Quantification of [99mTc]Tc-HDP bone SPECT/CT: can we improve the body weight based standardized uptake value with a more robust normalization?

Abstract Background The introduction of quantitative SPECT/CT allows more objective assessments of tracer accumulation in SPECT. However standardized uptake values (SUV) still do not play a big role for orthopedic or oncologic questions. With a more reliable normalization, the use of quantitative me...

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Main Authors: Tiberiu Damian, Noel Spielhofer, Jakob Heimer, Alexander W. Sauter, Cristina Popescu, Daniel Hausmann, Jason L. Manser, Karim Eid, Rahel A. Kubik-Huch, Irene A. Burger
Format: Article
Language:English
Published: SpringerOpen 2024-11-01
Series:EJNMMI Research
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Online Access:https://doi.org/10.1186/s13550-024-01167-6
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author Tiberiu Damian
Noel Spielhofer
Jakob Heimer
Alexander W. Sauter
Cristina Popescu
Daniel Hausmann
Jason L. Manser
Karim Eid
Rahel A. Kubik-Huch
Irene A. Burger
author_facet Tiberiu Damian
Noel Spielhofer
Jakob Heimer
Alexander W. Sauter
Cristina Popescu
Daniel Hausmann
Jason L. Manser
Karim Eid
Rahel A. Kubik-Huch
Irene A. Burger
author_sort Tiberiu Damian
collection DOAJ
description Abstract Background The introduction of quantitative SPECT/CT allows more objective assessments of tracer accumulation in SPECT. However standardized uptake values (SUV) still do not play a big role for orthopedic or oncologic questions. With a more reliable normalization, the use of quantitative measures might also be of use for a more objective assessment of lesions. We retrospectively included patients that received a quantitative [99mTc]-HDP bone SPECT/CT scan of the lumbar spine for 4 body weight (BW) categories. Measurements of bone activity (kBq/cc) and bone density in Hounsfield Units (HU) in a standard volume of interest in the femur, the first and the fifth lumbar vertebra of all patients, without active disease within these regions was made. Correlations between tracer uptake and clinical parameters (BW, height, age, gender) were assessed with a multiple regression and based on the model coefficients, a correction formula was calculated and applied. Results The strongest correlation between measured activity in L1 and patient parameters was found for BW (r= -0.64, p < 0.001), compared to height (r = -0.28, p = 0.002) and age (r = -0.34, p = 0.001). Furthermore, there was a weak positive correlation between tracer accumulation and bone density (r: 0.35, p < 0.001). Using standard normalization with BW there was a very weak positive correlation between SUVBW at L1 and BW with a slight overestimation in heavier subjects (r = 0.15, p = 0.09). The calculated correction based on the multiple regression of activity as dependent variable, and weight, age and bone density as significant predictors resulted in more robust uptake values with non-significant associations to BW, height, age or density. However, there was still a wide interindividual range of values for normalized bone activity. Conclusion Using an age, bone density and weight-based normalization significantly decreased the interindividual variability of normal uptake on quantitative SPECT/CT compared to the regularly used BW adjusted SUVBW. However, a generalized normalization is difficult in the presence of strong patient effects, not attributable to the measured clinical variables.
