Abstract
1527
Purpose: To explore the value of skeletal standardized uptake value(SUV) obtained by quantitative SPECT/CT in differential diagnosis of bone metastases from benign lesions.
Methods: Retrospective analysis of 51 patients with malignant tumors who underwent whole body bone imaging and quantitative SPECT/CT imaging and visually detected no more than 3 imaging agent concentrated lesions in the SPECT/CT imaging range. The region of interest(ROI) of the lesion concentrated by the imaging agent is sketched by an experienced physician and technician, and the ROI of the normal bone of the spinal vertebral body adjacent to the normal vertebral body or other bones is delineated to obtain the maximum SUV(SUVmax) and the average SUV(SUVave). Fifty-one patients were enrolled, 28 males and 23 males with an average age of 58.8±9.5 (37-77) years. A total of 88 focal spots of the imaging agent and corresponding normal sites were obtained, including 40 benign lesions and 48 metastatic lesions. Statistical analysis was performed using SPSS 22.0 statistical software. The SUVmax and SUVave of all lesions were paired with the corresponding normal sites. The SUVmax values and SUVave of metastases and benign lesions were analyzed by two independent samples and the receiver operator characteristic(ROC)curves of SUVmax and SUVave were analysed.
Results: Among the 88 lesions, 37 were located in the spine, 32 in the thorax, 13 in the pelvis, 5 Located at 5 limbs, 1 is located in the skull. The SUVmax value of all lesions was 20.73±14.01 (3.90-92.61), and the SUVmax value of the corresponding normal parts was 5.88±2.36 (2.08-12.52). The difference between the two groups was statistically significant (t=10.343, P<0.01). The SUVave of all lesions were 8.42±4.81 (37-77), and the SUVave of the corresponding normal sites were 3.10±1.51 (0.65-7.54). The difference between the two groups was statistically significant (t=11.342, P<0.01). The SUVmax of metastases was 24.77±16.32 (3.90-92.61), and the SUVmax of benign lesions was 15.89±8.51 (4.68-42.32). The difference between the two groups was statistically significant (t=3.273, P=0.002). The SUVave of metastases were 9.09±5.59 (0.81-29.08), and the SUVave of benign lesions were 7.61±3.57 (1.66-17.48). There was no significant difference between the two groups (t=1.44, P=0.154). The area under the curve (AUC) values of the SUVmax curves were greater than that of the SUVave curve. AUCs of the SUVmax and SUVave were0.687 (P=0.03) and 0.576(P=0.223), respectively. SUVmax had greater accuracy for discriminating bone metastasis from benign lesions. Hot foci of the patients with malignant neoplasms in bone SPECT/CT may be discriminated using SUVmax with a certain accuracy, and the optimal cut-off value was 17.705.
Conclusions: The SUVmax and SUVave value of the hot lesions were significantly larger than the corresponding normal parts. The SUVmax of bone metastases were significantly larger than that of benign lesions, and there was no significant difference in SUVave between the two groups. Therefore, the SUVmax has certain value for the differential diagnosis of metastases from benign lesions.