18F-FDG PET与99Tcm- MDP显像诊断肿瘤骨转移的比较

目的　研究1 8F 脱氧葡萄糖 (FDG)PET显像对肿瘤骨转移的诊断价值 ,并与99Tcm 亚甲基二膦酸盐 (MDP)骨显像比较。方法　 4 3例确诊的肿瘤患者在 1个月内先后行1 8F FDGPET及99Tcm MDP骨显像 ,其中 2 4例经其他检查及随访证实为骨转移。对比分析 2种显像结果。结果　 2 4例骨转移患者FDGPET显像均为阳性 ,骨显像阳性 2 2例 ,灵敏度分别为 10 0 %和 91.7% ,差异无显著性 (P >0 0 5 )。19例无骨转移患者中FDGPET显像阴性 18例 ,骨显像阴性 11例 ,特异性分别为 94 .7%和5 7 9% ,差异有显著性 (P <0 0 5 )。 2种方法检测骨转移的准确性分别为 97.7%和 76 .7% ,差异有显著性 (P <0 0 5 )。结论　1 8F FDGPET显像诊断肿瘤骨转移的灵敏度与99Tcm MDP骨显像无明显差别 ,但有更高的特异性和准确性。

Comparison of 18 F-FDG PET with 99 Tcm-MDP bone scan in detection of bone metastases

Objective To evaluate the usefulness of 18F-fluorodeoxyglucose (FDG) PET for detecting bone metastases in patients with tumors, and to compare the results of 18F-FDG PET with that of 99Tcm-methylene diphosphonic acid (MDP) whole body bone scan. Methods 18F-FDG PET and 99Tcm-MDP whole body bone scan were performed within one month apart in 43 tumor patients. Twenty-four of them were with confirmed bone metastases and the remaining 19 were confirmed without bone metastases. Results Among 24 patients with confirmed bone metastases, 18F-FDG PET and 99Tcm-MDP whole body bone scan accurately diagnosed 24 and 22, respectively. Among the remaining 19 cases without bone metastases, 18F-FDG PET and 99Tcm-MDP whole body bone scan correctly gave 18 and 11 negative results, respectively. The sensitivity, specificity and accuracy of 18F-FDG PET and 99Tcm-MDP bone scan were 100%, 94.7% , 97.7% and 91.7%, 57.9%, 76.7%, respectively. The differences between specificities and accuracies of the two methods were significant, while no significant difference between the sensitivities of the two methods. Conclusion Our results indicate that for the detection of bone metastases in patients with malignant tumors 18F-FDG PET shows a similar sensitivity but better specificity and accuracy compared with 99Tcm-MDP bone scan.