Correlation Between the Maximum Standard Uptake Value and Mean Hounsfield Unit on Single-photon Emission Computed Tomography-computed Tomography to Discriminate Benign and Metastatic Lesions Among Patients with Breast Cancer

Overview

Journal Asian Spine J

Date 2024 Jun 25

PMID 38917860

Authors

S Thadchaiani Saminathan

Wan Aireene Wan Ahmed

Norazlina Mat Nawi

Nashrulhaq Tagiling

Ilyana Aziz

Yusri Udin

Mohd Fazrin Mohd Rohani

Wan Mohd Nazlee Wan Zainon

Mohammad Khairul Azhar Abdul Razab

Affiliations

Soon will be listed here.

Abstract

Study Design: Retrospective study.

Purpose: To compare and correlate technetium-99m methylene diphosphonate uptake between benign and metastatic bone lesions using semiquantitative analysis of maximum standard uptake value (SUVmax) and mean Hounsfield unit (HU) in single-photon emission computed tomography-computed tomography (SPECT-CT).

Overview Of Literature: Qualitative interpretation of metastatic bone lesions in breast cancer on bone scintigraphy is often complicated by coexisting benign lesions.

Methods: In total, 185 lesions were identified on bone and SPECT-CT scans from 32 patients. Lesions were classified as metastatic (109 sclerotic lesions) and benign (76 lesions) morphologically on low-dose CT. Semiquantitative analysis using SUVmax and mean HU was performed on the lesions and compared. To discriminate benign and metastatic lesions, the correlation between SUVmax and mean HU was determined using the intraclass correlation coefficients.

Results: The SUVmax was higher in metastatic lesions (20.66±14.36) but lower in benign lesions (10.18±12.79) (p<0.001). The mean HU was lower in metastatic lesions (166.62±202.02) but higher in benign lesions (517.65±192.8) (p<0.001). A weak negative correlation was found between the SUVmax and the mean HU for benign lesions, and a weak positive correlation was noted between the SUVmax and the mean HU on malignant lesions with no statistical significance (p=0.394 and 0.312, respectively). The cutoff values obtained were 10.8 for SUVmax (82.6% sensitivity and 84.2% specificity) and 240.86 for the mean HU (98.7% sensitivity and 88.1% specificity) in differentiating benign from malignant bone lesions.

Conclusions: Semiquantitative assessment using SUVmax and HU can complement qualitative analysis. Metastatic lesions had higher SUVmax but lower mean HU than benign lesions, whereas benign lesions demonstrated higher mean HU but lower SUVmax. A weak correlation was found between the SUVmax and the mean HU on malignant and benign lesions. Cutoff values of 10.8 for the SUVmax and 240.86 for the mean HU may differentiate bone metastases from benign lesions.

Citing Articles

Diagnostic Ability of Quantitative Parameters of Whole-Body Bone SPECT/CT Using a Full-Ring 360° Cadmium-Zinc-Telluride Camera for Detecting Bone Metastasis in Patients with Prostate Cancer.

Yoo I, Hong S, Lee S, Yang H, Kim K, Kim S Diagnostics (Basel). 2024; 14(23).

PMID: 39682622 PMC: 11639772. DOI: 10.3390/diagnostics14232714.

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