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Nuclear Medicine and Molecular Imaging
Published in: Nuclear Medicine and Molecular Imaging 4/2019

01-08-2019 | Computed Tomography | Original Article

Minimum Standardized Uptake Value from Quantitative Bone Single-Photon Emission Computed Tomography/Computed Tomography for Evaluation of Femoral Head Viability in Patients with Femoral Neck Fracture

Authors: Hyun Gee Ryoo, Won Woo Lee, Ji Young Kim, Eunjung Kong, Woo Hee Choi, Joon-Kee Yoon, K-SPECT Group

Published in: Nuclear Medicine and Molecular Imaging | Issue 4/2019

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Abstract

Purpose

Bone single-photon emission computed tomography/computed tomography (SPECT/CT) has been widely used for evaluation of femoral head viability in patients with femoral neck fracture. The current study aimed to investigate utility of standardized uptake value (SUV) from quantitative bone SPECT/CT for assessment of femoral head viability.

Methods

From March 2015 to November 2018, quantitative bone SPECT/CT was performed in 9 patients with non-viable femoral head post femoral neck fracture and in 31 controls. Maximum (SUVmax), mean (SUVmean), and minimum standardized uptake values (SUVmin) were measured over femoral head and neck. Mann-Whitney U test with Bonferroni correction was used to compare SUVs of ipsilateral and contralateral femurs from femoral neck fracture patients with those of control femurs.

Results

As for femoral head viability, SUVmax and SUVmean were not significantly decreased in non-viable femoral heads compared to those in controls. Only the SUVmin was significantly reduced in non-viable femoral heads (mean ± standard deviation, 0.57 ± 0.38) than in controls (0.95 ± 0.26, p = 0.006) and contralateral femoral heads (1.36 ± 0.59, p = 0.008). The cutoff SUVmin of 0.61 (g/mL) yielded a sensitivity of 77.8% and specificity of 87.1% for detection of non-viable femoral heads (p = 0.006). Contralateral femoral necks of the femoral neck fracture patients showed significantly higher SUVmean and SUVmin (3.17 ± 1.20 and 1.64 ± 0.63) than those of controls (2.32 ± 0.53 and 1.04 ± 0.27; p = 0.021 and p = 0.002, respectively), which seemed to reflect weight bearing effect or metabolic derangement.

