摘要
目的对比分析18 F标记的氟化钠(18 F-Fluoride,18 F-NaF)PET/CT骨显像与99m Tc标记的亚甲基二膦酸盐(99m Tc-MDP)骨显像(bone scintigraphy,BS)对诊断乳腺癌骨转移的临床价值。方法回顾性分析经病理证实为乳腺癌且临床怀疑骨转移的48例女性患者,在1周内分别行18 F-NaF PET/CT骨显像与BS检查,以病理学或临床随访结果为诊断依据,分别在病例和病灶水平上比较两种检查方法的诊断效能。结果48例乳腺癌患者经证实38例、147个病灶为骨转移瘤。在病例水平上,18 F-NaF PET/CT与BS显示骨转移瘤的检出率及特异度间的差异无统计学意义(P=0.210,P=0.582),18 F-NaF PET/CT显示骨转移瘤的灵敏度高于BS(P<0.01),18 F-NaF PET/CT发现乳腺癌骨转移瘤的效能与标准组高度一致(Kappa=0.934,μ=14.369,P<0.01),而BS发现乳腺癌骨转移瘤的效能与标准组中等一致(Kappa=0.413,μ=2.888,P<0.05)。在病灶水平上,18 F-NaF PET/CT发现骨转移灶的检出率、灵敏度、特异度和符合率均高于BS(χ^2=9.892,χ^2=23.263,χ^2=9.028,χ^2=30.897,P<0.01),18 F-NaF PET/CT发现乳腺癌骨转移灶的效能与标准组高度一致(Kappa=0.881,μ=16.942,P<0.01),而BS发现乳腺癌骨转移灶的效能与标准组一致性差(Kappa=0.238,μ=2.674,P<0.05)。结论18 F-NaF PET/CT骨显像对乳腺癌骨转移的诊断效能总体优于BS,具有一定的临床指导意义和应用价值。
Objective To compare and analyze the clinical value of 18 F-NaF PET/CT and 99m Tc-MDP bone scintigraphy(BS)in the diagnosis of breast cancer with bone metastasis.Methods 48 female patients with breast cancer confirmed in pathology and clinically suspected bone metastasis were retrospectively analyzed.18 F-NaF PET/CT bone imaging and BS examination were performed within one week respectively.Based on pathology or clinical follow-up results,the diagnostic efficacy of the two methods was compared at the level of cases and lesions.Results A total of 38 patients and 147 lesions were detected to have bone metastases.At the case level,there was no statistically significant difference between 18 F-NaF PET/CT and BS in the detection rate and specificity of bone metastases(P=0.210,P=0.582).18 F-NaF PET/CT showed a sensitivity of bone metastases higher than that by BS(P<0.01);18 F-NaF PET/CT showed the efficacy in diagnosing bone metastases in breast cancer highly consistent with the standard group(Kappa=0.934,μ=14.369,P<0.01),while BS showed an efficacy moderately consistent with standard group(Kappa=0.413,μ=2.888,P<0.05).At the lesion level,the detection rate,sensitivity,specificity and coincidence rate of bone metastases were higher in 18 F-NaF PET/CT than in BS(χ^2=9.892,χ^2=23.263,χ^2=9.028,χ^2=30.897,P<0.01);the efficacy of 18 F-NaF PET/CT in detecting bone metastases was highly consistent with the standard group(Kappa=0.881,μ=16.942,P<0.01),while BS showed a poor consistence(Kappa=0.238,μ=2.674,P<0.05).Conclusion 18 F-NaF PET/CT bone imaging is,on the whole,superior to BS in the diagnosis of breast cancer with bone metasta sis,and thus has certain clinical guiding significance and application value.
作者
倪明
汪世存
谢强
张洪波
NI Ming;WANG Shicun;XIE qiang;ZHANG hongbo(Department of Nuclear Medicine,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,P.R.China;Department of Radiation Oncology,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,P.R.China)
出处
《医学影像学杂志》
2020年第9期1648-1652,共5页
Journal of Medical Imaging
基金
安徽省自然科学基金面上项目(编号:1908085MH271)
中国科学院B类先导专项培育项目(编号:XDB39000000)。