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Preliminary Study for Quantitative Assessment of Sacroiliitis Activity Using Bone SPECT/CT: Comparison of Diagnostic Performance of Quantitative Parameters

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Abstract

Purpose

We compared the feasibility of quantitative analysis methods using bone SPECT/CT with those using planar bone scans to assess active sacroiliitis.

Methods

We retrospectively reviewed whole-body bone scans and pelvic bone SPECT/CTs of 8 patients who had clinically confirmed sacroiliitis and enrolled 24 patients without sacroiliitis as references. The volume of interest of each sacroiliac joint, including both the ilium and sacrum, was drawn. Active arthritis zone (AAZ) was defined as the zone of voxels with higher SUV than sacral mean SUV within the VOI of SI joint. Then, the following SPECT/CT quantitative parameters, SUVmax (maximum SUV), SUV50% (mean SUV in highest 50% of SUV), and SUV-AAZ, and the ratio of those values to sacral mean SUV (SUVmax/S, SUV50%/S, SUV-AAZ/S) were calculated. For the planar bone scan, the mean count ratio of SI joint/sacrum (SI/S) was conventionally measured.

Results

Most of the SPECT/CT parameters of the sacroiliitis group were significantly higher than the normal group, whereas SI/S of the planar bone scan was not significantly different between the two groups. In receiver operating characteristic curve analysis, SUV-AAZ/S showed the highest AUC of 0.992, followed by SUV50%/S and SUVmax/S. All ratio parameters of the SPECT/CT showed higher AUC values than the SUV parameters of SI joint or SI/S of the planar scan.

Conclusions

The quantitative analyses of bone SPECT/CT showed better performance in assessing active sacroiliitis than the planar bone scan. SPECT/CT parameters using the ratio of the SI joint to sacrum showed more favorable results than SUV parameters such as SUVmax, SUV50%, and SUV-AAZ.

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Data Availability

The datasets generated during the current study are available from the corresponding author on request.

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Acknowledgements

The authors would like to thank Youngwoong Ha and Jangwon Park, technologists in the Department of Nuclear Medicine, Asan Medical Center, for their excellent technical assistance.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Koeun Lee, Yong-il Kim, Jungsu S. Oh & Jin-Sook Ryu

  2. Department of Nuclear Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea

    Hyunji Kim

  3. Health Innovation Big Data Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea

    Bumwoo Park

  4. Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea

    Woo Hyun Shim

  5. Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Seokchan Hong & Yong-Gil Kim

Authors
  1. Koeun Lee
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Contributions

The study was designed by Jin-Sook Ryu and Yong-il Kim. Material preparation and data collection were performed by Koeun Lee, Seokchan Hong, Yong-Gil Kim, Bumwoo Park, and Woo Hyun Shim. The data analysis was performed by Koeun Lee and Jungsu S. Oh. The first draft of the manuscript was written by Koeun Lee, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jin-Sook Ryu.

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Conflict of Interest

Author Koeun Lee, Author Hyunji Kim, Author Yong-il Kim, Author Bumwoo Park, Author Woo Hyun Shim, Author Jungsu S. Oh, Author Seokchan Hong, Author Yong-Gil Kim, and Author Jin-Sook Ryu declare that they have no competing interests.

Ethics Approval and Consent to Participate

The present study was approved by the institutional review board of the Asan Medical Center (IBR No: 2021–0113), and the requirement for written consent was waived by the institutional review board. All procedures performed in this study involving human participants were in accordance with the ethical standards of the respective Institutional Research Committee and with the 2013 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent for Publication

The Institutional Review Board at our institute approved this retrospective study, and the requirement to obtain informed consent was waived.

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Lee, K., Kim, H., Kim, Yi. et al. Preliminary Study for Quantitative Assessment of Sacroiliitis Activity Using Bone SPECT/CT: Comparison of Diagnostic Performance of Quantitative Parameters. Nucl Med Mol Imaging 56, 282–290 (2022). https://doi.org/10.1007/s13139-022-00766-2

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  • DOI: https://doi.org/10.1007/s13139-022-00766-2

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