^(99)Tc^(m)-MDP SPECT/CT定量分析预测前列腺癌单发骨转移的价值

Value of^(99)Tc^(m)-MDP SPECT/CT quantitative analysis in predicting single bone metastasis of prostate cancer

目的探讨^(99)Tc^(m)-MDP SPECT/CT骨定量分析预测前列腺癌骨单发转移的诊断价值。方法回顾性分析2018年1月至2019年10月本院就诊的102例前列腺癌单发骨转移和67例前列腺癌良性骨关节退变患者,分析^(99)Tc m-MDP骨定量SPECT/CT影像数据和一般临床、病理资料。以手术结果和增强MRI做为骨转移诊断的“金标准”。勾画^(99)Tc^(m)-MDP摄取增高灶的容积感兴趣区(volume of interest,VOI),测量最大的标准摄取值(SUVmax)和标准摄取值均值(SUVmean)。应用多因素Logistic回归分析筛选出预测骨单发转移的最佳参数。结果多因素Logistic回归分析结果显示高SUVmax(OR=1.110,95%CI 1.034~10.191,P=0.004)、高血清游离前列腺特异性抗原(fPSA)水平(OR=0.962,95%CI 0.935~0.989,P=0.007)、高血清总前列腺特异抗原(tPSA)水平(OR=1.054,95%CI 0.85~0.95,P<0.001)和Gleason评分大于7(OR=0.15,95%CI 0.045~0.480,P=0.001)为前列腺癌骨转移的独立危险因子。结论SPECT/CT骨定量分析的半定量指标SUVmax和SUVmean,可作为前列腺癌单发骨转移的一项诊断指标,也可作为患者治疗、随访过程中的一项客观临床参考指标。

Objective To explore the diagnostic value of^(99)Tc^(m)-MDP SPECT/CT bone quantitative analysis in predicting single bone metastasis of prostate cancer(PCa).Methods^(99)Tc^(m)-MDP bone quantitative SPECT/CT imaging data and general clinical and pathological data of 102 patients with isolated bone metastasis of prostate cancer and 67 PCa patients with degenerative changes of bone in our hospital from January 2018 to October 2019 were analyzed retrospectively.Surgical results and enhanced MRI were regarded as the gold standard for the diagnosis of bone metastasis.The volume of interest(VOI)of the lesion^(99)Tc^(m)-MDP was delineated,and the maximum standardized uptake value(SUVmax)and the mean standardized uptake value(SUVmean)were recorded respectively.Multivariate Logistic regression analysis was used to screen the best parameters for predicting single bone metastasis.Results Logistic regression analysis showed high SUVmax(OR=1.110,95%CI 1.034-10.191,P=0.004),high serum free prostate specific antigen(fPSA)level(OR=0.962,95%CI 0.935-0.989,P=0.007),high serum total prostate specific antigen(tPSA)level(OR=1.054,95%CI 0.85-0.95,P<0.001)and Gleason score greater than 7(OR=0.15,95%CI 0.045-0.480,P=0.001)were independent risk factors for bone metastasis of prostate cancer.Conclusion SUVmax and SUVmean,semi-quantitative indexes of SPECT/CT bone quantitative analysis,can be used as diagnostic indexes of single bone metastasis of prostate cancer,and can also be used as objective clinical reference indexes in the treatment and follow-up of patients.