目的:本研究旨在使用集成的SPECT/CT扫描仪,通过定量测量和比较基于99mTc-MDP在正常脊柱和骨盆中的SUV的各种标准化方法,确定一种相对稳健的SUV,用于指导临床实践。
方法:在2017年6月至2019年9月之间,共有500名肿瘤患者(平均年龄,60.9;男性,66.0%)的患者接受了99mTc-MDP的骨SPECT/CT扫描。根据患者体重(BW)计算4962例脊柱和骨盆骨的平均SUV(SUVmean),瘦体重(LBM),骨矿物质含量(BMC),体表面积(BSA),和体重指数(BMI),定义为SUVBW,SUVlbm,SUVbmc,SUVBSA,和SUVbmi,分别。比较了上述参数的变异系数(CoV),用相关性和多元线性回归分析比较这些参数受性别影响的程度,年龄,高度,体重,BMI,和CT值。
结果:正常脊柱和骨盆中的平均SUV表现出相对较大的变异性:SUVbw为4.573±1.972,对于SUVlbm,3.555±1.517,SUVbmc为0.163±0.071,SUVbsa为0.124±0.052,SUVbmi为1.668±0.732。总的来说,与其他SUV相比,SUVbsa在所有椎骨和骨盆中的CoV相对最低(42.1%)。对于相关性分析,所有SUV均显示与年龄和CT值的弱相关性,但显着相关性。对于回归分析,SUVbsa只受到年龄的影响,BMI,和CT值独立。这些变量对SUVbsa的影响均小于对常规SUVbw的影响。
结论:骨SPECT/CT定量检测99mTc-MDP在正常骨中的SUVs可作为评价肿瘤骨转移的参考依据。但应该根据具体地点进行评估。SUVbsa在所有SUV归一化变化中表现出优越的鲁棒性,表明潜在的临床应用。
OBJECTIVE: This study aimed to identify a relatively robust SUV for guiding clinical practice through quantitative measurement and comparison of various normalization methods based on the SUV of 99mTc-MDP in the normal spine and pelvis using an integrated SPECT/CT scanner.
METHODS: Between June 2017 and September 2019, a total of 500 oncology patients (mean age, 60.9; men, 66.0%) who underwent bone SPECT/CT scans with 99mTc-MDP were enrolled in this retrospective study. The mean SUV (SUVmean) of 4962 spinal and pelvic bones was calculated based on the patients\' body weight (BW), lean body mass (LBM), bone mineral content (BMC), body surface area (BSA), and body mass index (BMI), defined as SUVbw, SUVlbm, SUVbmc, SUVbsa, and SUVbmi, respectively. The coefficients of variation (CoVs) of the aforementioned parameters were compared, and the correlation and multiple linear regression analyses were used to compare the extent to which these parameters were affected by sex, age, height, weight, BMI, and CT values.
RESULTS: The average SUVs in the normal spine and pelvis displayed a relatively wide variability: 4.573 ± 1.972 for SUVbw, 3.555 ± 1.517 for SUVlbm, 0.163 ± 0.071 for SUVbmc, 0.124 ± 0.052 for SUVbsa, and 1.668 ± 0.732 for SUVbmi. In general, SUVbsa had relatively lowest CoV (42.1%) in all vertebrae and pelvis compared with other SUVs. For correlation analyses, all SUVs displayed weak but significant correlations with age and CT values. For regression analyses, SUVbsa was influenced only by age, BMI, and CT values independently. The effects of these variables on SUVbsa were all smaller than those on conventional SUVbw.
CONCLUSIONS: The SUVs of 99mTc-MDP in normal bone derived from quantitative bone SPECT/CT could serve as a reference for evaluating tumor bone metastasis, but it should be assessed on a site-specific basis. SUVbsa exhibited superior robustness among all the SUV normalization variations, indicating potential clinical applications.