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Matsuda N, Otsuka H, Kasai R, Otani T, Bollos LACL, Azane S, Kunikane Y, Otomi Y, Ueki Y, Okabe M, Amano M, Tamaki M, Wakino S, Takao S, Harada M. Quantitative evaluation of 67Ga-citrate scintigraphy in the management of nephritis. Sci Rep 2024; 14:16313. [PMID: 39009630 PMCID: PMC11250846 DOI: 10.1038/s41598-024-66823-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 07/04/2024] [Indexed: 07/17/2024] Open
Abstract
In 67Ga-citrate scintigraphy (Ga-S), visual assessment is used by evaluating renal-uptake comparison with liver and spine and is simple and objective. We adopted the standardized uptake value (SUV) for 67Ga-citrate and proposed two quantitative indices, active nephritis volume (ANV) and total nephritis uptake (TNU). This study clarified the utility of new Ga-S-based quantitative indices in nephritis management. Before SUV measurement, the Becquerel calibration factor of 67Ga-citrate was obtained using a phantom experiment. Seventy patients who underwent SPECT/CT imaging were studied. SUV, ANV, and TNU were calculated using a quantitative analysis software for bone SPECT. SUVmean, ANV, and TNU were analyzed using the (1) threshold method (set 40%) and constant-value method for (2) vertebral SUVmax, and (3) vertebral SUVmean. ROC analysis was used to evaluate SUV, ANV, and TNU diagnostic abilities to distinguish nephritis presence and absence as well as interstitial nephritis (IN) and non-IN. The area under the curve (AUC) for nephritis presence or absence had a good value (0.80) for SUVmean (1), ANV (3), and TNU (3). The AUC for differentiation between IN and non-IN groups had a good value (0.80) for SUVmean (1). Thus, the new Ga-S-based quantitative indices were useful to evaluate nephritis and distinguish IN and non-IN.
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Affiliation(s)
- Noritake Matsuda
- Department of Radiology, Tokushima University Hospital, Kuramoto-cho 2-50-1, Tokushima, 770-8503, Japan
| | - Hideki Otsuka
- Department of Medical Imaging/Nuclear Medicine, Tokushima University Graduate School of Biomedical Sciences, Kuramoto-cho 3-18-15, Tokushima, Tokushima, 770-8503, Japan.
| | - Ryosuke Kasai
- Department of Medical Imaging/Nuclear Medicine, Tokushima University Graduate School of Biomedical Sciences, Kuramoto-cho 3-18-15, Tokushima, Tokushima, 770-8503, Japan
| | - Tamaki Otani
- Advance Radiation Research, Education and Management Center, Tokushima University, Kuramoto-cho 3-18-15, Tokushima, Tokushima, 770-8503, Japan
| | | | - Shota Azane
- Department of Radiology, Tokushima University Hospital, Kuramoto-cho 2-50-1, Tokushima, 770-8503, Japan
| | - Yamato Kunikane
- Department of Radiology, Tokushima University Hospital, Kuramoto-cho 2-50-1, Tokushima, 770-8503, Japan
| | - Yoichi Otomi
- Department of Radiology and Radiation Oncology, Tokushima University Graduate School of Biomedical Sciences, Kuramoto-cho 2-50-1, Tokushima, 770-8503, Japan
| | - Yuya Ueki
- Tokushima University Graduate School of Biomedical Sciences, Kuramoto-cho 3-18-15, Tokushima, Tokushima, 770-8503, Japan
| | - Mana Okabe
- Radiology Service, Shiga University of Medical Science Hospital, Seta Tsukinowacho, Otsu-shi, Shiga, 520-2192, Japan
| | - Masafumi Amano
- Department of Radiology, Tokushima University Hospital, Kuramoto-cho 2-50-1, Tokushima, 770-8503, Japan
| | - Masanori Tamaki
- Department of Nephrology, Tokushima University Graduate School of Biomedical Sciences, Kuramoto-cho 2-50-1, Tokushima, 770-8503, Japan
| | - Shu Wakino
- Department of Nephrology, Tokushima University Graduate School of Biomedical Sciences, Kuramoto-cho 2-50-1, Tokushima, 770-8503, Japan
| | - Shoichiro Takao
- Tokushima University Graduate School of Biomedical Sciences, Kuramoto-cho 3-18-15, Tokushima, Tokushima, 770-8503, Japan
| | - Masafumi Harada
- Tokushima University Graduate School of Biomedical Sciences, Kuramoto-cho 3-18-15, Tokushima, Tokushima, 770-8503, Japan
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Ueki Y, Otsuka H, Otani T, Kasai R, Otomi Y, Ikemitsu D, Azane S, Kunikane Y, Bando T, Matsuda N, Okada Y, Takayama T, Harada M. Combined visual and quantitative assessment of somatostatin receptor scintigraphy for staging and restaging of neuroendocrine tumors. Jpn J Radiol 2024; 42:519-535. [PMID: 38345724 DOI: 10.1007/s11604-024-01529-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/03/2024] [Indexed: 04/30/2024]
Abstract
PURPOSE Somatostatin receptor scintigraphy (SRS) using 111In-DTPA-DPhe1-octreotide (pentetreotide) has become an integral part of neuroendocrine neoplasm management. The lack of precise quantification is a disadvantage of SRS. This study aimed to adapt the standardized uptake value (SUV) to SRS, establish the SUV range for physiological uptake in the liver, kidney, and spleen, and elucidate the utility of combined visual and quantitative SRS assessment for staging and restaging of neuroendocrine tumors (NETs). MATERIALS AND METHODS This study included 21 patients with NETs who underwent 111In-pentetreotide SRS. The SUV of physiological and pathological uptake was calculated using bone single-photon emission computed tomography (SPECT) quantitative analysis software (GI-BONE). For visual analysis, the primary and metastatic lesions were scored visually on planar and SPECT images using a five-point scale. We assessed the relationships between