Publications by authors named "Hazlin Hashim"

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Maximum standardized uptake value from quantitative bone single-photon emission computed tomography/computed tomography in differentiating metastatic and degenerative joint disease of the spine in prostate cancer patients.

Ann Nucl Med 2020 Jan 14;34(1):39-48. Epub 2019 Oct 14.

Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, Penang, Malaysia.

Objective: Qualitative interpretation in bone scan is often complicated by the presence of degenerative joint disease (DJD), especially in the elderly patient. The aim of this study is to compare objectively Tc-MDP tracer uptake between DJD and osseous metastases of the spine using semi-quantitative assessment with SPECT SUV.

Methods: Bone scan with SPECT/CT using Tc-MDP was performed in 34 patients diagnosed with prostate carcinoma. SPECT/CT was performed based on our institutional standard guidelines. SUV based on body weight in 238 normal vertebrae visualized on SPECT/CT was quantified as baseline. A total of 211 lesions in the spine were identified on bone scan. Lesions were characterized into DJD or bone metastases based on its morphology on low-dose CT. Semi-quantitative evaluation using SUV was then performed on 89 DJD and 122 metastatic bone lesions. As most of the bone lesions were small in volume, the effect of partial volume effect (PVE) on SUV was also assessed. The corrected SUV values were obtained based on the recovery coefficient (RC) method.

Results: The mean SUV for normal vertebrae was 7.08 ± 1.97, 12.59 ± 9.01 for DJD and 36.64 ± 24.84 for bone metastases. The SUV of bone metastases was significantly greater than DJD (p value < 0.05). To assess for diagnostic accuracy, receiver operating characteristic (ROC) curve was performed. The area under the curve (AUC) was found to be fairly high at 0.874 (95% CI 0.826-0.921). The cutoff SUV value ≥ 20 gave a sensitivity of 73.8% and specificity of 85.4% in differentiating bone metastases from DJD. The corrected SUV for both DJD and bone metastases was smaller with a mean of 6.82 ± 6.02 and 24.77 ± 20.61, respectively. The cutoff SUV value was also lower with a value of 10, which gave a sensitivity of 73.8% and specificity of 86.5%.

Conclusion: SPECT SUV was significantly higher in bone metastases than DJD. Semi-quantitative assessment with SUV can complement qualitative analysis. A cutoff SUV of ≥ 20 can be used to differentiate bone metastases from DJD. Partial volume effect should be taken into consideration in the quantification of small lesion size.
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http://dx.doi.org/10.1007/s12149-019-01410-4DOI Listing
January 2020
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