# Establishing Standardized Uptake Value Threshold for Urologic Malignancies With New Analytic Software Based on Extended Single-Photon Emission Computed Tomography-Processed Bone Scintigraphy Images

## TL;DR

This paper introduces a new software tool for nuclear medicine imaging that helps establish accurate diagnostic thresholds for urologic cancers.

## Contribution

The paper presents a novel method for defining optimal SUV thresholds using GI-BONE software with extended SPECT imaging.

## Key findings

- The GI-BONE system enables BCF calculation for SPECT images, enabling SUV analysis.
- The method allows clinicians to establish disease-specific SUV thresholds for improved diagnosis.
- The approach enhances analytical refinement in conventional SPECT imaging for better evaluation.

## Abstract

Accurate reference thresholds are critical for reliable interpretation and quantification in nuclear medicine imaging. In recent years, single-photon emission computed tomography (SPECT)/CT systems capable of standardized uptake value (SUV) analysis have become commercially available; however, most SPECT/CT systems lack the capability to perform SUV analysis. The GI-BONE system (AZE Co., Ltd., Tokyo, Japan) is a new vendor-free software that incorporates a tool for calculating the becquerel calibration factor (BCF), which converts SPECT images from a count-based scale to a radioactivity concentration scale comparable to that of PET. This study aimed to first describe a way for defining optimal SUV threshold specific to GI-BONE analysis using extended SPECT (xSPECT), which is characterized by its capability to facilitate more precise diagnosis and evaluation through enhanced analytical refinement to conventional SPECT imaging. This approach can guide clinicians in formulating their own disease system-specific thresholds, an indispensable step in adapting GI-BONE as a newly applicable and reliable mode of xSPECT verification technology.