SPECT/CT融合骨显像诊断肺癌单发骨转移的价值

Validity of SPECT/CT bone fusing imaging in the diagnosis of single bone metastasis of lung cancer

目的探讨单光子发射计算机断层成像技术/电子计算机X射线断层扫描技术(SPECT/CT)融合骨显像在诊断肺癌单发骨转移中的价值。方法回顾性分析2014年6月至2015年6月行全身骨显像并对单发可疑病灶行SPECT/CT断层融合显像进一步检查的肺癌患者80例,分别统计两种方法的诊断结果,并与最终结果对照。病理确定3例,由2种以上影像技术结果确定45例,随访结果确定32例。计算两者灵敏度、特异性、准确性、阳性预测值、阴性预测值。采用SPSS 17.0统计学软件,χ2检验比较全身骨显像与SPECT/CT融合骨显像的诊断结果。结果全身骨显像和SPECT/CT断层融合显像对肺癌骨转移的诊断效能分别是:特异性58.3%vs 91.7%(χ2=10.67,P<0.05),准确性71.3%vs 90.0%(χ2=9.002,P<0.05),阳性预测值70.6%vs 92.9%(χ2=7.318,P<0.05),灵敏度81.8%vs 88.6%(χ2=0.81,P>0.05),阴性预测值72.4%vs 86.8%(χ2=0.81,P>0.05)。结论SPECT/CT断层融合显像诊断肺癌单发骨转移的特异性、准确性、阳性预测值优于全身骨显像。SPECT/CT融合骨显像诊断肺癌单发骨转移具有重要价值。

Objective To investigate the validity of single-photon emission computed tomography/computed tomography（ SPECT/CT） bone fusing imaging in the diagnosis of single bone metastasis of lung cancer. Methods A retrospective study was conducted during June 2014 and June 2015 on 80 patients with confirmed lung cancer. All patients underwent99 Tc-methylene diphosphonate whole-body planar bone scintigraphy and had suspected bone metastasis. These patients were then further evaluated with SPECT/CT. The diagnostic results of the two methods were compared. The final results were confirmed with pathology findings（ n = 3）,with more than 2 kinds of radiological imaging findings（ n= 45）,and with 1-year follow-up（ n = 32）. The diagnostic sensitivity,specificity,accuracy,positive and negative predictive values of the two methods were compared. The results were analyzed with SPSS 17. 0 software and χ2 test.Results For bone scintigraphy and SPECT/CT fusion imaging,the specificity was 58.3% vs 91.7%（ χ2= 10.67,P〈0.05）,accuracy was 71.3% vs 90. 0%（ χ2= 9. 002,P〈 0. 05）,positive predictive value was 70. 6% vs 92. 9%（ χ2=7.318,P〈0.05）,sensitivity was 81.8% vs 88.6%（ χ2= 0.81,P〉0.05）,and the negative predictive value was 72.4%vs 86.8%（ χ2= 0.81,P〉0.05）. Conclusion In the diagnosis of single bone metastasis of lung cancer,the SPECT/CTbone fusion imaging was superior to whole-body planar bone scintigraphy for its specificity,accuracy and positive predictive value. SPECT/CT fusion bone imaging is of great value in the diagnosis of single bone metastasis of lung cancer.