目的评估SPECT/CT骨显像结合定量分析在SAHPO综合征(Synovitis,acne,pustulosis,hyperostosis and osteitis,SAPHO)诊疗中的临床应用价值。方法纳入自2023-05—2024-12临床确诊的35例SAPHO综合征,收集患者详细资料,包括存在骨关节症状...目的评估SPECT/CT骨显像结合定量分析在SAHPO综合征(Synovitis,acne,pustulosis,hyperostosis and osteitis,SAPHO)诊疗中的临床应用价值。方法纳入自2023-05—2024-12临床确诊的35例SAPHO综合征,收集患者详细资料,包括存在骨关节症状的部位、发病时间、有无皮肤改变等,所有患者均进行全身骨显像及局部病灶SPECT/CT检查,通过数据处理软件获取SUV参数,记录显像前后1周内红细胞沉降率、C-反应蛋白,分析比较SPECT/CT图像及定量参数与临床数据的相关性。结果全身骨显像显示所有患者均存在前胸壁不同程度放射性摄取增多,SPECT/CT融合图像能够清晰显示各部位骨质改变及代谢情况,表现为前胸壁骨质破坏、硬化、肥厚,关节间隙变窄或消失,肋软骨或肋锁韧带骨化,伴或不伴周围软组织肿胀。SPECT/CT定量参数SUVmax与红细胞沉降率呈正相关(r=0.338,P=0.047),SUVmax与C-反应蛋白呈正相关(r=0.346,P=0.042)。结论SPECT/CT骨显像能够全面显示SAPHO综合征骨关节受累及局部骨质破坏、修复状况,较平面骨显像更为准确,结合SUV定量摄取值可以更为直观显示受累骨骼的代谢状态,但是其与病变所处阶段及临床症状间的关联性还需深入探讨。展开更多
BACKGROUND^(68)Ga(gallium)-PSMA PET-CT(prostate-specific membrane antigen-directed Positron emission tomography-computed tomography)has established its role in prostate cancer management as targeted molecular imaging....BACKGROUND^(68)Ga(gallium)-PSMA PET-CT(prostate-specific membrane antigen-directed Positron emission tomography-computed tomography)has established its role in prostate cancer management as targeted molecular imaging.However,limited studies are available on the diagnostic accuracy of^(99m)Tc(Technetium)-PSMASPECT/CT.Due to its cost effectiveness and better feasibility,it needs to be explored more extensively for its incorporation into routine clinical practice.AIM To analyse the diagnostic accuracy of^(99m)Tc-PSMA-SPECT/CT for detection of primary prostate carcinoma.METHODS As a prospective study in a tertiary hospital,^(99m)Tc-PSMA-SPECT/CT was performed in 29 outpatients with suspected prostate cancer,with a median age of 66(range:50-82)years.The findings were compared to histopathology as the gold standard.RESULTS Nineteen of twenty-nine patients were positive on^(99m)Tc-PSMA-SPECT/CT,of which 16(84.2%)had prostate cancer on histopathology,while the remaining ten were negative on imaging,of which three had prostate cancer,leading to an overall sensitivity,specificity,and accuracy of 84.2%,70%,and 79.3%,respectively,on visual analysis.Prostate:background and prostate:liver ratios were 37.18±48.85 and 5.35±7.35 in the malignant group,while 6.65±5.17 and 1.14±0.56 in the benign group,respectively.The area under the curve values for prostate:background and prostate:liver ratios were 0.833(95%confidence interval[CI]:0.677-0.990,P=0.005)and 0.767(95%CI:0.596-0.937,P=0.024),respectively,on receiver operator curve analysis.A cut-off value>10.45 for prostate:background ratio(sensitivity 85%and specificity 88.9%),and>1.15 for prostate:liver ratio(sensitivity 75%and specificity of 77.8%respectively)was found to be pertinent to differentiate between the malignant vs benign groups.CONCLUSION^(99m)Tc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.展开更多
文摘目的评估SPECT/CT骨显像结合定量分析在SAHPO综合征(Synovitis,acne,pustulosis,hyperostosis and osteitis,SAPHO)诊疗中的临床应用价值。方法纳入自2023-05—2024-12临床确诊的35例SAPHO综合征,收集患者详细资料,包括存在骨关节症状的部位、发病时间、有无皮肤改变等,所有患者均进行全身骨显像及局部病灶SPECT/CT检查,通过数据处理软件获取SUV参数,记录显像前后1周内红细胞沉降率、C-反应蛋白,分析比较SPECT/CT图像及定量参数与临床数据的相关性。结果全身骨显像显示所有患者均存在前胸壁不同程度放射性摄取增多,SPECT/CT融合图像能够清晰显示各部位骨质改变及代谢情况,表现为前胸壁骨质破坏、硬化、肥厚,关节间隙变窄或消失,肋软骨或肋锁韧带骨化,伴或不伴周围软组织肿胀。SPECT/CT定量参数SUVmax与红细胞沉降率呈正相关(r=0.338,P=0.047),SUVmax与C-反应蛋白呈正相关(r=0.346,P=0.042)。结论SPECT/CT骨显像能够全面显示SAPHO综合征骨关节受累及局部骨质破坏、修复状况,较平面骨显像更为准确,结合SUV定量摄取值可以更为直观显示受累骨骼的代谢状态,但是其与病变所处阶段及临床症状间的关联性还需深入探讨。
文摘BACKGROUND^(68)Ga(gallium)-PSMA PET-CT(prostate-specific membrane antigen-directed Positron emission tomography-computed tomography)has established its role in prostate cancer management as targeted molecular imaging.However,limited studies are available on the diagnostic accuracy of^(99m)Tc(Technetium)-PSMASPECT/CT.Due to its cost effectiveness and better feasibility,it needs to be explored more extensively for its incorporation into routine clinical practice.AIM To analyse the diagnostic accuracy of^(99m)Tc-PSMA-SPECT/CT for detection of primary prostate carcinoma.METHODS As a prospective study in a tertiary hospital,^(99m)Tc-PSMA-SPECT/CT was performed in 29 outpatients with suspected prostate cancer,with a median age of 66(range:50-82)years.The findings were compared to histopathology as the gold standard.RESULTS Nineteen of twenty-nine patients were positive on^(99m)Tc-PSMA-SPECT/CT,of which 16(84.2%)had prostate cancer on histopathology,while the remaining ten were negative on imaging,of which three had prostate cancer,leading to an overall sensitivity,specificity,and accuracy of 84.2%,70%,and 79.3%,respectively,on visual analysis.Prostate:background and prostate:liver ratios were 37.18±48.85 and 5.35±7.35 in the malignant group,while 6.65±5.17 and 1.14±0.56 in the benign group,respectively.The area under the curve values for prostate:background and prostate:liver ratios were 0.833(95%confidence interval[CI]:0.677-0.990,P=0.005)and 0.767(95%CI:0.596-0.937,P=0.024),respectively,on receiver operator curve analysis.A cut-off value>10.45 for prostate:background ratio(sensitivity 85%and specificity 88.9%),and>1.15 for prostate:liver ratio(sensitivity 75%and specificity of 77.8%respectively)was found to be pertinent to differentiate between the malignant vs benign groups.CONCLUSION^(99m)Tc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.
