[1]王宇峰,刘海娜,张居洋,等.SPECT/CT融合显像对乳腺癌骨转移的诊断价值[J].国际放射医学核医学杂志,2014,38(6):387-391.[doi:10.3760/cma.j.issn.1673-4114.2014.06.010]
　Wang Yu-feng,Liu Hai-na,Zhang Ju-yang,et al.Clinical value of SPECT/CT fusion imaging in diagnosing metastatic bone lesions in breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(6):387-391.[doi:10.3760/cma.j.issn.1673-4114.2014.06.010]
点击复制

SPECT/CT融合显像对乳腺癌骨转移的诊断价值(/HTML)
分享到：

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
38
期数:
2014年第6期
页码:
387-391
栏目:
出版日期:
2014-11-25

文章信息/Info

Title:
Clinical value of SPECT/CT fusion imaging in diagnosing metastatic bone lesions in breast cancer
作者:
王宇峰;  刘海娜;  张居洋;  何苗;  惠华;  张敬
徐州市肿瘤医院核医学科, 221000
Author(s):
Wang Yu-feng;  Liu Hai-na;  Zhang Ju-yang;  He Miao;  Hui Hua;  Zhang Jing
Department of Nuclear Medicine, Xuzhou Cancer Hospital, Xuzhou 221000, China
关键词:
乳腺肿瘤; 肿瘤转移; 体层摄影术; 发射型计算机; 单光子; 体层摄影术; X线计算机
Keywords:
Breast neoplasms; Neoplasm metastasis; Tomography; emission-computed; single-photon; Tomography; X-ray computer
DOI:
10.3760/cma.j.issn.1673-4114.2014.06.010
摘要:
目的 评价SPECT/CT融合显像对99Tcm-MDP全身骨显像难于确诊的乳腺癌骨病灶的鉴别诊断价值。方法 对99Tcm-MDP全身骨显像难于确诊的132例乳腺癌患者的210个病灶行局部SPECT/CT同机融合断层显像,以临床随访及病理检查获得最终诊断结果,计算SPECT/CT融合显像对骨转移灶的诊断准确率、灵敏度、特异度、阳性预测值及阴性预测值,并对比不同部位病灶的诊断准确率差异。结果 ①210个病灶经SPECT/CT融合断层显像正确诊断的恶性病灶82个(39.0%),良性病灶112个(53.3%),诊断准确率为92.4%(194/210),灵敏度为94.3%,特异度为91.1%,阳性预测值为88.2%,阴性预测值为95.7%.②SPECT/CT同机融合断层显像对不同部位的病灶的诊断准确率不一致,脊椎的诊断准确率最高,为95.9%(94/97),肋骨最低,为83.7%(36/43),其差异有统计学意义(χ2=7.81,P<0.05).结论 SPECT/CT同机融合显像能够对99Tcm-MDP全身骨显像难于确诊的病灶进行准确诊断,其对不同部位的病灶的诊断准确率有差异,脊椎的诊断准确率最高,肋骨最低。
Abstract:
Objective To evaluate the diagnostic value of SPECT/CT fusion imaging in indeterminate lesions on 99Tcm-MDP whole-body bone scan in patients with breast cancer.Methods 210 bone lesions of 132 patients with breast cancer,for whom the natures of the lesions were unable to be determined by the 99Tcm-MDP whole-body bone scan,were examined by the SPECT/CT fusion imaging simultaneously.The natures of the lesions were eventually confirmed by pathology and clinical follow-up.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of SPECT/CT fusion imaging for diagnosing bone-metastases were calculated.In addition,the diagnostic accuracy of SPECT/CT fusion imaging for bone lesions in various parts of the body was also analyzed.Results ①Of 210 bone lesions,82 of bone metastases and 112 benign bone lesions were correctly diagnosed by SPECT/CT fusion imaging.The diagnostic accuracy,sensitivity,specificity,positive prediction value and negative prediction value was 92.4% (194/210),94.3% (82/87),91.1% (112/123),88.2% (82/93),95.7% (112/117),respectively.②The diagnostic accuracy of 99Tcm-MDP SPECT/CT for spinal bone lesions were significantly higher than that for rib lesions (95.9% versus 83.7%,χ2=7.81,P<0.05).Conclusions ①92.4% bone lesions in patients with breast cancer,which can not determined on 99Tcm-MDP whole-body bone scan,can be diagnosed by SPECT/CT fusion imaging accurately.②Diagnositic compliance rate of SPECT/CT fusion imaging is different in different parts with obscure lesion,which is the highest in the spine,the minimum in ribs.

