Utility of Quantitative and Semi-Quantitative SPECT/CT Metrics in Differentiating Mueller-Weiss Syndrome

Area of Science:

• Nuclear Medicine
• Radiology
• Orthopedics

Background:

• Mueller-Weiss syndrome (MWS) is a rare condition causing osteonecrosis of the navicular bone in adults.
• Accurate diagnosis of MWS is crucial for effective treatment and management.

Purpose of the Study:

• To evaluate the diagnostic performance of quantitative and semi-quantitative standardized uptake value (SUV) measurements using Tc-99m MDP SPECT/CT.
• To differentiate MWS from other foot pathologies based on SPECT/CT findings.

Main Methods:

• Retrospective review of 21 MWS patients and 5 controls who underwent Tc-99m MDP SPECT/CT.
• Measurement of SUVmax in the navicular bone (N) and tibial metaphysis/diaphysis (Tm/Td).
• Calculation of N/Tm and N/Td uptake ratios for semi-quantitative analysis.

Main Results:

• MWS patients exhibited significantly higher navicular SUVmax and N/Tm, N/Td ratios compared to controls (p < 0.001).
• SUVmax and uptake ratios correlated positively with MWS severity (Maceira stage) and visual uptake intensity.
• Established diagnostic thresholds for SUVmax and ratios demonstrated high accuracy (AUC > 0.93) in distinguishing MWS.

Conclusions:

• Quantitative and semi-quantitative SUV analysis on SPECT/CT is a reliable method for diagnosing MWS.
• Semi-quantitative ratios offer a practical and reproducible alternative for early MWS detection and treatment planning.