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Diagnostics
Volume 16
Issue 1
10.3390/diagnostics16010018
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

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

by
Yi-Ching Lin
1,2,3,
Shih-Chuan Tsai
1,
Chia-Hung Kao
4,5,6,7 and
Shun-Ping Wang
3,8,*
1
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
2
Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung 406, Taiwan
3
Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
4
Department of Nuclear Medicine, China Medical University, Taichung 404, Taiwan
5
Artificial Intelligence Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
6
Graduate Institute of Biomedical Sciences, School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
7
Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan
8
Department of Orthopaedics, Taichung Veterans General Hospital, Taichung 407, Taiwan
*
Author to whom correspondence should be addressed.
Diagnostics 2026, 16(1), 18; https://doi.org/10.3390/diagnostics16010018 (registering DOI)
Submission received: 8 November 2025 / Revised: 12 December 2025 / Accepted: 17 December 2025 / Published: 20 December 2025
(This article belongs to the Section Medical Imaging and Theranostics)
Review Reports Versions Notes

Abstract

Background/Objectives: Mueller–Weiss syndrome (MWS) is a rare condition characterized by spontaneous adult-onset osteonecrosis of the navicular bone. This study aimed to assess the diagnostic value of quantitative and semi-quantitative standardized uptake value (SUV) measurements on Tc-99m MDP SPECT/CT for differentiating MWS from other foot pathologies. Methods: We retrospectively reviewed 21 MWS patients who underwent SPECT/CT and compared them with 10 feet from 5 non-MWS patients as controls. MWS severity was staged using the Maceira classification. Volumes of interest (VOIs) were defined in the lateral navicular and distal tibia. SUVmax values were measured for the navicular bone (N), tibial metaphysis (Tm), and diaphysis (Td). Uptake ratios (N/Tm and N/Td) were calculated for semi-quantitative comparison. Results: MWS patients showed significantly higher SUVmax in the navicular compared with controls (9.2 vs. 1.5, p < 0.001). Both N/Tm and N/Td ratios were also significantly elevated (p < 0.001). SUVmax and uptake ratios positively correlated with Maceira stage and visual navicular uptake intensity. Diagnostic thresholds of N SUVmax > 3.77 (AUC = 0.93), N/Tm > 1.139 (AUC = 0.95), and N/Td > 0.93 (AUC = 0.93) effectively distinguished MWS from non-MWS cases. Conclusion: Quantitative and semi-quantitative SUV analysis on SPECT/CT offers a reliable tool for diagnosing MWS and evaluating disease severity. Semi-quantitative ratios, by normalizing metabolic variability, provide a practical and reproducible alternative to absolute SUV measurements for early detection and treatment planning in MWS.
Keywords: Mueller–Weiss; navicular; Maceira classification; SUV; bone scan; SPECT/CT; quantitative; semi-quantitative Mueller–Weiss; navicular; Maceira classification; SUV; bone scan; SPECT/CT; quantitative; semi-quantitative

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MDPI and ACS Style

Lin, Y.-C.; Tsai, S.-C.; Kao, C.-H.; Wang, S.-P. Utility of Quantitative and Semi-Quantitative SPECT/CT Metrics in Differentiating Mueller–Weiss Syndrome. Diagnostics 2026, 16, 18. https://doi.org/10.3390/diagnostics16010018

AMA Style

Lin Y-C, Tsai S-C, Kao C-H, Wang S-P. Utility of Quantitative and Semi-Quantitative SPECT/CT Metrics in Differentiating Mueller–Weiss Syndrome. Diagnostics. 2026; 16(1):18. https://doi.org/10.3390/diagnostics16010018

Chicago/Turabian Style

Lin, Yi-Ching, Shih-Chuan Tsai, Chia-Hung Kao, and Shun-Ping Wang. 2026. "Utility of Quantitative and Semi-Quantitative SPECT/CT Metrics in Differentiating Mueller–Weiss Syndrome" Diagnostics 16, no. 1: 18. https://doi.org/10.3390/diagnostics16010018

APA Style

Lin, Y.-C., Tsai, S.-C., Kao, C.-H., & Wang, S.-P. (2026). Utility of Quantitative and Semi-Quantitative SPECT/CT Metrics in Differentiating Mueller–Weiss Syndrome. Diagnostics, 16(1), 18. https://doi.org/10.3390/diagnostics16010018

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