18F-NaF PET/CT显像与99mTc-MDP SPECT骨显像对乳腺癌患者骨转移诊断的对比研究  

Comparative study of 18F-NaF PET/CT imaging and 99mTc-MDP SPECT imaging in the diagnosis of breast cancer patients with bone metastasis

作　　者：石庆学 许欣茹 郭佳 左峰 张宗鹏 张国旭 王治国 SHI Qing-xue;XU Xin-ru;GUO Jia;ZUO Feng;ZHANG Zong-peng;ZHANG Guo-xu;WANG Zhi-guo(Department of Nuclear Medicine,General Hospital of Northern Theater Command,Shenyang 110840;China Medical Univeristy,Shenyang 110122,China)

机构地区：[1]北部战区总医院核医学科,辽宁沈阳110840 [2]中国医科大学,辽宁沈阳110122

出　　处：《中国临床医学影像杂志》2021年第1期40-43,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨18F-NaF PET/CT显像与99mTc-MDP SPECT显像对乳腺癌患者骨转移的诊断价值。方法:回顾性分析2017年12月—2019年6月间我院收治的乳腺癌患者35例。所有患者均在2周内行18F-NaF PET/CT显像与99mTc-MDP SPECT显像,以病理结果、X线、CT、MRI、临床随访等综合评价为诊断标准进行分析。结果:35例患者共检出病灶209处,其中29例患者的184处病灶最终确诊为骨转移灶,18F-NaF PET/CT诊断出全部29例骨转移患者,另误诊1例;99mTc-MDP SPECT确诊其中27例患者有骨转移,误诊2例,漏诊2例。以病例数为统计对象比较18F-NaF PET/CT与99mTc-MDP SPECT诊断效能,18F-NaF PET/CT显像的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为100.00%、83.33%、96.67%、100.00%、97.14%,99mTc-MDP SPECT全身骨显像的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为93.10%、66.67%、92.86%、66.67%、88.57%,差异无统计学意义(P>0.05);以病灶数为统计对象比较18F-NaF PET/CT与99mTc-MDP SPECT诊断效能,18FNaF PET/CT显像的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为98.91%、72.00%、96.29%、90.00%、95.69%,99mTcMDP SPECT全身骨显像的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为87.50%、60.00%、94.15%、39.47%、84.21%,差异有统计学意义(P<0.05)。结论:18F-NaF PET/CT显像诊断乳腺癌骨转移的效能优于99mTc-MDP SPECT全身骨显像。Objective:To explore the diagnostic value of18F-NaF PET/CT imaging and99mTc-MDP SPECT imaging in bone metastasis of breast cancer patients.Methods:A retrospective analysis of 35 breast cancer patients admitted to our hospital from December 2017 to June 2019 was performed.All patients underwent18F-NaF PET/CT imaging and99mTc-MDP SPECT imaging within 2 weeks.Comprehensive evaluations including pathological findings,X-ray,CT,MRI,and clinical follow-up were used as diagnostic criteria for analysis.Results:A total of 209 lesions were detected in 35 patients,184 of which were finally diagnosed as bone metastases,29 of which were diagnosed as bone metastases by18F-NaF PET/CT,1 of which was misdiagnosed,27 of which were diagnosed as bone metastases by99mTc-MDP SPECT,2 of which were misdiagnosed and 2 of which were missed.The diagnostic efficacy of18F-NaF PET/CT and99mTc-MDP SPECT was compared with the number of cases.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of18FNaF PET/CT imaging were 100.00%,83.33%,96.67%,100.00%,and 97.14%.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of99mTc-MDP SPECT whole-body bone imaging were 93.10%,66.67%,92.86%,66.67%and 88.57%.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of18F-NaF PET/CT imaging were 98.91%,72.00%,96.29%,90.00%and 95.69%with no statistical significance(P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of99mTc-MDP SPECT whole-body bone imaging were 87.50%,60.00%,94.15%,39.47%and 84.21%(P<0.05).Conclusion:18F-NaF PET/CT imaging is more effective than99mTc-MDP SPECT systemic bone imaging in the diagnosis of breast cancer bone metastasis.

关 键 词：乳腺肿瘤 骨肿瘤 肿瘤转移 正电子发射断层显像术 体层摄影术 发射型计算机 单光子 

分 类 号：R737.9[医药卫生—肿瘤] R738.1[医药卫生—临床医学]