Conclusions

The non-viable femoral heads from the femoral neck fracture showed significantly reduced SUVmin. Quantitative bone SPECT/CT holds promise for objective evaluation of femoral head viability.
Appendix
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Literature
1.
Lewis SL, Rees JI, Thomas GV, Williams LA. Pitfalls of bone scintigraphy in suspected hip fractures. Br J Radiol. 1991;64:403–8.CrossRefPubMed
2.
Sarikaya I, Sarikaya A, Holder LE. The role of single photon emission computed tomography in bone imaging. Semin Nucl Med. 2001;31:3–16.CrossRefPubMed
3.
Collier BD, Carrera GF, Johnson RP, Isitman AT, Hellman RS, Knobel J, et al. Detection of femoral head avascular necrosis in adults by SPECT. J Nucl Med. 1985;26:979–87.PubMed
4.
Ryu JS, Kim JS, Moon DH, Kim SM, Shin MJ, Chang JS, et al. Bone SPECT is more sensitive than MRI in the detection of early osteonecrosis of the femoral head after renal transplantation. J Nucl Med. 2002;43:1006–11.PubMed
5.
Luk WH, Au-Yeung AW, Yang MK. Diagnostic value of SPECT versus SPECT/CT in femoral avascular necrosis: preliminary results. Nucl Med Commun. 2010;31:958–61.CrossRefPubMed
6.
Agarwal KK, Mukherjee A, Sharma P, Bal C, Kumar R. Incremental value of 99mTc-MDP hybrid SPECT/CT over planar scintigraphy and SPECT in avascular necrosis of the femoral head. Nucl Med Commun. 2015;36:1055–62.CrossRefPubMed
7.
Han S, Oh M, Yoon S, Kim J, Kim JW, Chang JS, et al. Risk stratification for avascular necrosis of the femoral head after internal fixation of femoral neck fractures by post-operative bone SPECT/CT. Nucl Med Mol Imaging. 2017;51:49–57.CrossRefPubMed
8.
Bailey DL, Willowson KP. An evidence-based review of quantitative SPECT imaging and potential clinical applications. J Nucl Med. 2013;54:83–9.CrossRefPubMed
9.
Bailey DL, Willowson KP. Quantitative SPECT/CT: SPECT joins PET as a quantitative imaging modality. Eur J Nucl Med Mol Imaging. 2014;41(Suppl 1):S17–25.CrossRef
10.
Suh MS, Lee WW, Kim YK, Yun PY, Kim SE. Maximum standardized uptake value of (99m) Tc Hydroxymethylene diphosphonate SPECT/CT for the evaluation of temporomandibular joint disorder. Radiology. 2016;280:890–6.CrossRefPubMed
11.
Lee H, Kim JH, Kang YK, Moon JH, So Y, Lee WW. Quantitative single-photon emission computed tomography/computed tomography for technetium pertechnetate thyroid uptake measurement. Medicine (Baltimore). 2016;95:e4170.CrossRef
12.
Kim J, Lee HH, Kang Y, Kim TK, Lee SW, So Y, et al. Maximum standardised uptake value of quantitative bone SPECT/CT in patients with medial compartment osteoarthritis of the knee. Clin Radiol. 2017;72:580–9.CrossRefPubMed
13.
Kim HJ, Bang JI, Kim JY, Moon JH, So Y, Lee WW. Novel application of quantitative single-photon emission computed tomography/computed tomography to predict early response to Methimazole in Graves' disease. Korean J Radiol. 2017;18:543–50.CrossRefPubMedPubMedCentral
14.
Kang YK, Park S, Suh MS, Byun SS, Chae DW, Lee WW. Quantitative single-photon emission computed tomography/computed tomography for glomerular filtration rate measurement. Nucl Med Mol Imaging. 2017;51:338–46.CrossRefPubMedPubMedCentral
15.
Kim JY, Kim JH, Moon JH, Kim KM, Oh TJ, Lee DH, et al. Utility of quantitative parameters from single-photon emission computed tomography/computed tomography in patients with destructive thyroiditis. Korean J Radiol. 2018;19:470–80.CrossRefPubMedPubMedCentral
16.
Kim J, Lee H, Lee H, Bang JI, Kang YK, Bae S, et al. Quantitative single-photon emission computed tomography/computed tomography for evaluation of salivary gland dysfunction in Sjogren's syndrome patients. Nucl Med Mol Imaging. 2018;52:368–76.CrossRefPubMed
17.
Lee R, So Y, Song YS, Lee WW. Evaluation of hot nodules of thyroid gland using Tc-99m Pertechnetate: a novel approach using quantitative single-photon emission computed tomography/computed tomography. Nucl Med Mol Imaging. 2018;52:468–72.CrossRefPubMed
18.
Bae S, Kang Y, Song YS, Lee WW, Group KS. Maximum standardized uptake value of foot SPECT/CT using Tc-99m HDP in patients with accessory navicular bone as a predictor of surgical treatment. Medicine (Baltimore). 2019;98:e14022.CrossRef
19.
Casara D, de Besi P, Fiorentino M, Fornasiero A, Melanotte P, Palu G, et al. False positive bone scan in bone tumors of the lower limb. Eur J Nucl Med. 1977;2:179–81.CrossRefPubMed
20.
Lee WW, Kim TU, Kim TH, Jung CY, Moon JH. Usefulness of three-phasic bone scan in young male patients suspected of post-traumatic reflex sympathetic dystrophy syndrome. Nucl Med Mol Imaging. 2001;35:52–60.
21.
Israel O, Lubushitzky R, Frenkel A, Iosilevsky G, Bettman L, Gips S, et al. Bone turnover in cortical and trabecular bone in normal women and in women with osteoporosis. J Nucl Med. 1994;35:1155–8.PubMed
22.
Fogelman I, Bessent RG, Cohen HN, Hart DM, Lindsay R. Skeletal uptake of diphosphonate. Method for prediction of post-menopausal osteoporosis. Lancet. 1980;2:667–70.CrossRefPubMed
23.
Israel O, Front D, Hardoff R, Ish-Shalom S, Jerushalmi J, Kolodny GM. In vivo SPECT quantitation of bone metabolism in hyperparathyroidism and thyrotoxicosis. J Nucl Med. 1991;32:1157–61.PubMed
24.
Markisz JA, Knowles RJ, Altchek DW, Schneider R, Whalen JP, Cahill PT. Segmental patterns of avascular necrosis of the femoral heads: early detection with MR imaging. Radiology. 1987;162:717–20.CrossRefPubMed
25.
Beltran J, Herman LJ, Burk JM, Zuelzer WA, Clark RN, Lucas JG, et al. Femoral head avascular necrosis: MR imaging with clinical-pathologic and radionuclide correlation. Radiology. 1988;166:215–20.CrossRefPubMed
Metadata
Title
Minimum Standardized Uptake Value from Quantitative Bone Single-Photon Emission Computed Tomography/Computed Tomography for Evaluation of Femoral Head Viability in Patients with Femoral Neck Fracture
Authors
Hyun Gee Ryoo
Won Woo Lee
Ji Young Kim
Eunjung Kong
Woo Hee Choi
Joon-Kee Yoon
K-SPECT Group
Publication date
01-08-2019
Publisher
Springer Berlin Heidelberg
Published in
Nuclear Medicine and Molecular Imaging / Issue 4/2019
Print ISSN: 1869-3474
Electronic ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-019-00600-2

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