A voxel based visulization and quantitation in identifying scintigraphy bone lesions and its potential impact on diagnostic and therapeutic applications

Despite a wide array of clinical SPECT/CT applications in many fields of nuclear medicine, its quantitative application of bone imaging has not been well established. SPECT/CT has been considered not quantitative but qualitative because there has been a very limited report on the proven clinical utility of quantitative SPECT (SUV) for any disease model up to present. We proposed a visual pixilated assessment and quantitative evaluation of changes in local tracer uptake and bone lesion boundaries for patients with bone disease susing DICOM file viewer and MATLAB for data analysis. The technique applied to an IEC phantom and a limited number of NM bone images. Initial phantom imaging provided an accurate quantitation with less than %5 error compare to the known inserted activity. There was good correlation (CC= 0.88) between MATLAB and Xeleris SUV calculations for patients with bone diseases. Extent and severity of pre and post therapy responses for any selected tomography slices as well as identification of the CT information density (HU) for an individually selected voxel can be achieved in particular, where tumor cell resistance can be variable and so the response to therapy. The interchangeability of the DICOM files together with MATLAB can be done conveniently without the special application software from any vendors to provide a personalized quantification for bone SPECT/CT.