PET/CT检查在骨与软组织恶性肿瘤诊断中敏感性的评价

Assessment on the diagnostic accuracy of PET/CT on bone and soft tissue sarcomas

目的评价PET/CT检查在骨与软组织肿瘤诊断中的意义,以为采用这项影像学检查技术协助诊断骨与软组织肿瘤提供依据。方法本研究以我科影像学资料库为基础,提取其中有完整PET/CT资料以及病理学诊断的患者SUVmax值数据,以SUVmax=2.5作为临界值,评价PET/CT检查在不同种类的骨与软组织肿瘤诊断中的敏感度。结果本研究共纳入426处恶性骨与软组织肿瘤。其中,骨肉瘤PET/CT检查平均SUVmax值为(8.0±6.0),软骨肉瘤为(7.0±4.8),尤文肉瘤为(6.1±2.9),脊索瘤为(3.9±1.9),滑膜肉瘤为(5.7±3.3),梭形细胞肉瘤为(5.8±4.1),未分化多形性恶性肿瘤为(9.5±5.6),脂肪肉瘤为(3.6±1.8),小细胞恶性软组织肉瘤为(8.1±5.5),腺泡状软组织肉瘤为(3.8±1.8),平滑肌肉瘤为(6.9±3.8),横纹肌肉瘤为(4.3±1.8)。PET/CT诊断骨源性和软组织源性恶性肿瘤灶的敏感度均高于90%。结论 PET/CT在诊断骨与软组织肉瘤的方面有较高的敏感度,尤其在诊断未经治疗的骨与软组织肉瘤方面有极高的诊断敏感度。

Objective To find out the applicability of PET/CT study in the diagnosis of bone and soft tissue sarcomas,and to provide guidance for the future application of PET/CT in the clinical practice of orthopedic oncology.Methods Radiological materials of patients presented to our department for the treatment of primary bone and soft tissue sarcomas were collected.Diagnostic accuracy of PET/CT was evaluated using a SUVmax cutoff value of 2.5 for different bone and soft tissue sarcomas.Results Bone and soft tissue sarcomas in 426 sites were analyzed in the current study.The average SUVmax of osteosarcoma was(8.0±6.0),chondrosarcoma(7.0±4.8),Ewing’s sarcoma(6.1±2.9),chordoma(3.9±1.9),synovial sarcoma(5.7±3.3),spindle cell sarcoma(5.8±4.1),pleomorphic undifferentiated sarcoma(9.5±5.6),liposarcoma(3.6±1.8),small cell sarcoma(8.1±5.5),alveolar soft part sarcoma(3.8±1.8),leiomyosarcoma(6.9±3.8),rhabdomyosarcoma(4.3±1.8).PET/CT sensitivity was higher than 90%in the diagnosis of bone and soft tissue sarcomas.Conclusions PET/CT can accurately detect most bone and soft tissue sarcomas with nearly 100%sensitivity.