Longitudinal analysis of bone metabolism using SPECT/CT and (99m)Tc-diphosphono-propanedicarboxylic acid: comparison of visual and quantitative analysis.
Longitudinal analysis of bone metabolism using SPECT/CT and (99m)Tc-diphosphono-propanedicarboxylic acid: comparison of visual and quantitative analysis.
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DOI：
10.1186/s13550-016-0217-4
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发表时间：
2016-12
期刊：
影响因子：
3.2
通讯作者：
Kuwert T
中科院分区：
文献类型：
--
作者：
Beck M;Sanders JC;Ritt P;Reinfelder J;Kuwert T
骨转移瘤（OM）的治疗反应通常通过骨密度图（BS）进行监测。本研究的目的是比较示踪剂摄取变化的视觉评价与OM中绝对单位的定量;回顾性分析了在时间点1和2（TP 1/2）接受BS SPECT/CT的19例患者的52个OM，TP 1和2之间平均为10.3个月。由两名独立阅片员在两个TP的平面CT和SPECT/CT中目视比较病变中的示踪剂摄取，并将其分类为退行性、稳定性或进行性。通过测量峰值标准化摄取值（SUV）进行定量分析。基于定量，病变类似地分类为消退（> 30%减少）、进行性（> 30%增加）或稳定（静止）。如果可用，下胸椎或腰椎参考区域的摄取用于标准化。在TP 1和TP 2的OM中，发现平均SUV峰值（±SD）分别为20.4（±20.8）和16.4（±11.5）。对于参考区域，平均SUV均值为5.6（±1.9）和4.9（±2.2）。定量和目视评估之间的一致性仅为中等，平面动脉造影的平均Cohen kappa值为0.42，SPECT/CT为0.62。52个病灶中有11 - 22个出现不一致，这取决于阅片者以及是否考虑平面或SPECT成像。与以绝对单位测量摄取相比，在大约三分之一的病例中，骨显像对肿瘤代谢变化的视觉评价产生不一致的结果。
The therapy response of osseous metastases (OM) is commonly monitored by bone scintigraphies (BS). The aim of this study was to compare visual evaluation of changes in tracer uptake with quantitation in absolute units in OMs; 52 OMs from 19 patients who underwent BS with SPECT/CT at time points one and two (TP1/2) were analyzed retrospectively, with an average of 10.3 months between TP1 and 2. Tracer uptake in lesions was visually compared by two independent readers in both planar scintigraphies and SPECT/CT across both TPs and classified as regressive, stable, or progressive. Quantitative analysis was performed by measuring peak standardized uptake values (SUV). Based on quantitation, lesions were similarly classified as regressive (>30 % decrease), progressive (>30 % increase), or stable (rest). If available, uptake in reference regions in the lower thoracic or lumbar spine was used for normalization. In OMs at TP1 and TP2, mean SUVpeak (±SD) was found to be 20.4 (±20.8) and 16.4 (±11.5), respectively. For the reference region, mean SUVmean was 5.6 (±1.9) and 4.9 (±2.2). Agreement between quantitative and visual assessment was only moderate, with an average Cohen’s kappa of 0.42 for planar scintigraphy and 0.62 for SPECT/CT. Discrepancies occurred in between 11 and 22 of the 52 lesions, depending on the reader and whether planar or SPECT imaging was considered. Compared to measuring uptake in absolute units, visual evaluation of skeletal scintigraphies for change in tumor metabolism yields inconsistent results in roughly one third of the cases.