Department of Nuclear Medicine, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China.
BMC Med Imaging. 2021 Feb 27;21(1):39. doi: 10.1186/s12880-021-00569-5.
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 Tc-MDP with SPECT/CT to investigate the feasibility of standardized uptake value (SUV) for differential diagnosis of benign and malignant bone lesions.
A retrospective study was carried out involving 221 patients (116 males and 105 females) who underwent SPECT/CT scan using Tc-MDP. The maximum SUV (SUV), mean SUV (SUV) 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 SUV 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.
The SUV and SUV of normal vertebrae in males were markedly higher than those in females (P < 0.0009). The SUV 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 SUV 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 SUV of normal group, benign bone lesion group and malignant bone metastasis foci group showed statistical differences in both males and females.
Our study evaluated SUV and SUV of normal vertebrae, benign bone lesion and malignant bone metastasis foci with a large sample population. Preliminary results proved the potential value of SUV 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.
定量骨 SPECT/CT 可用于疾病随访和患者间比较。对于骨转移恶性病变，脊柱是最常受累的部位。然而，很少有大样本量的定量研究调查正常颈椎、胸椎和腰椎的所有节段。本研究旨在使用 Tc-MDP 对 SPECT/CT 进行正常椎体定量研究，以探讨标准化摄取值（SUV）在鉴别良恶性骨病变中的可行性。
回顾性分析 221 例（男 116 例，女 105 例）患者 Tc-MDP SPECT/CT 扫描资料。获得 2416 个正常椎体、157 个良性骨病变和 118 个恶性骨转移灶的最大 SUV（SUV）、平均 SUV（SUV）和 CT 值（亨氏单位，HU）。分析正常椎体 SUV 与正常椎体 CT 值、患者年龄、身高、体重、BMI 的相关性。对相同部位和性别进行正常组、良性组和恶性组的数据进行统计学分析。
男性正常椎体 SUV 和 SUV 明显高于女性（P<0.0009）。男性和女性各正常椎体节段的 SUV 与 CT 值呈强负相关（r=-0.89 和-0.92，P<0.0009）。男性正常椎体 SUV 与体重、身高和 BMI 显著相关（r=0.4，P<0.0009；r=0.28，P=0.005；r=0.22，P=0.026），与女性体重和 BMI 显著相关（r=0.32，P=0.009；r=0.23，P=0.031）。男性和女性正常组、良性骨病变组和恶性骨转移灶组 SUV 差异有统计学意义。
本研究评估了大样本人群正常椎体、良性骨病变和恶性骨转移灶的 SUV 和 SUV。初步结果证明了 SUV 在鉴别良恶性骨病变中的潜在价值。该结果可为椎体病变的临床诊断和疗效评估提供定量参考。
