摘要
目的采用ROC曲线比较18F-FDG符合线路显像、99mTc-MDP骨显像及二者联合对乳腺癌骨转移的检出效能。方法收集手术病理诊断为乳腺癌的女性患者113例,均于4周内先后接受18 F-FDG符合线路显像及99mTc-MDP骨显像;对两种显像结果按5分法评分,以二者评分之和为联合评分值,以病理诊断或临床随访为确诊"金标准",比较ROC曲线下面积(AUC),评价99mTc-MDP骨显像、18F-FDG符合线路显像及联合评分法对乳腺癌骨转移患者的检出效能,比较不同方法在各自最佳诊断阈值下的灵敏度、特异度、准确率、阳性预测值(PPV)和阴性预测值(NPV)。结果113例中,12例(10.62%)最终确诊为骨转移,101例(89.38%)无骨转移。99mTc-MDP骨显像、18F-FDG符合线路显像以及二者联合诊断评分的ROC曲线分析显示三者AUC分别为0.991、0.874和0.993,三种方法对乳腺癌骨转移的诊断效能均佳,尤以99mTc-MDP骨显像与联合诊断为最佳(P均<0.01)。最佳阈值点下,单独18F-FDG符合线路显像、99mTc-MDP骨显像及联合检出骨转移患者的灵敏度分别为75.00%(9/12)、75.00%(9/12)、83.33%(10/12),特异度为100%(101/101)、98.02%(99/101)、98.02%(99/101),准确率为97.35%(110/113)、95.58%(108/113)、96.46%(109/113),PPV为100%(9/9)、81.82%(9/11)、83.33%(10/12),NPV为97.12%(101/104)、97.06%(99/102)、98.02%(99/101)。结论 99mTc-MDP骨显像对乳腺癌骨转移患者的检出效能优于18F-FDG符合线路显像,二者联合可提高对骨转移患者的检出率。
Objective To observe the efficacy of ^18F_FDG SPECT coincidence （^18F-FDG SPECT）, ^99mTc-MDP bone scin- tigraphy （BS） and combination of the two techniques （^18 F-FDG SPECT＋^99mTc-MDP BS） for detecting bone metastasis from breast cancer by ROC curve analysis. Methods Totally 113 patients with breast cancer underwent both ^99mTc-MDP BS and ^18F-FDG SPECT within 4 weeks. The images were interpreted according to 5-point scale, and the scale of ^18 F-FDG SPECT＋^99mTc-MDP BS was the sum of ^18 F-FDG SPECT plus ^99mTc-MDP BS. The final diagnosis of bone metastases was established by pathology or follow-up, and then ROC curve analysis was performed. The area under the curve （AUC）, the sensitivity, specificity, accuracy rate, positive predictive value （PPV）, negative predictive value （NPV） of cut-off point were compared. Results Of 113 cases, 12 （12/113, 10. 62%） were finally confirmed as bone metastases, while 101 （101/ 113, 89.38%） were negative. The AUC was 0. 991 for 99mTc-MDP BS, 0. 874 for ^18F-FDG SPECT, and 0. 993 for ^18F- FDG SPECT＋^99mTc-MDP BS, respectively. AUC of ^99mTc-MDP BS and ^18F-FDG SPECT＋^99mTc-MDP BS were signifi- cantly larger than that of ^18 F-FDG SPECT （all P〈0. 01）. The optimal sensitivity of ^18 F-FDG SPECT,^ 99m Tc-MDP BS and ^18F-FDG SPECT＋^99mTc-MDP BS was 75.00% （9/12）, 75.00% （9/12） and 83. 33% （10/12）, respectively, the specifici- ty was 100% （101/101）, 98.02% （99/101） and 98.02% （99/101）, respectively , the accuracy rate was 97.35% （110/ 113）, 95.58% （108/113） and 96.46% （109/113）, respectively , while PPV was 100% （9/9）, 81.82% （9/11）, 83.33% （10/12） and NPV was 97.12% （101/104）, 97.06% （99/102） and 98.02% （99/101）, respectively. Conclusion The effi- cacy of ^99mTc-MDP BS for detecting malignant bone metastasis was superior to that of ^18 F-FDG SPECT alone. The detec- tion ability can be obviously improved by combination of these two techniques.
出处
《中国医学影像技术》
CSCD
北大核心
2012年第12期2175-2179,共5页
Chinese Journal of Medical Imaging Technology
