^18FDG-PET和^99mTc-MDP骨扫描检测骨转移瘤价值的比较

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51 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%、50%,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20例.21例不相符的结果中20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.

Comparison of 18FDG-PET And 99mTc-MDP Bone Scan in Detecting Bone Metastases

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.