertebrae using SPECT/CT with Tc-99m methylene diphosphonate, Am J Nucl Med Mol Imaging 6 (2016), 262–268.

11.

Keyes

J.W.

Jr , SUV: Standard uptake or silly useless value? J Nucl Med 36 (1995), 1836–1839.

12.

Meikle

S.R.

, Hutton

B.F.

, Bailey

D.L.

, A transmission-dependent method for scatter correction in SPECT, J Nucl Med 35 (1994), 360–367.

13.

Sullivan

D.C.

, Obuchowski

N.A.

, Kessler

L.G.

, Raunig

D.L.

, Gatsonis

et al, Metrology Standards for Quantitative Imaging Biomarkers, Radiology 277 (2015), 813–825.

14.

Nakamura

, Tomiguchi

, Tanaka

, Reliability and advantages of using non-uniform Chang’s attenuation correction method using a CT-based attenuation coefficient map in (99m)Tc-GSA SPECT/CT hepatic imaging, EJNMMI Phys 2 (2015), 17.

15.

Gerety

E.L.

, Lawrence

E.M.

, Wason

, Yan

, Hilborne

et al, Prospective study evaluating the relative sensitivity of 18F-NaF PET/CT for detecting skeletal metastases from renal cell carcinoma in comparison to multidetector CT and 99mTc-MDP bone scintigraphy, using an adaptive trial design, Ann Oncol 26 (2015), 2113–2118.

16.

Huang

S.C.

, Anatomy of SUV. Standardized uptake value, Nucl Med Biol 27 (2000), 643–646.

17.

Thie

J.A.

, Understanding the standardized uptake value, its methods, and implications for usage, J Nucl Med 45 (2004), 1431–1434.

18.

Win

A.Z.

, Aparici

C.M.

, Normal SUV values measured from NaF18- PET/CT bone scan studies, PLoS One 9 (2014), e108429.

19.

Nguyen

X.C.

, So

, Chung

J.H.

, Lee

W.W.

, Park

S.Y.

et al, High correlations between primary tumours and loco-regional metastatic lymph nodes in non-small-cell lung cancer with respect to glucose transporter type 1-mediated 2-deoxy-2-F18-fluoro-D-glucose uptake, Eur J Cancer 44 (2008), 692–698.

20.

Otsuka

, Fukunaga

, Morita

, Sone

, Yoneda

et al, [The usefulness of bone marrow scintigraphy in the detection of bone metastasis from prostatic cancer], Kaku Igaku 22 (1985), 169–176.

21.

Nakahara

, Daisaki

, Yamamoto

, Iimori

, Miyagawa

et al, Use of a digital phantom developed by QIBA for harmonizing SUVs obtained from the state-of-the-art SPECT/CT systems: A multicenter study, EJNMMI Res 7 (2017), 53.

22.

Bailey

D.L.

, Willowson

K.P.

, An evidence-based review of quantitative SPECT imaging and potential clinical applications, J Nucl Med 54 (2013), 83–89.

23.

Mittal

B.R.

, Sood

, Shukla

, Vatsa

, Bhusari

et al, 99mTc-TRODAT-1 SPECT/CT imaging as a complementary biomarker in the diagnosis of parkinsonian syndromes, Nucl Med Commun 39(4) (2018), 312–318.

24.

Cachovan

, Vija

A.H.

, Hornegger

, Kuwert

, Quantification of 99mTc-DPD concentration in the lumbar spine with SPECT/CT, EJNMMI Res 3 (2013), 45.

25.

Dumanskiy

Y.V.

, Syniachenko

O.V.

, Stepko

P.A.

, Taktashov

G.S.

, Chernyshova

O.Y.

et al, The state of bone metabolism in lung cancer patients, Exp Oncol 40 (2018), 136–139.

26.

Bussard

K.M.

, Gay

C.V.

, Mastro

A.M.

, The bone microenvironment in metastasis; what is special about bone? Cancer Metastasis Rev 27 (2008), 41–55.

27.

Gumustekin

, Akar

, Dane

, Yildirim

, Seven

et al, Handedness and bilateral femoral bone densities in men and women, Int J Neurosci 114 (2004), 1533–1547.

28.

Hamanami

, Tokuhiro

, Inoue

, Finding the optimal setting of inflated air pressure for a multi-cell air cushion for wheelchair patients with spinal cord injury, Acta Med Okayama 58 (2004), 37–44.

29.

Schwartz

, Shani

, Soskolne

W.A.

, Touma

, Amir

et al, Uptake and biodistribution of technetium-99m-MD32P during rat tibial bone repair, J Nucl Med 34 (1993), 104–108.

30.

Rudin

, Manestar

, Ullrich

, Erhardt

, Grob

, The Anatomical Course of the Lateral Femoral Cutaneous Nerve with Special Attention to the Anterior Approach to the Hip Joint, J Bone Joint Surg Am 98 (2016), 561–567.