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Relationship between tumor volume and quantitative values calculated using two-dimensional bone scan images.

Shota Hosokawa1,2, Kazumasa Inoue3, Yasuyuki Takahashi2

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The bone scan index (BSI) can estimate tumor volume, but its accuracy varies with tumor uptake and location. Thoracic spine tumors require careful BSI interpretation due to potential underestimation of tumor burden.

Keywords:
Bone scan indexBone scintigraphyComputer-aided diagnosisGeant4Monte Carlo simulation

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Area of Science:

  • Nuclear Medicine
  • Medical Imaging
  • Oncology

Background:

  • The bone scan index (BSI) quantifies bone tumor burden using 2D imaging.
  • Its accuracy in reflecting 3D tumor volume is not fully established.
  • BSI is used for prognosis and treatment assessment.

Purpose of the Study:

  • To investigate the relationship between tumor volume and BSI.
  • To evaluate the accuracy of 2D BSI in representing 3D tumor spread.
  • To assess the impact of radiotracer uptake on BSI accuracy.

Main Methods:

  • Monte Carlo simulation (MCS) of a gamma camera and anthropomorphic phantom.
  • Simulated technetium-99m-labeled methylene diphosphonate (99mTc-MDP) uptake in bone, soft tissue, and tumors.
  • Analysis of simulated bone scan images using BSI calculation software.

Main Results:

  • BSI increased with higher tumor 99mTc-MDP uptake.
  • Significant differences in BSI were not always observed for uptake increases of eightfold or more.
  • BSI correlated with tumor volume for four-to-eightfold uptake but underestimated volume in the thoracic spine.

Conclusions:

  • BSI is generally a good indicator of tumor volume, influenced by 99mTc-MDP uptake.
  • BSI values from thoracic spine tumors require cautious interpretation.
  • Further validation is needed for BSI accuracy across different skeletal segments.