^(123)I-MIBG xSPECT/CT定量参数在儿童神经母细胞瘤骨转移中的诊断价值  

^(123)I-MIBG xSPECT/CT Quantitative Parameters in the Diagnosis of Pediatric Neuroblastoma Bone Metastases

作　　者：王晓雅 王观筠 周子昂 阚英[1] 王巍[1] 杨吉刚[1] WANG Xiaoya;WANG Guanyun;ZHOU Ziang;KAN Ying;WANG Wei;YANG Jigang(Department of Nuclear Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院核医学科,北京100050

出　　处：《中国医学影像学杂志》2025年第3期286-291,共6页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金(82102088,82272034)。

摘　　要：目的探讨定量^(123)I-MIBG xSPECT/CT显像在儿童神经母细胞瘤骨转移中的诊断价值。资料与方法回顾性分析2022年3月—2023年3月首都医科大学附属北京友谊医院61例经病理证实为神经母细胞瘤患儿的^(123)I-MIBGxSPECT/CT图像,分析骨转移病灶及正常骨定量参数的部分影响因素,比较两者的标准化摄取值(SUV)差异,采用受试者工作特征曲线分析最大标准化摄取值(SUVmax)、平均标准化摄取值(SUVavg)、最小标准化摄取值(SUVmin)和峰值标准摄取值(SUVpeak)对骨转移病灶的诊断价值。结果不同体质参数间的正常骨SUV差异均无统计学意义(r=-0.204~0.071,P均>0.05)。骨转移病灶的SUVmax、SUVavg、SUVmin、SUVpeak显著高于正常骨(Z=-10.118~-9.703,P<0.0001);Curie评分不同分区间骨转移病灶SUV测量结果差异无统计学意义(H=0.226、0.107、0.149、0.342,P均>0.05)。SUVmax、SUVavg、SUVmin和SUVpeak的曲线下面积分别为0.929(95%CI 0.884~0.974)、0.948(95%CI 0.906~0.989)、0.935(95%CI 0.890~0.981)、0.942(95%CI0.899~0.985);敏感度分别为90.9%、90.2%、93.7%、92.3%,特异度分别为86.9%、93.4%、85.2%、88.5%,差异有统计学意义(P<0.0001);SUVmax、SUVavg、SUVmin和SUVpeak的最佳诊断阈值分别为0.39 g/ml、0.33 g/ml、0.20 g/ml、0.33 g/ml。结论当SUVavg高于0.33 g/ml临界值时,对骨转移病灶具有高度提示性。x SPECT/CT定量指标提高了神经母细胞瘤骨转移诊断的特异性,证明了^(123)I-MIBG xSPECT/CT显像定量分析的高诊断效能及其作为视觉评估诊断辅助的潜在效用。Purpose To investigate the diagnostic value of quantitative^(123)I-Metaiodobenzylguanidine(MIBG)xSPECT/CT imaging in bone metastases of neuroblastoma in children.Materials and Methods We retrospectively assessed^(123)I-MIBG xSPECT/CT images of 61 children with neuroblastoma confirmed by pathology analyzed the influencing factors of bone metastatic lesions and normal bone quantitative parameters from March 2022 to March 2023 in Beijing Friendship Hospital,Capital Medical University,and compared the differences in standard uptake value(SUV).We used receiver operating characteristics curves to determine the optimum maximum standard uptake value(SUVmax),average standard uptake value(SUVavg),minimum standard uptake value(SUVmin)and peak standard uptake value(SUVpeak)cut-off value to diagnose bone metastatic lesions.Results There was no statistically significant difference in normal bone SUV values among different physical parameters(r=-0.204-0.071,all P>0.05).SUVmax,SUVavg,SUVmin and SUVpeak of bone metastatic lesions were significantly higher than those of normal bone(Z=-10.118--9.703,all P<0.0001),and there was no significant statistical difference in SUV measurements of bone metastatic lesions among different Curie score intervals(H=0.226,0.107,0.149,0.342,all P>0.05).The area under the curve of SUVmax,SUVavg,SUVmin and SUVpeak were 0.929(95%CI 0.884-0.974),0.948(95%CI 0.906-0.989),0.935(95%CI 0.890-0.981),0.942(95%CI 0.899-0.985);sensitivity was 90.9%,90.2%,93.7%,92.3%,and specificity was 86.9%,93.4%,85.2%,88.5%,respectively,with statistically significant differences(P<0.0001).The optimal diagnostic thresholds for SUVmax,SUVavg,SUVmin and SUVpeak were 0.39 g/ml,0.33 g/ml,0.20 g/ml and 0.33 g/ml,respectively.Conclusion We demonstrate that SUVavg above 0.33 g/ml in neuroblastoma patients have best diagnostic efficacy in the diagnosis of bone metastasis of neuroblastoma.Quantitative indexes of xSPECT/CT increase the specificity of diagnosing bone metastases of neuroblastoma,demonstrating the high diagnostic efficienc

关 键 词：神经母细胞瘤 肿瘤转移 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 标准化摄取值 诊断 

分 类 号：R730.264[医药卫生—肿瘤] R445.3[医药卫生—临床医学] R445.4