The Value of Quantitative Analysis of Radionuclide Bone SPECT/CT Imaging in Vertebral Compression Fracture: a Retrospective Study

Overview

Journal BMC Med Imaging

Publisher Biomed Central

Specialty Radiology

Date 2024 Oct 8

PMID 39379844

Authors

Yuhua Wang

Feifei Qiao

Na Li

Ye Liu

Yahong Long

Kang Xu

Jiantao Wang

Wanchun Zhang

Affiliations

Soon will be listed here.

Abstract

Background: Most patients with osteoporosis experience vertebral compression fracture (VCF), which significantly reduces their quality of life. These patients are at a high risk of secondary VCF regardless of treatment. Thus, accurate diagnosis of VCF is important for treating and preventing new fractures. We aimed to investigate the diagnostic and predictive value of quantitative bone imaging techniques for fresh VCF.

Methods: From November 2021 to March 2023, 34 patients with VCF were enrolled in this study, all of whom underwent routine Tc-MDP whole-body bone planar scan and local SPECT/CT imaging. The maximum standard uptake value (SUVmax) of 57 fresh VCF, 57 normal adjacent vertebrae, and 19 old VCF were measured. Based on the site of the fracture, fresh VCFs were regrouped into the intervertebral-type group and the margin-type group. Meanwhile, 52 patients who had no bone metastasis or VCFs in their bone scan were assigned to the control group. The SUVmax of 110 normal vertebral bodies and 10 old VCFs in the control group were measured.

Results: The median SUVmax of fresh VCF was 19.80, which was significantly higher than the SUVmax of other groups. The receiver operator characteristic (ROC) curve showed that the cut-off value of SUVmax was 9.925 for diagnosing fresh VCF. The SUVmax in the intervertebral-type group was significantly higher than that in the margin-type group (P = 0.04). The SUVmax of normal vertebrae was higher among patients than among the control group (P<0.01), but the CT HU value showed no significant difference.

Conclusion: The quantitative technique of bone SPECT/CT has a significant value in diagnosing fresh VCF. It can also determine the severity of fractures. In addition, whether the SUVs of the vertebrae adjacent to the fractured vertebra can predict re-fracture deserves further studies.

References

Imamudeen N, Basheer A, Mohamed Iqbal A, Manjila N, Haroon N, Manjila S . Management of Osteoporosis and Spinal Fractures: Contemporary Guidelines and Evolving Paradigms. Clin Med Res. 2022; 20(2):95-106. PMC: 9242734. DOI: 10.3121/cmr.2021.1612. View

Ji C, Rong Y, Wang J, Yu S, Yin G, Fan J . Risk Factors for Refracture following Primary Osteoporotic Vertebral Compression Fractures. Pain Physician. 2021; 24(3):E335-E340. View

Zhao Q, Gu X, Liu Z, Cheng L . The Value of Radionuclide Bone Imaging in Defining Fresh Fractures Among Osteoporotic Vertebral Compression Fractures. J Craniofac Surg. 2016; 27(3):745-8. DOI: 10.1097/SCS.0000000000002594. View

Dugonjic S, Ajdinovic B, Cirkovic M, Ristic G . Bone scintigraphy can diagnose osteoporotic vertebral compression fractures better than conventional radiography. Hell J Nucl Med. 2018; 20 Suppl:155. View

Yang Z, Xing D, Dong Z, Wei J, Zhang L, Gao S . Epidemiological Investigation of 387 Individuals Over 65 Years Old With Osteoporotic Fractures. Altern Ther Health Med. 2023; 29(3):207-211. View

Genant H, Jergas M, Palermo L, Nevitt M, Valentin R, Black D . Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis The Study of Osteoporotic Fractures Research Group. J Bone Miner Res. 1996; 11(7):984-96. DOI: 10.1002/jbmr.5650110716. View

Li Y, Zheng X, Wang R, Wu H, Han S, Deng Z . SPECT-CT versus MRI in localizing active lesions in patients with osteoporotic vertebral compression fractures. Nucl Med Commun. 2018; 39(7):610-617. DOI: 10.1097/MNM.0000000000000857. View

