Skip to main content

Assessment of SPECT-CT fusion images and semi-quantitative evaluation using SUV in 123I-IMP SPECT in patients with choroidal melanoma

Annals of Nuclear Medicine volume 34, pages 864–872 (2020)Cite this article

Abstract

Objectives

The aim of this study was to assess the diagnostic ability of N-isopropyl-p-[I-123] iodoamphetamine (IMP) SPECT semi-quantitative evaluation based on the standardized uptake value (SUV) in patients with choroidal melanoma. The secondary aim was to investigate the 6-h IMP SPECT imaging in comparison with 24-h imaging.

Methods

Twenty-five patients (14 males and 11 females, mean age of 59.2-year-old) were analyzed in this retrospective study. Patients underwent 24-h IMP SPECT imaging with a gamma camera after intravenous injection of IMP. Twelve of 25 patients underwent 6-h SPECT imaging in addition to the 24-h imaging. All acquired SPECT images were fused with CT images using an image-analysis software. To assess the utility of semi-quantitative evaluation method, we introduced an image evaluation method using SUVmax comparing with conventional count-based uptake index (UI) evaluation of the lesion. Volumes-of-interest (VOIs) for SUVmax and regions-of-interest (ROIs) for UI were drawn referring to the SPECT-CT fusion image. Then the relationship between the 6- and 24-h images was examined both in SUV and UI evaluation. Furthermore, the relationship between the size category classification (SCC) by UICC/AJCC: 1–4 scales and each semi-quantitative value using SUVmax and UI was also assessed.

Results

SUVmax of the tumor was significantly higher than that of the normal side; 2.37 ± 0.88 and 1.77 ± 0.39 (P < 0.05) on 6-h image, 4.17 ± 1.73 and 2.04 ± 0.45 (P < 0.001) on 24-h image, respectively. UI of the tumor was also significantly higher than that of the normal side; 2.24 ± 0.67 and 1.53 ± 0.35 (P < 0.01) on 6-h image, 3.79 ± 1.24 and 1.67 ± 0.44 (P < 0.001) on 24-h image, respectively. There was a strong significant linear relationship in the evaluation with SUVmax between 6˗ and 24-h on the tumor side (R2 = 0.88, P < 0.0001), compared to that with Tumor˗UI (R2 = 0.35, P < 0.05). In addition, SUVmax of the tumor clearly differentiated the SCC of the tumor category 4 from that of category 1, where SUVmax of the tumor for categories 1‒4 were 2.56 ± 0.59, 4.33 ± 1.92, 4.63 ± 1.45, and 5.73 ± 1.69, respectively (P < 0.05, for categories 1 and 4).

Conclusions

The semi-quantitative evaluation by SUV of 123I-IMP SPECT images fused with CT images is useful for detecting choroidal melanoma. Moreover, 6-h imaging with SUV-based evaluation of 123I-IMP SPECT is promising compared to the conventional count-based UI evaluation method.

Trial registration This study is registered in UMIN Clinical Trials Registry (UMIN-CTR) as UMIN study ID: UMIN000038174.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

References

  1. Kato K, Kubota T, Ikeda M, Tadokoro M, Abe S, Nakano S, et al. Low efficacy of 18F-FDG PET for detection of uveal malignant melanoma compared with 123I-IMP SPECT. J Nucl Med. 2006;47:404–9.

    CAS  PubMed  Google Scholar 

  2. Singh P, Singh A. Choroidal melanoma. Oman J Ophthalmol. 2012;5(1):3–9.

    Article  Google Scholar 

  3. Goto H. Clinical efficacy of 123I-IMP SPECT for the diagnosis of malignant uveal melanoma. Int J Clin Oncol. 2004;9:74–8.

    Article  Google Scholar 

  4. Sou R, Oku N, Ohguro N, Hibino S, Fujikado T, Tano Y. The clinical role of N-isopropyl-p-[123I]-iodoamphetamine single photon emission computed tomography in the follow-up of choroidal melanoma after radiotherapy. Jpn J Ophthalmol. 2004;48:54–8.

    Article  Google Scholar 

  5. Abe K, Sasaki M, Koga H, Kaneko K, Sawamoto H, Yoshikawa H, et al. Clinical role of 123I-IMP SPECT for the differential diagnosis of ocular malignant melanoma: a time-course analysis. Nucl Med Commun. 2007;28:567–73.

    Article  Google Scholar 

  6. Inoue Y, Hara T, Ikari T, Takahashi K, Miyatake H, Abe Y. Super-early images of brain perfusion SPECT using (123)I-IMP for the assessment of hyperperfusion in stroke patients. Ann Nucl Med. 2018;32:695–701.

    Article  Google Scholar 

  7. Holman BL, Wick MM, Kaplan ML, Hill TC, Lee RG, Wu JL, et al. The relationship of the eye uptake of N-isopropyl-p-[123I]iodoamphetamine to melanin production. J Nucl Med. 1984;25(3):315–9.

    CAS  PubMed  Google Scholar 

  8. Cohen MB, Saxton RE, Lake RR, Cagle L, Graham LS, Nizze A, et al. Detection of malignant melanoma with iodine-123 iodoamphetamine. J Nucl Med. 1988;29:1200–6.

    CAS  PubMed  Google Scholar 

  9. Ono S, Fukunaga M, Otsuka N, Nagai K, Morita K, Furukawa T, et al. Visualization of ocular melanoma with N-isopropyl-p-[123I]-iodoamphetamine. J Nucl Med. 1988;29:1448–500.

