Analysis of the application value of SUV in quantitative SPECT/CT for diagnosing benign and malignant bone lesions.

Objective: To analyze the application value of standardized uptake value (SUV) in quantitative single-photon emission computed tomography/computed tomography (SPECT/CT) based on the maximum expectation reconstruction algorithm for diagnosing benign and malignant bone lesions.

Subjects and methods: A retrospective analysis was conducted on the clinical data of 83 patients suspected of bone metastasis who underwent quantitative SPECT/CT bone scans in our hospital from September 2023 to July 2024. A total of 91 high-metabolic bone lesions were outlined for SUV measurement, while the spinal SUV of patients with normal bone metabolism were outlined as the control group (46 vertebral bodies). The maximum SUV (SUVmax), mean SUV (SUVmean), and minimum SUV (SUVmin) of benign lesions (benign group), malignant lesions (malignant group), and the control group were measured and compared. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic value of SUV in differentiating benign and malignant bone lesions using quantitative SPECT/CT.

Results: Based on the final diagnosis determined by pathology and/or imaging follow-up for 6-12 months or more, 50 malignant bone lesions and 41 benign bone lesions were identified. The levels of SUVmax, SUVmean, and SUVmin in the malignant and benign groups were higher than those in the control group, with the malignant group showing higher levels than the benign group (P<0.05). Receiver operating characteristic curve analysis showed that the areas under the curves for SUVmax, SUVmean, and SUVmin were 0.867, 0.909, and 0.896, respectively. The optimal cut-off value for SUVmax was 26.58g/mL, with a specificity of 100% and a sensitivity of 65.27%; for SUVmean, the optimal cutoff value was 12.75g/mL, with a sensitivity of 78.36% and a specificity of 93.54%; for SUVmin, the optimal cut-off value was 9.13g/mL, with a sensitivity and specificity of 81.42% and 89.87%, respectively. The diagnostic detection rate of quantitative SPECT/CT fusion imaging combined with SUVmean analysis (91.21%) was higher than that of conventional SPECT/CT fusion imaging qualitative analysis (74.73%) (P<0.05).

Conclusion: Standardized uptake value in quantitative SPECT/CT to some extent supplements the qualitative analysis of tumor bone metastasis and benign bone lesions, offering a higher accuracy in diagnosing tumor bone metastasis and differentiating between benign and malignant lesions compared to conventional SPECT/CT bone fusion imaging.