Effects of CT-based attenuation correction on quantitative SPECT/CT of jawbone.

OBJECTIVE: With single photon emission computed tomography (SPECT)/computed tomography (CT) quantitative examinations, CT-based attenuation correction (CTAC) is considered necessary, though its effect on the quantitative values of an examined area close to the body surface, such as the jawbone, has not been elucidated. We performed an investigation to determine whether quantitative evaluation using a bone SPECT standalone device without CT is possible. SUBJECTS AND METHODS: The calculated indices were maximum standardized uptake value (SUVmax) and SUVpeak. Grouping was performed based on the presence or absence of CTAC. The CTAC group underwent CTAC, while the noAC group did not.Validation was performed using clinical data of patients who underwent a jawbone SPECT/CT examination. Becquerel calibration factor (BCF) is required for calculation of SUV, and was determined with values obtained with both phantom and syringe methods. The index for the uptake areas in each group was assessed using a paired t-test. RESULTS: Using BCF obtained with the phantom method, both SUVmax and SUVpeak were higher in the noAC group. In contrast, BCF obtained with the syringe method showed no significant difference between the CTAC and noAC groups in regard to SUVmax and SUVpeak. This tendency was found regardless of the device used. Also, a high correlation was observed between the groups for both devices (r=0.95 and 0.93). CONCLUSION: Our findings show that BCF obtained with a syringe method should be used when performing quantitative evaluation without CTAC. They also indicate that quantitative evaluation using a SPECT standalone device may be possible for jawbone SPECT/CT examinations.

Effectiveness of quantitative bone SPECT/CT for bone metastasis diagnosis.

OBJECTIVE: This study was conducted to investigate the utility of standardized uptake value (SUV) derived from bone single photon emission tomography/computed tomography (SPECT/CT) for diagnosing bone metastasis. SUBJECTS AND METHODS: One hundred forty-seven patients with malignant cancer (breast or prostate cancer), joint disorders, primary skeletal disease, or cartilaginous bone neoplasms who underwent skeletal quantitative SPECT/CT were retrospectively investigated. Acquired data were classified as normal fourth lumbar vertebra, skeletal degenerative changes, or bone metastasis. Receiver operating characteristic (ROC) curves were used to determine the optimum cut-off value for SUVmax to distinguish among these diagnoses. RESULTS: Mean SUVmax values for the normal L4 bone (n=101), skeletal degenerative changes (n=47) and bone metastasis (n=64) groups were 4.47±1.66 (range 1.01-11.25), 6.99±2.58 (2.21-14.6), and 25.4±15.7 (3.88-98.87), respectively. Compared to the other two groups, SUVmax for the bone metastasis group was significantly higher (P<0.001). In the normal bone group, sensitivity, specificity and accuracy for discriminating bone metastasis were 96.3%, 95.1%, and 95.7% respectively, with a best SUVmax cut-off value of 7.40. For the skeletal degenerative changes group sensitivity, specificity and accuracy were 87.5%, 93.6%, and 90.4% respectively, with a best SUVmax cut-off value of 11.26. CONCLUSION: Quantitative bone SPECT/CT may be useful for bone metastasis diagnosis.