ArticleEJNMMI physics2024
From SPECT/CT towards absolute quantification? - the case of unilateral condylar hyperplasia of the mandible.
Article in EJNMMI physics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Critical review of partial volume correction methods in PET and SPECT imaging: benefits, pitfalls, challenges, and future outlook.European journal of nuclear medicine and molecular imaging · 2026Review
- Quantitative SPECT/CT: Technique and Clinical Applications.Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer · 2026Review
- Unilateral mandibular condylar hyperplasia with ipsilateral masticator muscle and parotid gland hypertrophy: a rare incidental finding on brain MRI.BMC musculoskeletal disorders · 2025Article
- Facial Foramen Diagnostic and Surgical Role as Reference Points in Asymmetries-Cone-Beam Computed Tomography Preliminary Study.Journal of clinical medicine · 2025Article
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Abstract
backgroundUnilateral condylar hyperplasia (UCH) of the mandible is a rare condition characterized by asymmetric growth of the mandibular condyles. Bone scintigraphy with SPECT(/CT) is commonly used to diagnose UCH and guide treatment. Still, varying results have been reported using the traditional threshold of 55%:45% in relative tracer uptake. While absolute quantification of uptake on SPECT/CT could improve results, optimal correction and reconstruction settings are currently unknown.
methodsThree anthropomorphic phantoms representing UCH were developed from patient CT volumes and produced using 3D printing technology. Fillable spherical inserts of different sizes (Ø: 8-15 mm) were placed in the condylar positions representing symmetrical and asymmetrical distributions. Recovery coefficients were determined for SPECT/CT using various reconstruction corrections, including attenuation and scatter correction (ACSC), resolution modeling (RM), and partial volume correction (PVC) using phantom measurements. Uptake ratios between condyles and condyle to clivus were evaluated. Finally, the impact of these correction techniques on absolute activity and diagnostic accuracy was assessed in a retrospective patient cohort for the diagnostic threshold of 55%:45%.
resultsThe activity was only partially recovered in all spherical inserts (range: 22.5-64.9%). However, RM improved relative recovery by 20.2-62.3% compared to ACSC. In the symmetric phantoms, the 95% confidence interval (CI) of condyle ratios included the diagnostic threshold (57.6%:42.4%) for UCH when using ACSC potentially leading to false positives, but not for ACSCRM datasets. Partial volume corrections coefficients from the NEMA IQ phantom was positionally dependent, with improvements seen performing PVC using coefficients derived from anthropomorphic phantoms. Retrospective application in a patient cohort showed only a weak linear correlation (R²: 0.25-0.67) and large limits of agreement (9.6-12.5%) between different reconstructions. Up to 44% of patients were reclassified using the 55%:45% threshold. Using clinical outcome data, ACSCRM had highest sensitivity (91%; 95% CI 59-100%) and specificity (66%; 95% CI 47-81%), significantly improving specificity (P = 0.038).
conclusionsAnthropomorphic phantoms were shown to be essential in determining optimal settings for acquisition, reconstruction, and analysis. SPECT/CT reconstructions with attenuation and scatter correction and resolution modeling are recommended and could improve specificity when using the 55%:45% threshold to assess condylar growth.
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