对比分析99mTc-MDP SPECT与18F-NaF PET/CT术前诊断肺癌骨转移的价值

摘要

Objective To compare the value of preoperative 99mTc-methylene diphosphona (MDP) SPECT and 18F-sodium fluride (NaF) PET/CT in diagnosis of bone metastases in patients with lung cancer. Methods Data of 274 lung cancer patients were analyzed retrospectively, including 107 patients underwent 18F-NaF PET/CT imaging and 167 underwent 99mTc-MDP SPECT imaging. Taking the results of pathology or follow-up as standards, 18F-NaF PET/CT and 99mTc-MDP SPECT were compared. Results There were only 2 equivocal patients with 18F-NaF PET/CT imaging among 107 patients, while 18 with 99mTc-MDP SPECT imaging in 167 patients. The sensitivity of 18F-NaF PET/CT and 99mTc-MDP SPECT was 100% (32/32) and 87. 72% (50/57) , respectively, the former was higher than the latter (P = 0. 046) , and the specificity was 98. 67% (74/75) and 92. 73% (102/110), respectively (x2 =2. 237, P = 0. 135). The accuracy rate of 18F-NaF PET/CT and 99mTc-MDP SPECT was 99.07% (106/107) and 91.02% (152/167), respectively (x2 =6. 287, P=0.012). Conclusion The sensitivity and accuracy rate of preoperative 18F-NaF PET/CT in evaluation bone metastases in patients with lung cancer are higher thanthose of 99mTc-MDP SPECT, suggesting that 18F-NaF PET/CT is a good method for diagnosing bone metastases in patients with lung cancer.%目的 对比分析99mTc-亚甲基二膦酸盐(MDP) SPECT与18F-氟化钠(NaF) PET/CT术前诊断肺癌骨转移灶的临床价值.方法 回顾性分析274例肺癌患者,其中107例接受18 F-NaF PET/CT检查,167例接受99mTc-MDP SPECT检查,以病理学结果或随访结果作为标准进行分析.结果 107例肺癌术前18 F-NaF PET/CT显像中,2例骨骼病灶性质待定；167例99mTc-MDP SPECT显像中,18例骨骼病灶性质待定.18F-NaF PET/CT和99mTc-MDP SPECT术前诊断肺癌骨转移灶的灵敏度分别为100％(32/32)和87.72％(50/57),前者高于后者(P=0.046),特异度分别为98.67％(74/75)和92.73％(102/110),差异无统计学意义(x2=2.237,P=0.135)；二者的准确率分别为99.07％(106/107)和91.02％(152/167),前者高于后者(x2=6.287,P=0.012).结论 18F-NaF PET/CT骨显像术前评价肺癌骨转移较99mTc-MDP SPECT的灵敏度和准确率高,是肺癌术前评价骨转移的较好方法.