18F-FDG SPECT/CT与99Tcm-MDP骨显像对肺癌骨转移诊断价值的对比研究

目的　比较18F FDGSPECT/CT显像与99Tcm MDP骨显像在肺癌骨转移诊断中的临床价值。方法　 19例经病理证实的肺癌患者同期进行18F FDGSPECT/CT显像和常规99Tcm MDP骨显像。结果　 19例患者 8例有骨转移 ,共发现 47个转移灶。18F FDGSPECT/CT发现 8例骨转移 ,99Tcm MDP骨显像发现 7例骨转移 (P >0 .0 5 ) ;18F FDGSPECT/CT发现 45个转移灶 ,99Tcm MDP骨显像发现 2 6个转移灶 (P <0 .0 1)。18F FDGSPECT/CT探测骨转移的灵敏度 95 .74% ,特异度 89.47% ,准确度93 .94% ;99Tcm MDP探测骨转移灵敏度 5 5 .3 2 % (P <0 .0 1) ,特异度为 94.74% (P >0 .0 5 ) ,准确度 66.67% (P <0 .0 1)。结论　在探测肺癌骨转移方面 ,18F FDGSPECT/CT显像较常规99Tcm MDP骨显像具有更高的灵敏度和准确度。对99Tcm MDP骨显像阴性、单一病灶及可疑脊椎转移患者 ,应进一步行18F FDGSPECT/CT显像 ,可起到信息互补、明确诊断的作用。

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

Objective To compare and evaluate the clinical value of 18 F FDG SPECT/CT imaging and 99 Tc m MDP whole body bone scan in detection of bone metastases from lung cancer. Methods Nineteen patients with lung cancer underwent 18 F FDG SPECT/CT and 99 Tc m MDP whole body bone scan. Results Eight of 19 patients were proved to have bone metastases and 47 foci were demonstrated as metastatic lesions. In 18 F FDG SPECT/CT, the positive findings were presented in 8 patients, and 7 patients in bone scintigraphy ( P >0.05). 45 foci were found in 18 F FDG SPECT/CT and 26 foci in 99 Tc m MDP ( P <0.01). 18 F FDG SPECT/CT had sensitivity of 95.74%, specificity of 89.47% and accuracy of 93.94% for diagnosis of bone metastasis. In bone scintigraphy they were 55.32%( P <0.01), 94.74%( P >0.05) and 66.67%( P <0.01). Conclusion In correctly diagnosing bone metastases, 18 F FDG SPECT/CT is more sensitive and accurate than 99 Tc m MDP bone scan. For the patients with suspected metastases in the spine, negative finding or single hot spot in 99 Tc m MDP bone scintigraphy, 18 F FDG SPECT/CT imaging is recommend as a further and complementary assessment of bone metastases.