^(99)mTc-MDP SPECT/CT显像定量分析对前列腺癌骨转移的诊断价值以及SUV的一致性研究  

Quantitative analysis of ^(99)mTc-MDP SPECT/CT imaging in the diagnosis of bone metastases from prostate cancer and the consistency of SUV

作　　者：陆海健 周勇 林红萍 吴雨豪 袭荣胜 LU Haijian;ZHOU Yong;LIN Hongping;WU Yuhao;XI Rongsheng(Department of Nuclear Medicine,Zhejiang Jinhua Guangfu Tumor Hospital,Jinhua 321000,China)

机构地区：[1]浙江金华广福肿瘤医院核医学科,321000

出　　处：《浙江医学》2023年第11期1152-1156,共5页Zhejiang Medical Journal

摘　　要：目的研究锝-99m-亚甲基二磷酸盐(^(99)mTc-MDP)单光子发射计算机断层成像(SPECT/CT)显像定量分析对前列腺癌骨转移的诊断价值以及标准化摄取值(SUV)的一致性,以期为临床诊疗提供参考。方法回顾性分析2021年1月到2022年3月在浙江金华广福肿瘤医院接受诊治的47例前列腺癌患者的^(99)mTc-MDP SPEC/CT显像影像学资料。所有患者均进行^(99)mTc-MDP SPECT/CT全身骨显像检查,收集患者骨转移瘤病灶平均体积、平均SUV(SUVmean)和最大SUV(SUVmax),并收集患者正常腰椎的SUVmax测量值,比较骨转移瘤病灶SUVmax测量值与正常腰椎的水平差异,采用ROC曲线分析SUVmax对前列腺癌骨转移的诊断效能。另外,分别采用CV、Bland-Altman、组内相关系数(ICC)分析同一观察者和不同观察者间测量结果的变异性和重复性。结果47例前列腺癌患者共测量前列腺癌骨转移瘤病灶337例,选取患者85个正常椎体进行对比,骨转移瘤病灶SUVmax测量值明显高于正常腰椎SUVmax测量值(P<0.05)。SUVmax对前列腺癌骨转移诊断价值的AUC值为0.876。不同观察者测量前列腺癌骨转移瘤病灶平均体积以及SUVmean具有极好的重复性(ICC值=0.979、0.967以及0.963、0.978);不同观察者测量前列腺癌骨转移瘤病灶SUVmax结果完全一致(ICC值=1.000)。同一观察者测量前列腺癌骨转移瘤病灶平均体积以及SUVmean具有极好的重复性(ICC值=0.952、0.965以及0.947、0.968);同一观察者两次测量前列腺癌骨转移瘤病灶SUVmax结果完全一致(ICC值=1.000)。2名观察者2次测量的SUVmean变异性明显高于SUVmax,差异均有统计学意义(均P<0.01)。结论^(99)mTc-MDP SPECT/CT显像定量分析对前列腺癌骨转移具有较好诊断价值,前列腺癌骨转移患者^(99)mTc-MDP显像SUV中,SUVmax的一致性在同一观察者或不同观察者较SUVmean更好,有利于临床评价前列腺癌骨转移患者的治疗效果。Objective To investigate the diagnostic value of technetium-99m-methylene diphosphate(^(99)mTc-MDP)SPECT/CT imaging for bone metastases in prostate cancer patients.Methods The clinical and imaging data of 47 patients with prostate cancer admitted in Zhejiang Jinhua Guangfu Tumor Hospital from January 2021 to March 2022 were retrospectively analyzed.All patients underwent whole body ^(99)mTc-MDP SPECT/CT examination.The volume of lesions,mean standardized uptake value(SUV)(SUVmean)and maximum SUV(SUVmax)of bone metastases were compared with those of normal lumbar vertebrae.The diagnostic value of SUVmax for prostate cancer bone metastasis was analyzed by the ROC curve.The coefficient of variance(CV),Bland-Altman,and intraclass correlation coefficient(ICC)were used to evaluate the variability and repeatability of the measurement results.Results A total of 337 metastatic bone lesions and 85 normal vertebral bodies from 47 patients were measured.The SUVmax of bone metastatic lesion was significantly higher than that of normal lumbar vertebrae(P<0.05).The AUC of SUVmax for the diagnosis of prostate cancer bone metastases were 0.876.The inter-reproducibility of mean volume and SUVmean of metastatic bone lesions was excellent(ICC value=0.979,0.967 and 0.963,0.978);that of the SUVmax of was all identical(ICC value=1.000).The intra-reproducibility of mean volume and SUVmean was also excellent(ICC values=0.952,0.965,and 0.947,0.968);and that of SUVmax was identical(ICC=0.952,0.965,0.947,0.968,value=1.000).The variability of SUVmean measured twice by two observers was significantly higher than that of SUVmax(both P<0.01).Conclusion The quantitative analysis of ^(99)mTc-MDP SPECT/CT imaging has good diagnostic value for prostate cancer bone metastasis.The consistency of SUVmax in the same observer or different observers is higher than SUVmean.

关 键 词：标准化摄取值 锝-99m-亚甲基二磷酸盐 前列腺癌 骨转移 一致性 

分 类 号：R737.25[医药卫生—肿瘤] R730.44[医药卫生—临床医学]