    CAS  PubMed  Google Scholar 

  10. Yoshimura M, Kanesaka N, Saito K, Koizumi K, Tokuuye K, Goto H. Diagnosis of uveal malignant melanoma by a new semiquantitative assessment of N-isopropyl-p-[123I]-iodoamphetamine. Jpn J Ophthalmol. 2011;55:148–54.

    CAS  Article  Google Scholar 

  11. Kaneta T, Ogawa M, Daisaki H, Nawata S, Yoshida K, Inoue T. SUV measurement of normal vertebrae using SPECT/CT with Tc-99m methylene diphosphonate. Am J Nucl Med Mol. 2016;6:262–8.

    CAS  Google Scholar 

  12. Ogura I, Kobayashi E, Nakahara K, Igarashi K, Haga-Tsujimura M, Toshima H. Quantitative SPECT/CT imaging for medication-related osteonecrosis of the jaw: a preliminary study using volume-based parameters, comparison with chronic osteomyelitis. Ann Nucl Med. 2019;33:776–82.

    Article  Google Scholar 

  13. Umeda T, Koizumi M, Fukai S, Miyaji N, Motegi K, Nakazawa S, et al. Evaluation of bone metastatic burden by bone SPECT/CT in metastatic prostate cancer patients: defining threshold value for total bone uptake and assessment in radium-223 treated patients. Ann Nucl Med. 2018;32:105–13.

    CAS  Article  Google Scholar 

  14. Nakahara T, Daisaki H, Yamamoto Y, Iimori T, Miyagawa K, Okamoto T, et al. Use of a digital phantom developed by QIBA for harmonizing SUVs obtained from the state-of-the-art SPECT/CT systems: a multicenter study. EJNMMI Res. 2017;7:53.

    Article  Google Scholar 

  15. Fukukita H, Suzuki K, Matsumoto K, Terauchi T, Daisaki H, Ikari Y, et al. Japanese guideline for the oncology FDG-PET/CT data acquisition protocol: synopsis of Version 2.0. Ann Nucl Med. 2014;28:693–705.

    Article  Google Scholar 

  16. Nagamitsu S, Yamashita Y, Tanigawa H, Chiba H, Kaida H, Ishibashi M, et al. Upregulated GABA inhibitory function in ADHD children with child behavior checklist-dysregulation profile: 123I-iomazenil SPECT study. Front Psychiatry. 2015;6:84.

    Article  Google Scholar 

  17. The AJCC Ophthalmic Oncology Task Force. International validation of the American Joint Committee on cancer's 7th Edition classification of uveal melanoma. JAMA Ophthalmol. 2015;133:376–383.

    Article  Google Scholar 

  18. The AJCC Ophthalmic Oncology Task Force. Malignant melanoma of the uvea. In: Edge SE, Bryd DR, Compton CA, Fritz AG, Greene FL, A T, editors. AJCC cancer staging manual. 7th ed. 2010. p. 547–59.

  19. Brovkina AF, Stoyukhina AS, Chesalin IP. Size-based classification of choroidal melanoma and its role in treatment decision-making. Vestn Oftalmol. 2016;132:4–7.

    CAS  Article  Google Scholar 

  20. Kujala E, Damato B, Coupland SE, Desjardins L, Bechrakis NE, Grange JD, et al. Staging of ciliary body and choroidal melanomas based on anatomic extent. J Clin Oncol. 2013;31:2825–31.

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank the staff of the Department of Molecular Imaging and Theranostics, NIRS, QST, Department of Radiology, Juntendo University School of Medicine, Department of Charged Particle Therapy Research, NIRS, QST for their support, advice, and cooperation.

Funding

This research was supported by the internal fund of QST hospital, QST, Chiba Japan.

Author information

Affiliations

  1. Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba City, Chiba, 263-8555, Japan

    Kana Yamazaki, Ryuichi Nishii, Kentaro Tamura & Tatsuya Higashi

  2. Department of Radiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Kana Yamazaki & Koji Murakami

  3. Radiological Technology Section, QST Hospital, Quantum Medical Science Directorate, National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba City, Chiba, 263-8555, Japan

    Takamasa Maeda

  4. Department of Charged Particle Therapy Research, National Institute of Radiological Sciences (NIRS) and QST Hospital, National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba City, Chiba, 263-8555, Japan

    Hirokazu Makishima, Goro Kasuya, Tachen Chang, Masaru Wakatsuki & Hiroshi Tsuji

Authors
  1. Kana Yamazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ryuichi Nishii
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takamasa Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hirokazu Makishima
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Goro Kasuya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tachen Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kentaro Tamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masaru Wakatsuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hiroshi Tsuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Koji Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Tatsuya Higashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

KY was responsible for the research and wrote the main manuscript text as the first author. RN was responsible for this study as a corresponding author, and coordinated and served the entire study. TM was a radiological technologist and contributed to confirm the reliability of the SPECT imaging and provided technical advice. HM, GK, TC, and HT were radiation oncologists who were responsible for the planning patient examination, carbon-ion radiotherapy, and subsequent management. KT, KM, and TH contributed to writing the final manuscript. All members administrated this study. All authors also read and approved the final version of the manuscript.

Corresponding author

Correspondence to Ryuichi Nishii.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Yamazaki, K., Nishii, R., Maeda, T. et al. Assessment of SPECT-CT fusion images and semi-quantitative evaluation using SUV in 123I-IMP SPECT in patients with choroidal melanoma. Ann Nucl Med 34, 864–872 (2020). https://doi.org/10.1007/s12149-020-01517-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-020-01517-z

Keywords

  • IMP SPECT
  • Choroidal melanoma
  • SUV
  • 6-h imaging