SPECT/CT骨定量标准化摄取值分析脊柱骨转移瘤的价值△

Significance of bone standardized uptake value of SPECT / CT for analyzing spinal metastases

摘要:

[目的] 探讨 SPECT/CT 骨定量标准化摄取值 (standardized uptake value, SUV) 分析对脊柱骨转移瘤的价值。[方法] 回顾性分析 2020 年 7 月—2021 年 12 月本院 54 例脊柱骨转移确诊患者的 99mTc-MDP SPECT/CT 骨显像资料。比较不同性别间正常椎体 SUV 差异；分析正常椎体 SUV 与身体参数相关性；比较正常骨与病灶之间、不同原发肿瘤病灶之间、边缘清晰与不清晰病灶之间 SUV 差异。采用 ROC 分析 SUVmax、SUVmean判断病灶与正常骨的价值。[结果]两性间正常椎骨 SUV_max、SU- V_mean差异均无统计学意义(P＞0.05)。正常椎骨 SUV_mean与年龄呈显著负相关(P＜0.05)；SUV_max 和 SUV_mean与 BMI 呈显著正相关 (P＜0.05)。脊柱骨转移病灶的 SUV_max、SUV_mean显著高于正常椎体(P＜0.05)。不同原发肿瘤间 SUV_max、SUV_mean差异均无统计学意义(P＞0.05)。边缘清晰与不清晰脊柱骨转移瘤病灶间 SUV_max、SUV_mean差异均无统计学意义(P＞0.05)。ROC 分析显示 SUV_max、 SUV_mean的 AUC 分别为 0.983(95%CI: 0.966~1.000)和 0.965(95%CI: 0.928~1.000)灵敏度分别为 92.6%和 96.3%，特异度分别为 96.3%和 88.9%；SUV_max和 SUV_mean对脊柱骨转移瘤最佳诊断阈值分别为 11.5、5.7。[结论]正常椎体骨 SUV 与 BMI 呈显著正相关，SPECT/CT 骨定量 SUV 分析对诊断脊柱骨转移瘤有一定临床价值。

Abstract:

[Objective] To explore the value of bone standardized uptake value (SUV) of SPECT/CT for spinal metastases. [Methods] The 99mTc-MDP SPECT/CT bone imaging data of 54 patients who were diagnosed of bone metastasis in our hospital from July 2020 to Decem- ber 2021 were retrospectively analyzed. The SUV were compared between the two genders in normal vertebrae, while the correlation between normal vertebral SUV and body parameters was analyzed. In addition, the SUVs were compared between the normal bone and lesions, among different primary tumor lesions, and between lesions with clear and unclear edges. Furthermore, receiver operator characteristic curve analy- sis was conducted to search the value of SUV_max and SUV_mean for differentiate lesion and normal bone. [Results] There were no significant dif- ferences in SUV_max and SUV_mean of normal vertebrae between two genders (P＞0.05) . However, the SUVmean of normal vertebrae was negatively correlated with age (P＜0.05) , while the SUVmax and SUVmean were positively correlated with BMI (P＜0.05) . The SUVmax and SUVmean in the vertebral metastases lesion were significantly higher than those in the normal vertebral bodies (P＜0.05) , nevertheless, there were no signifi- cant differences in SUVmax and SUVmean among different primary tumors (P＞0.05) . There were no significant differences in SUV_max and SU- V_mean between the lesion with clear edge and that with unclear edge (P＞0.05) . As results of ROC analysis, the SUV_max and SUV_mean had area under cure (AUC) of 0.983 (95%CI: 0.966~1.000) and 0.965 (95%CI: 0.928~1.000) , sensitivity of 92.6% and 96.3%, and specificity of 96.3%和 88.9% , respectively. The optimal diagnostic thresholds of SUV_max and SUV_mean were 11.5 and 5.7, respectively. [Conclusion] There is a significant positive correlation between normal vertebral bone SUV and BMI. SPECT/CT quantitative bone SUV analysis has cer- tain clinical value in the diagnosis of spinal bone metastases.