Tc-HDP SPECT/CT与F-NaF PET/CT在乳腺癌和前列腺癌骨转移中标准化摄取值的比较。

Comparison of standardized uptake values between Tc-HDP SPECT/CT and F-NaF PET/CT in bone metastases of breast and prostate cancer.

作者信息

Arvola Samuli, Jambor Ivan, Kuisma Anna, Kemppainen Jukka, Kajander Sami, Seppänen Marko, Noponen Tommi

机构信息

Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.

Department of Diagnostic Radiology, University of Turku, Turku, Finland.

出版信息

EJNMMI Res. 2019 Jan 24;9(1):6. doi: 10.1186/s13550-019-0475-z.

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 Tc-HDP SPECT/CT and F-NaF PET/CT.

METHODS

Twenty-six breast and 27 prostate cancer patients at high risk of bone metastases underwent both Tc-HDP SPECT/CT and F-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 (SUV, SUV, and SUV) 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 (R ≥ 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 SUV, SUV, and SUV, respectively. On the other hand, the SUVRs were similar between SPECT and PET with median differences of 2%, - 9%, and 2% for SUVR, SUVR, and SUVR, respectively.

CONCLUSION

The strong correlation between SUVs and similar SUVRs of Tc-HDP SPECT/CT and F-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.

背景

尽管近期技术进步使得定量单光子发射计算机断层扫描（SPECT）成为可能，但定量SPECT在临床实践中尚未得到广泛应用。本研究的目的是通过比较用锝-亚甲基二膦酸盐（Tc-HDP）SPECT/CT和氟代脱氧葡萄糖（F-NaF）PET/CT测量的标准摄取值（SUV），评估定量SPECT测量乳腺癌和前列腺癌骨转移摄取的可行性。

方法

26例乳腺癌和27例有骨转移高风险的前列腺癌患者在彼此14天内分别接受了Tc-HDP SPECT/CT和F-NaF PET/CT检查。使用有序子集期望最大化算法重建SPECT和PET数据以获得定量图像。识别出在两个数据集中均可见的转移性和良性骨骼病变，并确定其最大、峰值和平均SUV（SUVmax、SUVpeak和SUVmean）。还计算了病变与相邻正常骨之间的SUV比值（SUVR）。使用线性回归评估SPECT和PET的SUV之间的相关性，并使用Bland-Altman图评估SPECT和PET的SUV及SUVR之间的差异。

结果

共分析了231个骨骼病变，其中129个为转移性病变，102个为良性病变。当纳入所有病变时，SPECT和PET之间的所有三种SUV测量值均具有非常强的相关性（R≥0.80，p<0.001），并且PET SUV显著高于SPECT SUV（p<0.001）。SUVmax、SUVpeak和SUVmean的中位数差异分别为21%、12%和19%。另一方面，SPECT和PET之间的SUVR相似，SUVRmax、SUVRpeak和SUVRmean的中位数差异分别为2%、-9%和2%。