Bahloul Achraf, Verger Antoine, Blum Alain, Chawki Mohammad Bilal, Perrin Mathieu, Melki Saifeddine, Karcher Gilles, Marie Pierre-Yves, Imbert Laetitia
Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, France.
Université de Lorraine, INSERM U1254, IADI, Nancy, France.
Front Nucl Med. 2021 Sep 10;1:740275. doi: 10.3389/fnume.2021.740275. eCollection 2021.
An image display with a standardized uptake value (SUV) scale is recommended for analyzing PET exams, thus requiring the reconstruction of accurate images for both SUV measurement and visual analysis. This study aimed to determine whether such images may also be obtained with a high-speed CZT-SPECT/CT system, with a further application for the longitudinal monitoring of vertebral fractures. SPECT image reconstruction was optimized with an IEC phantom according to both image quality parameters and accuracy of measured activity. The optimized reconstruction process was applied to ≤15 min Tc-HDP SPECT spine recordings previously acquired from 25 patients (74 ± 12 years old) at both early (1.3 ± 1.1 months) and late (5.2 ± 2.3 months) stages after an acute vertebral fracture. A SPECT reconstruction with 32 equivalent iterations was selected based on the association of high detectability for spheres down to 0.6 ml in volume, with accurate measured activity, although the latter was affected by partial volume effect for spheres ≤5.6 ml. Coherent measurements were obtained on these high-quality SPECT images for the SUVmax from the intact vertebrae of patients, which were stable between basal SPECT/CT and follow-up SPECT/CT (for T1 vertebrae: 5.7 ± 1.1 vs. 5.8 ± 1.1, = 0.76), and from initially fractured vertebrae, which were dramatically higher on the basal compared with the follow-up SPECT (21.0 ± 8.5 vs. 11.2 ± 4.2, < 0.001), whereas inverse changes in SUVmax were observed for newly compacted fractures identified on follow-up SPECT (74.4 ± 2.0 vs. 21.8 ± 10.3, = 0.002). Finally, an image display with an SUV scale was shown to be advantageous for highlighting areas with >7.5 SUV, a level reached by 98% of vertebral fractures of <7 months and 4% of reference intact vertebrae. Bone scintigraphy of vertebral fractures may be obtained with this CZT-SPECT/CT system with fast 3D acquisitions and high-quality images displayed with a reliable SUV scale, approaching what is achieved and recommended for PET imaging.
建议使用具有标准化摄取值（SUV）刻度的图像显示器来分析PET检查，因此需要重建准确的图像以进行SUV测量和视觉分析。本研究旨在确定是否也可以使用高速CZT-SPECT/CT系统获得此类图像，并进一步应用于椎体骨折的纵向监测。根据图像质量参数和测量活性的准确性，使用IEC体模对SPECT图像重建进行了优化。将优化后的重建过程应用于先前从25例患者（74±12岁）在急性椎体骨折后的早期（1.3±1.1个月）和晚期（5.2±2.3个月）采集的≤15分钟的Tc-HDP SPECT脊柱记录。基于对体积低至0.6 ml的球体具有高可检测性且测量活性准确的关联，选择了32次等效迭代的SPECT重建，尽管对于体积≤5.6 ml的球体，测量活性受部分容积效应的影响。在这些高质量的SPECT图像上获得了患者完整椎体的SUVmax的连贯测量值，其在基础SPECT/CT和随访SPECT/CT之间是稳定的（对于T1椎体：5.7±1.1对5.8±1.1，P = 0.76），而在基础SPECT上最初骨折椎体的SUVmax明显高于随访SPECT（21.0±8.5对11.2±4.2，P < 0.001），而对于随访SPECT上识别出的新压实骨折，观察到SUVmax的反向变化（74.4±2.0对
