回顾性多中心研究：定量骨 SPECT/CT 预测副舟骨手术切除。

A retrospective multicenter study of quantitative bone SPECT/CT to predict the surgical removal of the accessory navicular bone.

机构信息

Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam-si.

Department of Nuclear Medicine, Hanyang University Guri Hospital, Guri-si, Gyeonggi-do.

出版信息

Nucl Med Commun. 2021 Sep 1;42(9):998-1004. doi: 10.1097/MNM.0000000000001433.

DOI:10.1097/MNM.0000000000001433

PMID:33867482

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8357044/

Abstract

OBJECTIVE

The maximum standardized uptake value (SUVmax) in single-photon emission computed tomography/computed tomography (SPECT/CT) can help quantify disease activity of the accessory navicular bone (ANB). In this multicenter quantitative bone SPECT/CT study, we investigated whether SUVmax was correlated with ANB severity, thereby allowing prediction of surgical resection for ANB treatment.

METHODS

Two-hundred forty-six patients (men:women = 135:111, mean age = 39.3 years), who had undergone quantitative Tc-99m diphosphonate SPECT/CT of the feet, were recruited from four hospitals. SUVmax was measured using vendor-provided quantitation software. The SUVmax values were compared in relation to ANB type (type 1 = 62, type 2 = 136 and type 3 = 14), presence of pain and surgical treatment.

RESULTS

SUVmax (mean ± SD) was the highest in type 2 ANB (4.41 ± 5.2; P = 0.0101). The 17 resected ANBs showed greater SUVmax (8.27 ± 5.23; P < 0.0001) than the 141 asymptomatic ANBs (2.30 ± 1.68) or the 54 symptomatic ANBs without surgery (6.15 ± 4.40). Since surgery is exclusively indicated for ANB type 2, surgical resection was investigated only in these cases. In univariate analysis, young age and SUVmax were significantly associated with surgical treatment, but only SUVmax was a significant predictor of surgery in multivariate analysis (P < 0.0001). Type 2 ANBs were treated by surgery in 32.5% (13/40) of the cases when SUVmax was ≥5, and in only 1.35% (1/74) of the cases when SUVmax was <5 (P < 0.0001).

CONCLUSION

ANB disease activity and excision were strongly associated with the SUVmax derived from quantitative bone SPECT/CT. Our study suggests an absolute SUVmax cutoff for ultimate ANB surgical treatment, but additional prospective studies are required to validate this finding.

摘要

目的

单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）中的最大标准化摄取值（SUVmax）可帮助量化副舟骨（ANB）的疾病活动度。在这项多中心定量骨 SPECT/CT 研究中，我们研究了 SUVmax 是否与 ANB 严重程度相关，从而能够预测 ANB 治疗的手术切除。

方法

从 4 家医院招募了 246 名患者（男性：女性= 135：111，平均年龄= 39.3 岁），他们接受了定量 Tc-99m 二膦酸盐 SPECT/CT 足部扫描。使用供应商提供的定量软件测量 SUVmax。比较了 SUVmax 值与 ANB 类型（类型 1= 62，类型 2= 136，类型 3= 14）、疼痛存在和手术治疗之间的关系。

结果

类型 2 ANB 的 SUVmax（平均值±标准差）最高（4.41±5.2；P=0.0101）。17 个切除的 ANB 的 SUVmax 较高（8.27±5.23；P<0.0001），而 141 个无症状的 ANB 的 SUVmax 较低（2.30±1.68），54 个无症状但未手术的 ANB 的 SUVmax 也较低（6.15±4.40）。由于手术仅适用于 ANB 类型 2，因此仅在这些情况下对手术进行了研究。在单因素分析中，年龄较小和 SUVmax 与手术治疗显著相关，但仅 SUVmax 在多因素分析中是手术的显著预测因素（P<0.0001）。当 SUVmax≥5 时，40 例中的 32.5%（13/40）的类型 2 ANB 进行了手术治疗，而当 SUVmax<5 时，仅 74 例中的 1.35%（1/74）进行了手术治疗（P<0.0001）。