Standardized Uptake Value Using Thyroid Quantitative SPECT/CT for the Diagnosis and Evaluation of Graves’ Disease: A Prospective Multicenter Study

Abstract

The clinical applications of the quantitative single photon emission computed tomography (SPECT)/computed tomography (CT) are being expanded to a variety of fields of nuclear medicine. However, clinical application of quantitative SPECT/CT for the evaluation of Graves’ disease (GD) still needs further investigation. Our aim was to investigate the feasibility of standard uptake value (SUV) of the thyroid for the clinical diagnosis and evaluation of GD. In this prospective multicenter study, 116 patients diagnosed with GD (Graves group) and 74 healthy volunteers (control group) were enrolled from 8 different hospitals. All patients underwent technetium pertechnetate (TcO99m4-) SPECT/CT imaging with Q.Metrix quantitative software and 24-hour thyroid radioactive iodine uptake (24h-RAIU) test. The SUVmax and SUVmean in Graves group were significantly higher than those of control group (P<0.01). Cut-off values of SUVmax and SUVmean to predict GD were 231.425 and 116.66 by ROC curves, respectively. The SUVmax and SUVmean in Graves patients were significantly related to serum thyroxine level with correlation coefficient of 0.493 and 0.512 for FT3 and 0.449 and 0.464 for FT4, respectively (all P<0.01). Additionally, the SUVmax and SUVmean in GD positively correlated with 24h-RAIU with a coefficient of 0.832 and 0.830, respectively (P<0.01). The volumes determined by Q.Metrix (35.65 ± 20.56ml) of 72 subjects also positively correlated with that from ultrasound (36.67 ± 21.00ml) with a coefficient of 0.927 (P<0.01). SUV measurements derived from thyroid SPECT/CT may be useful for the clinical diagnosis and evaluation of GD.

Single-Photon Emission Computed Tomography Image-Assisted Diagnosis of Thyroid Diseases under Convolutional Network Neural Algorithm

“…In this study, the sensitivity, specificity, accuracy, positive predictive rate, and negative predictive rate of 99m TcO 4 -SPECT in the diagnosis of thyroid disease were 95.2%, 90.3%, 91.5%, 94.3%, and 89.6%, respectively. e area under the curve of 99m TcO 4 -SPECT for thyroid disease diagnosis was 0.958, with a 95% confidence interval of 0.834 to 1, which indicated that SPECT imaging can accurately locate the lesion and obtain anatomical information, greatly reducing the misdiagnosis rate of 99m TcO 4 imaging, which was consistent with the results of Dong et al [20].…”

Tc-99m hydroxymethylene diphosphonate SPECT/CT for the evaluation of osteonecrosis of the jaw: preliminary study on diagnostic ability of maximum standardised uptake value

“…Kitajima et al 19 reported a case of periosteal sarcoma in a 10-year-old female patient, along with quantitative values obtained with bone SPECT/CT, which were useful to evaluate treatment response to preoperative chemotherapy. Dong et al 20 indicated SUV measurements derived from thyroid SPECT/CT may be useful for the clinical diagnosis and evaluation of Graves' disease. Arvola et al 21 showed that the strong correlation between SUVs and similar SUV ratios of 99m Tc-HDP SPECT/CT and 18 F-NaF PET/CT demonstrate that SPECT is an applicable tool for clinical quantification of bone metabolism in osseous metastases in breast and prostate cancer patients.…”

What validation tests can be done by the clinical medical physicist while waiting for the standardization of quantitative SPECT/CT imaging?

“…For this reason, doctors are unable to analyze changes in the standardized uptake value for imaged tumors if the patient has been examined with different scanners, even in the same nuclear medicine department. Clinical publications reporting SUVmax and SUVmean measured in patients' images should provide SPECT/CT acquisition parameters, but also details regarding the image reconstruction technique [20][21][22][23]. This would allow for an initial comparison of quantification results for pathological changes in images acquired with different SPECT/CT systems.…”