18F-FDG SPECT/CT与99mTc-MDP骨显像在检测肺癌骨转移中的对比研究

目的对比研究双探头符合线路SPECT/CT仪18F-脱氧葡萄糖(FDG)显像和99mTc-亚甲基二膦酸盐(MDP)显像对肺癌骨转移病灶的诊断效能。方法肺癌患者56例,分别行18F-FDGSPECT/CT胸腹部显像和99mTc-MDP全身骨显像,间隔时间不超过2周。结果56例患者中24例有骨转移,共发现92个转移灶;18F-FDGSPECT/CT检查发现68个转移灶,探测骨转移灶的灵敏度73.9%,特异性94.1%,准确率为81.1%;99mTc-MDP全身骨显像发现82个转移灶,探测骨转移灶灵敏度89.1%(P<0.01),特异性为72.5%(P<0.05),准确率为83.2%(P>0.05)。当把骨骼转移性病变以成骨性与溶骨性方式分类时,99mTc-MDP骨显像可判定94.3%的成骨性转移灶和82.1%的溶骨性转移灶,而18F-FDGSPECT/CT可判定58.5%的成骨性转移灶和94.9%的溶骨性转移灶。结论探测肺癌骨转移,18F-FDGSPECT/CT显像具有较高的特异性,99mTc-MDP骨显像具有较高的灵敏度,两者诊断的准确性无明显差异。99mTc-MDP骨显像联合18F—FDGSPECT/CT显像检测肺癌骨转移,可起到信息互补、明确诊断的作用。

Comparative Study on 18F-FDG SPECT/CT and 99mTc-MDP Bone Scan in Detection of Bone Metastases in Lung Cancer

Objective To compare the efficacy of 18F-FDG SPECT/CT and 99mTc-MDP Bone Scan in the diagnosis of bone metastases in lung cancer.Methods 18F-FDG SPECT/CT and 99mTc-MDP Bone Scan were performed on 56 patients with lung cancer.The interval of both examinations was within 2 weeks.CT,MRI,and the follow-up data were used as references.Results 24 of 56 patients had bone metastases with 92 metastatic lesions.Of the 92 metastatic lesions,68 loci were found in 18F-FDG SPECT/CT.The sensitivity,specificity and accuracy of 18F-FDG SPECT/CT in the diagnosis of bone metastasis were 73.9%,94.1% and 81.1%.82 metastatic lesions were found in 99mTc-MDP bone scan.The sensitivity,specificity and accuracy of 99mTc-MDP bone scan in the diagnosis of bone metastatis were 89.1%(P< 0.01),72.5%(P<0.005)and 83.2%(P>0.05).99mTc-MDP bone scan detected 94.3% of osteoblastic metastasis and 82.1% of osteolytic metastasis,whereas 18F-FDG SPECT/CT detected 58.5% of osteoblastic metastasis and 94.9% of osteolytic metastasis.Conclusion 99mTc-MDP bone scan is more sensitive,whereas 18F-FDG SPECT /CT is more specific in the diagnosis of bone metastasis in patients with lung cancer.Combined use of the two techniques might improve the diagnosis of bone metastasis.