University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.
J Med Imaging Radiat Oncol. 2023 Sep;67(6):595-601. doi: 10.1111/1754-9485.13528. Epub 2023 Apr 26.
Spectral detector computed tomography (SDCT) is a recent advancement that enables elemental material decomposition which could improve the detection of osseous metastases in the oncologic patient.
Sixteen patients who underwent oncologic staging SDCT as well as WBBS with Technetium-99 m hydroxydiphosphonate (Tc99m HDP) were included in this retrospective study. A total of 50 osseous metastases were identified and confirmed on bone scintigraphy. Quantitative ROI-based measurements of each lesion and a similar region of normal bone were performed, and the acquired spectral data were used for comparison. These parameters included effective atomic number (Z ), electron density (%EDW) and calcium suppression (HU). Receiver operating characteristic (ROC) analysis was performed.
In comparison to normal bone, osseous metastases showed statistically significantly elevated values in effective atomic number, electron density and calcium suppression. ROC analysis demonstrated outstanding discrimination with area under the curve (AUC) values of 0.934 and 0.915 for effective atomic number and electron density, and excellent discrimination with an AUC value of 0.884 for calcium suppression. Threshold values of effective atomic number (Z ) >9.7, electron density >115% EDW and calcium suppression values >0 HU were demonstrated to be able to differentiate an osseous lesion from normal bone with a sensitivity of 82%, 82% and 84% and a specificity of 86%, 92% and 88% respectively.
Spectral analysis of osseous metastases demonstrated significantly elevated values in effective atomic number, electron density and calcium suppression as compared to normal bone which would be useful adjunct quantitative parameters in CT imaging to increase diagnostic confidence.
能进行元素物质分解的光谱探测器 CT（SDCT）是最近的一项进展，它可以提高肿瘤患者中骨转移的检测能力。
本回顾性研究纳入了 16 名接受肿瘤分期 SDCT 以及用锝-99m 羟膦酸盐（Tc99m HDP）进行全身骨闪烁扫描的患者。共发现并确认了 50 个骨转移灶。对每个病变和相似的正常骨区域进行基于定量感兴趣区（ROI）的测量，并对获得的光谱数据进行比较。这些参数包括有效原子序数（Z）、电子密度（%EDW）和钙抑制（HU）。进行了受试者工作特征（ROC）分析。
与正常骨相比，骨转移灶的有效原子序数、电子密度和钙抑制值显著升高。ROC 分析显示，有效原子序数和电子密度的曲线下面积（AUC）值分别为 0.934 和 0.915，具有出色的区分能力，钙抑制的 AUC 值为 0.884，具有极好的区分能力。有效原子序数（Z）>9.7、电子密度>115% EDW 和钙抑制值>0 HU 的阈值被证明能够以 82%、82%和 84%的敏感性以及 86%、92%和 88%的特异性将骨病变与正常骨区分开来。
与正常骨相比，骨转移灶的有效原子序数、电子密度和钙抑制值显著升高，这将是 CT 成像中增加诊断信心的有用的辅助定量参数。