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spelling doaj-art-bb30234d5d274f169f070246e2a4def12025-01-12T12:39:25ZengSpringerOpenEJNMMI Research2191-219X2024-11-011411910.1186/s13550-024-01167-6Quantification of [99mTc]Tc-HDP bone SPECT/CT: can we improve the body weight based standardized uptake value with a more robust normalization?Tiberiu Damian0Noel Spielhofer1Jakob Heimer2Alexander W. Sauter3Cristina Popescu4Daniel Hausmann5Jason L. Manser6Karim Eid7Rahel A. Kubik-Huch8Irene A. Burger9Department of Radiology, Cantonal Hospital Baden, Affiliated Hospital for Research and Teaching of the Faculty of Medicine, University of ZurichDepartment of Nuclear Medicine, Cantonal Hospital Baden, Affiliated Hospital for Research and Teaching of the Faculty of Medicine, University of ZurichDepartment of Nuclear Medicine, Cantonal Hospital Baden, Affiliated Hospital for Research and Teaching of the Faculty of Medicine, University of ZurichDepartment of Radiology, Cantonal Hospital Baden, Affiliated Hospital for Research and Teaching of the Faculty of Medicine, University of ZurichDepartment of Nuclear Medicine, Cantonal Hospital Baden, Affiliated Hospital for Research and Teaching of the Faculty of Medicine, University of ZurichDepartment of Radiology, Cantonal Hospital Baden, Affiliated Hospital for Research and Teaching of the Faculty of Medicine, University of ZurichMDS Digital AGDepartment of Orthopaedics, Cantonal Hospital Baden, Affiliated Hospital for Research and Teaching of the Faculty of Medicine, University of ZurichDepartment of Radiology, Cantonal Hospital Baden, Affiliated Hospital for Research and Teaching of the Faculty of Medicine, University of ZurichDepartment of Nuclear Medicine, Cantonal Hospital Baden, Affiliated Hospital for Research and Teaching of the Faculty of Medicine, University of ZurichAbstract Background The introduction of quantitative SPECT/CT allows more objective assessments of tracer accumulation in SPECT. However standardized uptake values (SUV) still do not play a big role for orthopedic or oncologic questions. With a more reliable normalization, the use of quantitative measures might also be of use for a more objective assessment of lesions. We retrospectively included patients that received a quantitative [99mTc]-HDP bone SPECT/CT scan of the lumbar spine for 4 body weight (BW) categories. Measurements of bone activity (kBq/cc) and bone density in Hounsfield Units (HU) in a standard volume of interest in the femur, the first and the fifth lumbar vertebra of all patients, without active disease within these regions was made. Correlations between tracer uptake and clinical parameters (BW, height, age, gender) were assessed with a multiple regression and based on the model coefficients, a correction formula was calculated and applied. Results The strongest correlation between measured activity in L1 and patient parameters was found for BW (r= -0.64, p < 0.001), compared to height (r = -0.28, p = 0.002) and age (r = -0.34, p = 0.001). Furthermore, there was a weak positive correlation between tracer accumulation and bone density (r: 0.35, p < 0.001). Using standard normalization with BW there was a very weak positive correlation between SUVBW at L1 and BW with a slight overestimation in heavier subjects (r = 0.15, p = 0.09). The calculated correction based on the multiple regression of activity as dependent variable, and weight, age and bone density as significant predictors resulted in more robust uptake values with non-significant associations to BW, height, age or density. However, there was still a wide interindividual range of values for normalized bone activity. Conclusion Using an age, bone density and weight-based normalization significantly decreased the interindividual variability of normal uptake on quantitative SPECT/CT compared to the regularly used BW adjusted SUVBW. However, a generalized normalization is difficult in the presence of strong patient effects, not attributable to the measured clinical variables.https://doi.org/10.1186/s13550-024-01167-6Body weightSUVQuantitative SPECT/CTSingle photon emission computed tomographyComputed tomography
spellingShingle Tiberiu Damian
Noel Spielhofer
Jakob Heimer
Alexander W. Sauter
Cristina Popescu
Daniel Hausmann
Jason L. Manser
Karim Eid
Rahel A. Kubik-Huch
Irene A. Burger
Quantification of [99mTc]Tc-HDP bone SPECT/CT: can we improve the body weight based standardized uptake value with a more robust normalization?
EJNMMI Research
Body weight
SUV
Quantitative SPECT/CT
Single photon emission computed tomography
Computed tomography
title Quantification of [99mTc]Tc-HDP bone SPECT/CT: can we improve the body weight based standardized uptake value with a more robust normalization?
title_full Quantification of [99mTc]Tc-HDP bone SPECT/CT: can we improve the body weight based standardized uptake value with a more robust normalization?
title_fullStr Quantification of [99mTc]Tc-HDP bone SPECT/CT: can we improve the body weight based standardized uptake value with a more robust normalization?
title_full_unstemmed Quantification of [99mTc]Tc-HDP bone SPECT/CT: can we improve the body weight based standardized uptake value with a more robust normalization?
title_short Quantification of [99mTc]Tc-HDP bone SPECT/CT: can we improve the body weight based standardized uptake value with a more robust normalization?
title_sort quantification of 99mtc tc hdp bone spect ct can we improve the body weight based standardized uptake value with a more robust normalization
topic Body weight
SUV
Quantitative SPECT/CT
Single photon emission computed tomography
Computed tomography
url https://doi.org/10.1186/s13550-024-01167-6
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