Improving the Accuracy of Bone-Scintigraphy Imaging Analysis Using the Skeletal Count Index: A Study Based on Human Trial Data

The image quality index for whole-body bone scintigraphy has traditionally relied on the total count (Total-C) with a threshold of ≥1.5 million counts (MC). However, Total-C measurements are susceptible to variability owing to urine retention. This study aimed to develop a skeletal count (Skel-C)-ba...

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Main Authors: Ryosuke Miki, Tatsuya Tsuchitani, Yoshiyuki Takahashi, Kazuhiro Kitajima, Yasuyuki Takahashi
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Radiation
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Online Access:https://www.mdpi.com/2673-592X/5/1/5
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Summary:The image quality index for whole-body bone scintigraphy has traditionally relied on the total count (Total-C) with a threshold of ≥1.5 million counts (MC). However, Total-C measurements are susceptible to variability owing to urine retention. This study aimed to develop a skeletal count (Skel-C)-based index, focusing exclusively on bone regions, to improve the accuracy of image analysis in bone scintigraphy. To determine the optimal Skel-C-based threshold, Skel-C thresholds were set at 0.9, 1.0, 1.1, and 1.2 MC, and Total-C thresholds were set at 1.75, 2.0, and 2.25 MC. Patients were then categorized based on whether their values were above or below these thresholds. The group including all cases was defined as the Total-C 1.5 high group. Sensitivity and specificity were calculated for each group, and receiver operating characteristic analyses and statistical evaluations were conducted. The specificity of the bone scintigraphy image analysis program in the Skel-C < 0.9 MC group was significantly lower than that in the Skel-C ≥ 0.9 MC and Total-C 1.5 high groups. The decrease in specificity was evident only with Skel-C and was not identified based on Total-C levels. These findings highlight the importance of achieving Skel-C ≥ 0.9 MC and suggest that Total-C alone is insufficient for reliable image assessment.
ISSN:2673-592X