摘要
目的:评价正电子发射计算机断层扫描(positron emission tomography/computed tomography,PET/CT)18F标记的氟脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)全身显像与99mTc标记的亚甲基二磷酸盐(99mTc-methylene diphosphonate,99mTc-MDP)全身骨扫描(bone scintigraphy,BS)诊断转移性骨肿瘤的效能。方法:共计75例临床确诊的恶性肿瘤患者纳入本研究,平均年龄(59.85±13.50)岁。所有患者在2周内接受18F-FDG PET/CT显像和99mTc-MDP BS,以病例为单位,分别计算PET/CT显像与全身BS诊断骨转移的敏感度、特异度、阳性预测值(positive predictive value,PPV)、阴性预测值(negative predictive value,NPV)和准确度,并分析两者在全身不同区域的显像特点。结果:75例患者最终诊断为有骨转移者34例,无骨转移者41例。PET/CT显像诊断骨转移的敏感度和特异度分别为94.1%(32/34)和95.1%(39/41),诊断的PPV、NPV和准确性分别为94.1%、95.1%和94.7%。BS诊断的敏感度和特异度分别为91.2%(31/34)和65.9%(27/41),PPV、NPV和准确性分别为68.9%、90.0%和77.3%。PET/CT显像发现病灶数量较多的部位依次为脊柱、肋骨和骨盆,BS发现病灶数量较多的部位依次为肋骨、脊柱和四肢。结论:18F-FDG PET/CT显像诊断骨转移的特异性、准确性和PPV均明显高于BS,但两者在诊断敏感度和NPV方面并无明显差异。
Objective：To evaluate diagnostic value of PET/CT with 18 F-FDG and whole-body bone scintigraphy（BS）with 99m Tc-MDP for metastatic bone tumor in patients with malignancies.Methods：A total of 75 patients with malignances,average of 59.85 ± 13.59 years old,were included in this study.All patients underwent PET/CT imaging with 18 F-FDG and BS with 99m Tc-MDP for two weeks.Based on the diagnostic results of patients,we calculated the sensitivity,specificity,positive predictive value（PPV）,negative predictive value（NPV）,and accuracy of PET/CT imaging and BS method to detect bone metastasis.Moreover,image features on different body regions were assessed and compared between two imaging methods.Results：There were 34 patients diagnosed with skeletal metastasis among all 75 patients.The sensitivity of PET/CT was 94.1%（32/34） in detecting bone metastasis.The specificity of PET/CT was 95.1%（39/41）The PPV,NPV and accuracy of PET/CT were 94.1%,95.1% and 94.7%,respectively.For BS with 99m Tc-MDP,the sensitivity of detecting skeletal metastasis was 91.2%（31/34）and the specificity was 65.9%（27/41）.The PPV,NPV and accuracy of BS were 68.9 %,90 % and 77.3 %,respectively.On basis of region analysis,the main abnormal uptakes of 18 F-FDG were located in spine,rib and pelvis by PET/CT detection.For BS with 99m Tc-MDP,the main lesions were located in rib,spine and bones of limbs. Conclusion：The specificity,accuracy and PPV of PET/CT imaging were higher than those of BS.However,there was no significant difference in sensitivity and NPV between PET/CT imaging and BS.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2013年第1期126-130,共5页
Journal of Nanjing Medical University(Natural Sciences)
基金
江苏省人民医院诊疗新技术项目(2011年)
关键词
正电子发射计算机断层扫描
氟脱氧葡萄糖
骨转移
positron emissiion tomography/computed tomography
fluorodeoxyglucose
bone metastasis
