{"title":"已知或疑似炎性关节炎患者用高速360°CZT相机记录的两期全身骨断层显像的标准化摄取值分析","authors":"Franklin Rajadhas, Laetitia Imbert, Mathilde Fiorino, Caroline Morizot, Victor Boucher, Zohra Lamiral, Véronique Roch, Pierre-Yves Marie, Damien Loeuille, Isabelle Chary-Valckenaere, Achraf Bahloul","doi":"10.1007/s00259-025-07150-0","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>360° CZT-cameras provide whole-body bone SPECT/CT recordings at delayed (DEL) and blood-pool (BP) phases with short recording times but long visual analysis times. This study aims to determine whether a standardized uptake value (SUV)-based detection of inflammatory arthritis (IA) could facilitate this analysis.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We included 72 patients with known or suspected IA who underwent two-phase whole-body bone SPECT/CT after 550–650 MBq [<sup>99m</sup>Tc]Tc-HDP injection. Forty-eight patients also had ultrasound (US) for peripheral IA, and 42 had MRI for axial IA. The skeleton was segmented into 26 joint areas and analyzed by trained observers using a visual consensus methodology and SUVmax measurements.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 1836 joint areas were analyzed, including 1126 peripheral ones (limb joints excluding hips and shoulders). SUVmax was predictive of visually abnormal SPECT joints with high areas under receiver-operating-characteristic (ROC) curves for non-peripheral (BP-SPECT: 0.941 ± 0.017, DEL-SPECT: 0.910 ± 0.014) and especially peripheral (BP-SPECT: 0.980 ± 0.005, DEL-SPECT: 0.939 ± 0.012) joints. An SUVmax threshold-based prediction of visual SPECT abnormalities had high negative predictive values (BP-SPECT: 99.2% (1479/1491), DEL-SPECT: 97.2% (1333/1372)) but low positive predictive values (BP-SPECT: 35.1% (121/345), DEL-SPECT: 51.2% (237/463)). MRI- and US-defined IA were best predicted by a visually abnormal BP-SPECT due to higher specificities than SUVmax thresholds (all <i>p</i> < 0.05).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>On two-phase whole-body bone SPECT/CT, an SUVmax-based IA detection may not replace the conventional visual method. However, given the high negative predictive values provided by SUVmax thresholds, the time-consuming visual analysis of SPECT/CT slices could be confined to the small proportion of joints exceeding these thresholds.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"11 1","pages":""},"PeriodicalIF":7.6000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Standardized uptake value-based analysis of two-phase whole-body bone tomoscintigraphies recorded with a high-speed 360° CZT camera in patients with known or suspected inflammatory arthritis\",\"authors\":\"Franklin Rajadhas, Laetitia Imbert, Mathilde Fiorino, Caroline Morizot, Victor Boucher, Zohra Lamiral, Véronique Roch, Pierre-Yves Marie, Damien Loeuille, Isabelle Chary-Valckenaere, Achraf Bahloul\",\"doi\":\"10.1007/s00259-025-07150-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Purpose</h3><p>360° CZT-cameras provide whole-body bone SPECT/CT recordings at delayed (DEL) and blood-pool (BP) phases with short recording times but long visual analysis times. This study aims to determine whether a standardized uptake value (SUV)-based detection of inflammatory arthritis (IA) could facilitate this analysis.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>We included 72 patients with known or suspected IA who underwent two-phase whole-body bone SPECT/CT after 550–650 MBq [<sup>99m</sup>Tc]Tc-HDP injection. Forty-eight patients also had ultrasound (US) for peripheral IA, and 42 had MRI for axial IA. The skeleton was segmented into 26 joint areas and analyzed by trained observers using a visual consensus methodology and SUVmax measurements.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>A total of 1836 joint areas were analyzed, including 1126 peripheral ones (limb joints excluding hips and shoulders). SUVmax was predictive of visually abnormal SPECT joints with high areas under receiver-operating-characteristic (ROC) curves for non-peripheral (BP-SPECT: 0.941 ± 0.017, DEL-SPECT: 0.910 ± 0.014) and especially peripheral (BP-SPECT: 0.980 ± 0.005, DEL-SPECT: 0.939 ± 0.012) joints. An SUVmax threshold-based prediction of visual SPECT abnormalities had high negative predictive values (BP-SPECT: 99.2% (1479/1491), DEL-SPECT: 97.2% (1333/1372)) but low positive predictive values (BP-SPECT: 35.1% (121/345), DEL-SPECT: 51.2% (237/463)). MRI- and US-defined IA were best predicted by a visually abnormal BP-SPECT due to higher specificities than SUVmax thresholds (all <i>p</i> < 0.05).</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusion</h3><p>On two-phase whole-body bone SPECT/CT, an SUVmax-based IA detection may not replace the conventional visual method. However, given the high negative predictive values provided by SUVmax thresholds, the time-consuming visual analysis of SPECT/CT slices could be confined to the small proportion of joints exceeding these thresholds.</p>\",\"PeriodicalId\":11909,\"journal\":{\"name\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"volume\":\"11 1\",\"pages\":\"\"},\"PeriodicalIF\":7.6000,\"publicationDate\":\"2025-02-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00259-025-07150-0\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Nuclear Medicine and Molecular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00259-025-07150-0","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Standardized uptake value-based analysis of two-phase whole-body bone tomoscintigraphies recorded with a high-speed 360° CZT camera in patients with known or suspected inflammatory arthritis
Purpose
360° CZT-cameras provide whole-body bone SPECT/CT recordings at delayed (DEL) and blood-pool (BP) phases with short recording times but long visual analysis times. This study aims to determine whether a standardized uptake value (SUV)-based detection of inflammatory arthritis (IA) could facilitate this analysis.
Methods
We included 72 patients with known or suspected IA who underwent two-phase whole-body bone SPECT/CT after 550–650 MBq [99mTc]Tc-HDP injection. Forty-eight patients also had ultrasound (US) for peripheral IA, and 42 had MRI for axial IA. The skeleton was segmented into 26 joint areas and analyzed by trained observers using a visual consensus methodology and SUVmax measurements.
Results
A total of 1836 joint areas were analyzed, including 1126 peripheral ones (limb joints excluding hips and shoulders). SUVmax was predictive of visually abnormal SPECT joints with high areas under receiver-operating-characteristic (ROC) curves for non-peripheral (BP-SPECT: 0.941 ± 0.017, DEL-SPECT: 0.910 ± 0.014) and especially peripheral (BP-SPECT: 0.980 ± 0.005, DEL-SPECT: 0.939 ± 0.012) joints. An SUVmax threshold-based prediction of visual SPECT abnormalities had high negative predictive values (BP-SPECT: 99.2% (1479/1491), DEL-SPECT: 97.2% (1333/1372)) but low positive predictive values (BP-SPECT: 35.1% (121/345), DEL-SPECT: 51.2% (237/463)). MRI- and US-defined IA were best predicted by a visually abnormal BP-SPECT due to higher specificities than SUVmax thresholds (all p < 0.05).
Conclusion
On two-phase whole-body bone SPECT/CT, an SUVmax-based IA detection may not replace the conventional visual method. However, given the high negative predictive values provided by SUVmax thresholds, the time-consuming visual analysis of SPECT/CT slices could be confined to the small proportion of joints exceeding these thresholds.
期刊介绍：
The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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