参考文献/References:

[1] 李霓,郑荣寿,张思维,等.中国城乡女性乳腺癌发病趋势分析和预测[J] 中华预防医学杂志,2012,46(8):703-707.
[2] Kozlow W,Guise TA.Breast cancer metastasis to bone:mechanisms of osteolysis and implications for therapy[J].J Mammary Gland Biol Neoplasia,2005,10(2):169-180.
[3] 孟德刚,孙晓光,黄钢.SPECT/CT在临床肿瘤学中的应用[J].国际放射医学核医学杂志,2009,33(4):214-218.
[4] Utsunomiya D,Shiraishi S,Imuta M,et al.Added value of SPECT/CT fusion in assessing suspected bone metastasis:comparison with scintigraphy alone and nonfused scintigraphy and CT[J].J Radiology,2006,238(1):264-271.
[5] 江勇,米岚,余大富,等.SPECT/CT对脊柱病变鉴别诊断的价值[J].中华核医学杂志,2011,31(4):223-226.
[6] 孟德刚,孙晓光,黄刚,等.SPECT/CT骨显像在多发性骨髓瘤诊断中的临床应用[J].医学影像杂志,2010,20(4):559-562.
[7] 马玉波,王忠,顾爱春,等.SPECT/CT图像融合鉴别诊断疑似骨转移灶良恶性的价值[J].上海交通大学学报,2010,30(10):1246-1250.
[8] Römer W,Nömayr A,Uder M,et al.SPECT-guided CT for evaluating foci of increased bone metabolish classifield as indeterminate on SPECT in cancer patients[J].J Nucl Med,2006,47(7):1102-1106.
[9] Sharma P,Singh H,Kumar R,et al.Bone scintigrsphy in breast cancer:added value of hybrid SPECT-CT and its impact on patient management[J].Nucl Med Commun,2012,33(2):139-147.
[10] 顾涛颖,石洪成,陈曙光,等.SPECT-CT融合图像评价乳腺癌骨转移的增益价值[J].中国临床医学,2013,20(5):665-669.
[11] 张一秋,石洪成,陈曙光,等.SPECT/CT融合图像对脊柱单发病灶鉴别诊断的增益价值[J].中国临床医学,2010,17(5):741744.
[12] Schillaci O.Hybrid SPECT/CT:a new era for SPECT imaging?[J].Eur J Nucl Med Mol Imaging,2005,32(5):521-524.

相似文献/References:

