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      Standardized Uptake Value Using Thyroid Quantitative SPECT/CT for the Diagnosis and Evaluation of Graves’ Disease: A Prospective Multicenter Study

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          Abstract

          The clinical applications of the quantitative single photon emission computed tomography (SPECT)/computed tomography (CT) are being expanded to a variety of fields of nuclear medicine. However, clinical application of quantitative SPECT/CT for the evaluation of Graves’ disease (GD) still needs further investigation. Our aim was to investigate the feasibility of standard uptake value (SUV) of the thyroid for the clinical diagnosis and evaluation of GD. In this prospective multicenter study, 116 patients diagnosed with GD (Graves group) and 74 healthy volunteers (control group) were enrolled from 8 different hospitals. All patients underwent technetium pertechnetate ( T c O 99 m 4 - ) SPECT/CT imaging with Q.Metrix quantitative software and 24-hour thyroid radioactive iodine uptake (24h-RAIU) test. The SUVmax and SUVmean in Graves group were significantly higher than those of control group ( P<0.01). Cut-off values of SUVmax and SUVmean to predict GD were 231.425 and 116.66 by ROC curves, respectively. The SUVmax and SUVmean in Graves patients were significantly related to serum thyroxine level with correlation coefficient of 0.493 and 0.512 for FT 3 and 0.449 and 0.464 for FT 4, respectively (all P<0.01). Additionally, the SUVmax and SUVmean in GD positively correlated with 24h-RAIU with a coefficient of 0.832 and 0.830, respectively ( P<0.01). The volumes determined by Q.Metrix (35.65 ± 20.56ml) of 72 subjects also positively correlated with that from ultrasound (36.67 ± 21.00ml) with a coefficient of 0.927 ( P<0.01). SUV measurements derived from thyroid SPECT/CT may be useful for the clinical diagnosis and evaluation of GD.

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          Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine.

          The clinical performance of a laboratory test can be described in terms of diagnostic accuracy, or the ability to correctly classify subjects into clinically relevant subgroups. Diagnostic accuracy refers to the quality of the information provided by the classification device and should be distinguished from the usefulness, or actual practical value, of the information. Receiver-operating characteristic (ROC) plots provide a pure index of accuracy by demonstrating the limits of a test's ability to discriminate between alternative states of health over the complete spectrum of operating conditions. Furthermore, ROC plots occupy a central or unifying position in the process of assessing and using diagnostic tools. Once the plot is generated, a user can readily go on to many other activities such as performing quantitative ROC analysis and comparisons of tests, using likelihood ratio to revise the probability of disease in individual subjects, selecting decision thresholds, using logistic-regression analysis, using discriminant-function analysis, or incorporating the tool into a clinical strategy by using decision analysis.
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              Clinical practice. Graves' disease.

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                Author and article information

                Journal
                BioMed Research International
                BioMed Research International
                Hindawi Limited
                2314-6133
                2314-6141
                January 30 2019
                January 30 2019
                : 2019
                : 1-8
                Affiliations
                [1 ]Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
                [2 ]Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
                [3 ]Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, Hebei, China
                [4 ]Department of Nuclear Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shanxi, China
                [5 ]Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
                [6 ]Department of Nuclear Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China
                [7 ]Department of Nuclear Medicine, The People’s Hospital of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia, China
                [8 ]Department of Nuclear Medicine, Guangzhou Panyu Central Hospital, Guangzhou, China
                Article
                10.1155/2019/7589853
                5b98bf03-96db-4afa-8a18-448877287431
                © 2019

                http://creativecommons.org/licenses/by/4.0/

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