Wang Y, Ruiz Santiago F, Deng M, Nogueira-Barbosa M . Identifying osteoporotic vertebral endplate and cortex fractures. Quant Imaging Med Surg. 2017; 7(5):555-591. PMC: 5682396. DOI: 10.21037/qims.2017.10.05. View

Soldati E, Rossi F, Vicente J, Guenoun D, Pithioux M, Iotti S . Survey of MRI Usefulness for the Clinical Assessment of Bone Microstructure. Int J Mol Sci. 2021; 22(5). PMC: 7958958. DOI: 10.3390/ijms22052509. View

10.

Yu W, Xu W, Jiang X, Liang D, Jian W . Risk Factors for Recollapse of the Augmented Vertebrae After Percutaneous Vertebral Augmentation: A Systematic Review and Meta-Analysis. World Neurosurg. 2017; 111:119-129. DOI: 10.1016/j.wneu.2017.12.019. View

11.

. Prevention and management of osteoporosis. World Health Organ Tech Rep Ser. 2004; 921:1-164, back cover. View

12.

Kutsal F, Ergin Ergani G . Vertebral compression fractures: Still an unpredictable aspect of osteoporosis. Turk J Med Sci. 2020; 51(2):393-399. PMC: 8203169. DOI: 10.3906/sag-2005-315. View

13.

Lentle B, Koromani F, Brown J, Oei L, Ward L, Goltzman D . The Radiology of Osteoporotic Vertebral Fractures Revisited. J Bone Miner Res. 2019; 34(3):409-418. DOI: 10.1002/jbmr.3669. View

14.

Rao R, Singrakhia M . Painful osteoporotic vertebral fracture. Pathogenesis, evaluation, and roles of vertebroplasty and kyphoplasty in its management. J Bone Joint Surg Am. 2003; 85(10):2010-22. View

15.

Kano S, Tanikawa H, Mogami Y, Shibata S, Takanashi S, Oji Y . Comparison between continuous and discontinuous multiple vertebral compression fractures. Eur Spine J. 2012; 21(9):1867-72. PMC: 3459131. DOI: 10.1007/s00586-012-2210-6. View

16.

Zhao Y, Zhang T, Tang P . Diagnostic value of SPECT/CT bone imaging in fresh osteoporotic vertebral compression fractures. Hell J Nucl Med. 2022; 25(2):138-142. DOI: 10.1967/s002449912473. View

17.

Li C, Lai X, Liu N, Lin Y, Hu W . Correlation analysis of the vertebral compression degree and CT HU value in elderly patients with osteoporotic thoracolumbar fractures. J Orthop Surg Res. 2023; 18(1):457. PMC: 10294538. DOI: 10.1186/s13018-023-03941-z. View

18.

Szulc P, Munoz F, Marchand F, Delmas P . Semiquantitative evaluation of prevalent vertebral deformities in men and their relationship with osteoporosis: the MINOS study. Osteoporos Int. 2001; 12(4):302-10. DOI: 10.1007/s001980170120. View

19.

Mitani K, Takahashi T, Tokunaga S, Inoue T, Kanematsu R, Minami M . Therapeutic Prediction of Osteoporotic Vertebral Compression Fracture Using the AO Spine-DGOU Osteoporotic Fracture Classification and Classification-Based Score: A Single-Center Retrospective Observational Study. Neurospine. 2024; 20(4):1166-1176. PMC: 10762420. DOI: 10.14245/ns.2346776.388. View

20.

Okazaki T, Nakagawa H, Yagi K, Hayase H, Nagahiro S, Saito K . Bone scintigraphy for the diagnosis of the responsible level of osteoporotic vertebral compression fractures in percutaneous balloon kyphoplasty. Clin Neurol Neurosurg. 2016; 152:23-27. DOI: 10.1016/j.clineuro.2016.11.007. View