^(18)FDG-PET和^(99m)Tc-MDP骨扫描检测骨转移瘤价值的比较

Comparison of ^(18)FDG-PET And ^(99m)Tc-MDP Bone Scan in Detecting Bone Metastases

目的 :评价18FDG PET恶性肿瘤骨转移的作用及与99mTc MDP ECT比较。材料和方法 :经病理证实为恶性肿瘤患者 5 1例及非肿瘤性疾病 5例在本科同时接受18F FDG PET和99mTc MDP ECT检查 (时间间隔不超过 2周 )。骨转移的诊断由病理、X线或CT/MRI、随访超过 1年综合决定。结果 :99mTc MDP和18FDG PET对骨转移瘤诊断的灵敏度、特异性、准确率率分别为 93 .7%、93 .7%,97.5 %、5 0 %,90 .8%、62 .5 %。99mTc MDP和18FDG PET均为阳性 15例 ,其中证实骨转移为14例 ,假阳性 1例 ;均为阴性例数为 2 0例。 2 1例不相符的结果中 2 0例99mTc MDP ECT阳性而18F FDG PET为阴性。18F FDG PET和99mTc MDP ECT假阴性各 1例。均诊断为多发骨转移的 12例患者中99mTc MDP ECT发现的骨转移病灶数多于18F FDG PET。结论 :18F FDG PET与99mTc MDP骨扫描相比较对肿瘤骨转移的探测有较高的特异性 ,但敏感性较低。

Purpose: To compare the usefulness of positron emission tomography with 18 F-2-deoxyglucose ( 18 FDG-PET) and conventional technetium-99m methylene diophosphate ( 99m Tc-MDP) bone scan in the detection of bone metastases. Materials and Methods: Fifty-one patients with biopsy-proven malignancy and suspected bone metastases,and five patients with biopsy-proven benign lesions underwent whole body 18 FDG-PET and bone scan. Bone metastases were confirmed by biopsy,MRI/CT,and follow-up bone scan/ 18 FDG-PET for more than one year. Results: Diagnostic sensitivity specificity and accuracy of 18 FDG-PET and bone scan were 93.7% and 93.7%,97.5% and 50%,as well as 90.8% and 62.5% respectively. 15 positive and 20 negative scans obtained concordantly by both 18 FDG-PET and 99m Tc-MDP,bone metastases were confirmed in 14 /15 patients. One case was false-positive. 21 discordant findings between 18 FDG-PET and 99m Tc-MDP included 2 metastases (1 18 FDG-PET positive,1 99m Tc -MDP positive),and 20 benign lesions with positive 99m Tc-MDP but negative 18 FDG-PET. Conclusion: 18 FDG-PET has a better specificity,but a lower sensitivity in detecting bone metastases than that of 99m Tc-MDP bone scan.