99Tcm-MDP SPECT/CT骨显像与PET对肺癌单发骨转移瘤的诊断效能

The Diagnostic Efficacy of 99 Tc m - MDP SPECT/CT Bone Imaging withPET for Single Bone Metastases in Lung Cancer

目的分析99Tcm-亚甲基二膦酸盐(MDP)单光子发射型计算机断层扫描(SPECT/CT)骨显像和正电子发射型计算机断层扫描(PET)对诊断肺癌单发骨转移瘤的临床价值。方法回顾性收集2018年1月至2023年1月我院收治的肺癌患者临床资料165例,所有患者均行99Tcm-MDP SPECT/CT骨显像与PET检查,观察165例肺癌患者中发生单发骨转移瘤的例数;分别分析99Tcm-MDP SPECT/CT骨显像与PET对诊断肺癌单发骨转移瘤的预测准确度;绘制接收者操作特征曲线(ROC)对比99Tcm-MDP SPECT/CT骨显像与PET单一及联合检测对肺癌单发骨转移瘤的诊断效能。结果共计92例(55.76%)肺癌患者发生骨转移,其中有37例(40.22%)患者为单发骨转移;99Tcm-MDP SPECT/CT骨显像对肺癌单发骨转移瘤的阳性诊断率为72.97%,阴性诊断率为80.82%;PET对肺癌单发骨转移瘤的阳性诊断率为62.16%,阴性诊断率为76.71%;联合99Tcm-MDP SPECT/CT骨显像与PET对肺癌单发骨转移瘤的诊断阳性率为91.89%,阴性诊断率为93.15%;ROC验证99Tcm-MDP SPECT/CT骨显像与PET联合检测对肺癌单发骨转移瘤患者的曲线下面积(AUC)显著高于单一检测(P<0.05),灵敏度、特异性分别为91.89%、93.15%。结论99Tcm-MDP SPECT/CT骨显像与PET联合检测对于肺癌单发骨转移瘤具有较高的诊断效能,该方案能够作为有效显像检测方式评估病情程度,值得临床推广应用。

Objective To evaluate the clinical value of 99 Tc m-methylene diphosphonate(MDP)single photon emission computed tomography(SPECT/CT)bone imaging and positron emission computed tomography(PET)for the diagnosis of solitary bone metastases in lung cancer.Methods The clinical data of 165 lung cancer patients admitted to our hospital from January,2018 to January,2023 were retrospectively collected.All patients underwent 99 Tc m-MDP SPECT/CT bone imaging and PET testing to observe the number of cases of single bone metastases;The predictive accuracy of 99 Tc m-MDP SPECT/CT bone imaging and PET for the diagnosis of lung cancer was analyzed separately;The receiver operating characteristic curve(ROC)was plotted to compare 99 Tc m-MDP SPECT/CT bone imaging and PET with single or combined testing for the diagnosis of single bone metastases in lung cancer.The predictive accuracy of 99 Tc m-MDP SPECT/CT bone imaging and PET for the diagnosis of lung cancer single bone metastases was analyzed separately;The receiver operating characteristic curve(ROC)was plotted to compare the diagnostic efficacy of 99 Tc m-MDP SPECT/CT bone imaging and PET alone or in combination for the diagnosis of lung cancer single bone metastases.Results A total of 92 patients(55.76%)with lung cancer had bone metastases,among which 37 patients(40.22%)had single bone metastases;The positive diagnosis rate of 99 Tc m-MDP SPECT/CT bone imaging for lung cancer single bone metastases was 72.97%and the negative diagnosis rate was 80.82%;The positive diagnosis rate of PET for lung cancer single bone metastases was 62.16%and the negative diagnosis rate was 76.71%;The positive diagnosis rate of combined 99 Tc m-MDP SPECT/CT bone imaging and PET for lung cancer single bone metastases was 91.89%and the negative diagnosis rate was 76.71%.The positive diagnostic rate of 99 Tc m-MDP SPECT/CT bone imaging combined with PET was 91.89%and the negative diagnostic rate was 93.15%;ROC verified that the area under the curve(AUC)of 99 Tc m-MDP SPECT/CT bone imaging combined with PET was significantly higher than that of the single-marker test for patients with lung cancer with solitary bone metastases(P<0.05),and the sensitivity and specificity were 91.89%and 93.15%,respectively.Conclusion The combined 99 Tc m-MDP SPECT/CT bone imaging and PET has a high diagnostic efficacy for lung cancer with solitary bone metastases.The protocol can be used as a validated imaging test to assess the extent of the disease and is worthy of clinical application.