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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

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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.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea

    Hyun Gee Ryoo & Won Woo Lee

  2. Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea

    Won Woo Lee

  3. Department of Nuclear Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, South Korea

    Ji Young Kim

  4. Department of Nuclear Medicine, Yeungnam University Medical School and Hospital, Daegu, Gyeongsangbuk-do, South Korea

    Eunjung Kong

  5. Division of Nuclear Medicine, Department of Radiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Woo Hee Choi

  6. Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Woldeukeom-ro, Suwon-si, South Korea

    Joon-Kee Yoon

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  1. Hyun Gee Ryoo
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K-SPECT Group

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Correspondence to Won Woo Lee.

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Conflict of Interest

Hyun Gee Ryoo, Won Woo Lee, Ji Young Kim, Eunjung Kong, Woo Hee Choi, and Joon-Kee Yoon declare that there is no conflict of interest. This study was supported in part by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2018R1D1A1A09081961) and by the Korean Society of Nuclear Medicine Clinical Trial Network (KSNM CTN) working group funded by the Korean Society of Nuclear Medicine (KSNM-CTN-2017-01-01).

Ethical Approval

The study was approved by an institutional review board and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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The need for informed consents was waived by the institutional review board.

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Ryoo, H.G., Lee, W.W., Kim, J.Y. et al. 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. Nucl Med Mol Imaging 53, 287–295 (2019). https://doi.org/10.1007/s13139-019-00600-2

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