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

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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.

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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.

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Authors and 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

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  1. Kana Yamazaki
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  2. Ryuichi Nishii
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  11. Tatsuya Higashi
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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.

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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

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

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