the SUVs of the liver, kidney, and spleen in the dual phase, and among quantitative indices, visual score, and pathological lesions classification. RESULTS Sixty-three NEN lesions were evaluated. The mean ± standard deviation maximum SUVs (SUVmax) were liver: 4 h, 2.6 ± 1.0; 24 h, 2.2 ± 1.0; kidney: 4 h, 8.9 ± 1.8; 24 h, 7.0 ± 2.0; and spleen; 4 h, 11.3 ± 4.5; 24 h, 11.5 ± 7.6. Higher SUVmax was significantly associated with higher visual scores on dual-phase SPECT (4 h, p < 0.001; 24 h, p < 0.001) (4 h: scores 3 and 4, p < 0.05; scores 3 and 5: p < 0.01; scores 4 and 5: p < 0.01; 24 h: scores 3 and 4, p = 0.0748; scores 3 and 5: p < 0.01; scores 4 and 5: p < 0.01). CONCLUSION We adapted the SUV to SRS and established the range of SUV for physiological uptake in the liver, kidney, and spleen. Combined visual and quantitative assessment is useful for imaging individual lesions in greater detail, and may serve as a new tumor marker of SRS for staging and restaging of NETs.
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Affiliation(s)
- Yuya Ueki
- Tokushima University Graduate School of Health Sciences, Tokushima, Japan
| | - Hideki Otsuka
- Department of Medical Imaging/Nuclear Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
| | - Tamaki Otani
- Advance Radiation Research, Education and Management Center, Tokushima University, Tokushima, Japan
| | - Ryosuke Kasai
- Department of Medical Imaging/Nuclear Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yoichi Otomi
- Department of Radiology and Radiation Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Daiki Ikemitsu
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Shota Azane
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Yamato Kunikane
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Takanori Bando
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Noritake Matsuda
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Yasuyuki Okada
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tetsuji Takayama
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masafumi Harada
- Department of Radiology and Radiation Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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Missir E, Begley P, Jessop M, Singh N, Aplin M, McMeekin H, Parekh P, Raczek M, Dizdarevic S. Quantitative [123]I-Ioflupane DaTSCAN single-photon computed tomography-computed tomography in Parkinsonism. Nucl Med Commun 2023; 44:843-853. [PMID: 37395542 DOI: 10.1097/mnm.0000000000001729] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
AIM [123]I-Ioflupane (DaTSCAN) binds to the presynaptic dopamine transporter (DAT) and with a lower affinity to the serotonin transporter (SERT). We aimed to develop a novel method to quantify absolute uptake in the striatal (predominantly DAT binding) and extra-striatal regions (mainly SERT binding) using single-photon computed tomography-computed tomography (SPECT-CT) DaTSCAN and to improve DaTSCAN image quality. METHOD Twenty-six patients with Parkinsonism underwent DaTSCAN SPECT-CT prospectively. The scans were visually analyzed independently by two experienced reporters. Specific binding ratios (SBRs) from Chang attenuation corrected SPECT were obtained using GE DaTQuant. Normalized concentrations and specific uptakes (NSU) from measured attenuation and modelled scatter-corrected SPECT-CT were obtained using HERMES Hybrid Recon and Affinity and modified EARL volumes of interest. RESULTS Striatal NSU and SBR positively correlate ( R = 0.65-0.88, P = 0.00). SBR, normalized concentrations, and NSU box plots differentiated between scans without evidence of dopaminergic deficit and abnormal scans. Interestingly, body weight inversely correlated with normalized concentrations values in extra-striatal regions [frontal ( R = 0.81, P = 0.00); thalamus ( R = 0.58, P = 0.00); occipital ( R = 0.69, P = 0.00)] and both caudate nuclei [ R = 0.42, P = 0.03 (Right), R = 0.52, P = 0.01 (Left)]. Both reporters noted improved visual quality of SPECT-CT versus SPECT images for all scans. CONCLUSION DaTSCAN SPECT-CT resulted in more accurate quantification, improved image quality, and enabled absolute quantification of extra-striatal regions. More extensive studies are required to establish the full value of absolute quantification for diagnosis and monitoring the progression of neurodegenerative disease, to assess an interplay between DAT and SERT, and to verify whether serotonin and DATs are potentially dysfunctional in obesity.
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Affiliation(s)
| | - Patrick Begley
- Nuclear Medicine Department, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust
| | - Maryam Jessop
- Nuclear Medicine Department, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust
| | - Nitasha Singh
- Nuclear Medicine Department, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust
| | - Mark Aplin
- Nuclear Medicine Department, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust
| | | | | | - Malgorzata Raczek
- Nuclear Medicine Department, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust
| | - Sabina Dizdarevic
- Brighton and Sussex Medical School
- Nuclear Medicine Department, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust
- Clinical Imaging Science Centre, Neuroscience and Medicine, Brighton and Sussex Medical School, UK
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