Abstract
1169
Objectives: To investigate the clinical application and incremental value of the maximum standard uptake value (SUVmax) of quantitative SPECT/CT imaging in the differential diagnosis of benign and malignant bone lesions.
Methods: From April to December in 2019, one hundred and twenty-four patients with malignant tumors who underwent whole body bone scan(WBS) and quantitative SPECT/CT were enrolled. A total of 294 abnormal tracer-positive concentration lesions was detected, and 92 images of normal vertebra were included as the control group. The Differences of SUVmax among the benign, malignant, and control groups were analyzed. Two hundred and ninety-four lesions were further divided into two groups: 108 lesions in the experimental group with 46 patients (before August) and 186 lesions in the verification group with 78 patients (after August). The ROC curve was drawn through the experimental group to obtain a cut-off value of SUVmax, and the diagnostic efficacy of WBS, SPECT/CT qualitative analysis, and SPECT/CT qualitative combined with SUVmax quantitative analysis were compared. A 3-point scale was used when readers interpreted WBS and SPECT/CT images, which represented the likelihood of the lesion being benign or malignant, scored as 1=benign, 2=equivocal, and 3=malignant.
Results: Using follow-up imaging (CT, MRI, and/or PET/CT) for at least 6 months as the golden standard, 137 malignant, and 157 benign lesions were determined. The SUVmax of malignant lesions (27.23±14.44g/mL) was significantly higher than that of benign lesions (16.28±10.21g/mL) (P=0.00) and the controls (6.92±1.41g/mL) (P=0.00). Using the cut-off value of SUVmax >18.20g/mL obtained by the ROC curve in the experimental group, the diagnostic sensitivities of WBS, SPECT/CT qualitative analysis and the combiner were76.9%, 88.5%%, and 94.9%, the specificities were 77.8%, 93.5%, and 93.5%, the accuracies were 77.4%, 91.4%, and 94.1%, and the ROC area under the curve (AUC) were 0.75, 0.91, and 0.96, respectively. The SPECT/CT qualitative combined with SUVmax quantitative analysis had the highest diagnostic efficacy (P=0.01, Table 1 and Figure 1).
Conclusions: Quantitative SPECT/CT has important clinical application and incremental value in the differential diagnosis of benign and malignant bone lesions.