[1]杨雷,袁卫红,王家平,等.99Tcm-MIBI显像与钼靶X线对乳腺癌诊断的比较研究[J].国际放射医学核医学杂志,2016,40(2):111.[doi:10.3760/cma.j.issn.1673-4114.2016.02.005]
　Yang Lei,Yuan Weihong,Wang Jiaping,et al.Diagnostic value of technetium 99Tcm sestamibi and X-ray mammography in breast cancer: a comparison study[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):111.[doi:10.3760/cma.j.issn.1673-4114.2016.02.005]
[2]马乐,张万春,李晓敏.乳腺癌前哨淋巴结核素显像新进展[J].国际放射医学核医学杂志,2016,40(2):145.[doi:10.3760/cma.j.issn.1673-4114.2016.02.012]
　Ma Le,Zhang Wanchun,Li Xiaomin.Evolution of radionuclide imaging of sentinel node lymphscintigraphy in breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):145.[doi:10.3760/cma.j.issn.1673-4114.2016.02.012]
[3]储小飞,赵舒怡,樊赛军.肿瘤干细胞与辐射抗性的研究进展[J].国际放射医学核医学杂志,2015,39(5):431.[doi:10. 3760 / cma. j. issn. 1673-4114. 2015. 05. 019]
　chu xiaofei,zhao shuyi,fan saijun..advance progress of cancer stem cells and radioresistance[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):431.[doi:10. 3760 / cma. j. issn. 1673-4114. 2015. 05. 019]
[4]廖光星,冷志欣,肖国有.前列腺癌骨转移影像诊断方法研究进展[J].国际放射医学核医学杂志,2016,40(6):464.[doi:10.3760/cma.j.issn.1673-4114.2016.06.012]
　Liao Guangxing,Leng Zhixin,Xiao Guoyou.Progress of imaging in the diagnosis of bone metastases of prostate cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):464.[doi:10.3760/cma.j.issn.1673-4114.2016.06.012]
[5]陈伟君,孙达.99Tcm-MIBI显像在乳腺癌新辅助化疗中的应用价值[J].国际放射医学核医学杂志,2015,39(6):487.[doi:10.3760/cma.j.issn.1673-4114.2015.06.011]
　Chen Weijun,Sun Da.Clinical value of 99Tcm-MIBI imaging in neoadjuvant chemotherapy of breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):487.[doi:10.3760/cma.j.issn.1673-4114.2015.06.011]
[6]胡鸿,唐刚华,聂大红.乳腺癌分子显像研究进展[J].国际放射医学核医学杂志,2015,39(1):91.[doi:10.3760/cma.j.issn.1673-4114.2015.01.019]
　Hu Hong,Tang Ganghua,Nie Dahong.Progress on molecular imaging of breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):91.[doi:10.3760/cma.j.issn.1673-4114.2015.01.019]
[7]张胤,陈跃.18F-氟化钠PET/CT诊断肿瘤骨转移应用进展[J].国际放射医学核医学杂志,2015,39(1):96.[doi:10.3760/cma.j.issn.1673-4114.2015.01.020]
　Zhang Yin,Chen Yue.Application progress of 18F-NaF PET/CT in the diagnosis of neoplasm metastases[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):96.[doi:10.3760/cma.j.issn.1673-4114.2015.01.020]
[8]徐金苹,袁德晓,张江虹,等.辐射诱导的外泌体在肿瘤细胞侵袭转移中的作用[J].国际放射医学核医学杂志,2015,39(2):144.[doi:10.3760/cma.j.issn.1673-4114.2015.02.009]
　Xu Jinping,Yuan Dexiao,Zhang Jianghong,et al.The role of radiation-induced exosomes in tumor invasion and metastasis[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):144.[doi:10.3760/cma.j.issn.1673-4114.2015.02.009]
[9]刘雪辉,李洪均,于鸿煦.SPECT/CT融合显像对可疑骨转移灶的诊断效能[J].国际放射医学核医学杂志,2015,39(3):201.[doi:10.3760/cma.j.issn.1673-4114.2015.03.003]
　Liu Xuehui,Li Hongjun,Yu Hongxu.Diagnostic efficacy of SPECT/CT fusion imaging in assessing possible bone metastases[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):201.[doi:10.3760/cma.j.issn.1673-4114.2015.03.003]
[10]桂继琮,刘兴党.镭-223氯化物治疗去势抵抗性前列腺癌骨转移的研究进展[J].国际放射医学核医学杂志,2015,39(3):268.[doi:10.3760/cma.j.issn.1673-4114.2015.03.018]
　Gui Jicong,Liu Xingdang.Development in the study of radium-223 chloride for treating castration-resistant prostate carcinoma with bone metastases[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):268.[doi:10.3760/cma.j.issn.1673-4114.2015.03.018]
[11]刘超,邓智勇,刘鹏杰,等.89SrCL2与唑来膦酸联合治疗乳腺癌转移性骨肿瘤的疗效分析[J].国际放射医学核医学杂志,2014,38(5):300.[doi:10.3760/cma.j.issn.1673-4114.2014.05.006]
　Liu Chao,Deng Zhi-yong,Liu Peng-jie,et al.Analysis on the curative effect of combination therapy with zoledronic acid and 89SrCL2 on bone tumor with breast cancer metastasis[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(6):300.[doi:10.3760/cma.j.issn.1673-4114.2014.05.006]
[12]樊孝廉,鲁胜男,古炎发,等.乳腺癌患者骨病灶SPECT/CT融合显像的临床价值[J].国际放射医学核医学杂志,2013,37(4):221.[doi:10.3760/cma.j.issn.1673-4114.2013.04.008]
　FAN Xiao-lian,LU Sheng-nan,GU Yan-fa,et al.The clinical value of SPECT/CT fusion imaging in the diagnosis of bone metastasis of breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(6):221.[doi:10.3760/cma.j.issn.1673-4114.2013.04.008]
[13]袁超,李卫鹏,胡永全,等.89Sr治疗乳腺癌和前列腺癌多发性骨转移的临床观察[J].国际放射医学核医学杂志,2010,34(4):220.[doi:10.3760/cma.j.issn.1673-4114.2010.04.008]
　YUAN Chao,LI Wei-peng,HU Yong-quan,et al.Clinical observation of 89Sr treatment efficacy of multiple bone metastases in breast and prostate cancer patients[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(6):220.[doi:10.3760/cma.j.issn.1673-4114.2010.04.008]
[14]路宝士,高玉芳.血清CA15-3、CEA检测联合全身骨显像在乳腺癌骨转移中的诊断价值[J].国际放射医学核医学杂志,2011,35(2):107.[doi:10.3760/cma.j.issn.1673-4114.2011.02.010]
　LU Bao-shi,GAO Yu-fang.The value of combined examination of serum CA15-3, CEA level and whole body bone scan in the diagnosis of bone metastasis in breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2011,35(6):107.[doi:10.3760/cma.j.issn.1673-4114.2011.02.010]
[15]佟丽娟,王明泽,王丽梅.肺癌、乳腺癌、食道癌远端骨转移特点的对比研究[J].国际放射医学核医学杂志,2011,35(1):38.[doi:10.3760/cma.j.issn.1673-4114.2011.01.011]
　TONG Li-juan,WANG Ming-ze,WANG Li-mei.Comparative study between characteristics of the lung cancer, breast cancer and esophageal cancer distal bone metastases[J].International Journal of Radiation Medicine and Nuclear Medicine,2011,35(6):38.[doi:10.3760/cma.j.issn.1673-4114.2011.01.011]
[16]袁超,陶健,袁媛,等.血清CA15-3、CEA及全身骨显像联合检查对乳腺癌骨转移的诊断价值[J].国际放射医学核医学杂志,2009,33(6):353.[doi:10.3760/cma.j.issn.1673-4114.2009.06.011]
　YUAN Chao,TAO Jian,YUAN Yuan,et al.The diagnostic significance of CA15-3, CEA combined with whole body bone scan for bone metastases in patients with breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(6):353.[doi:10.3760/cma.j.issn.1673-4114.2009.06.011]
[17]张亶,章斌,邓胜明,等.18F-FDG PET/CT在乳腺癌术后随访中的价值[J].国际放射医学核医学杂志,2017,41(3):159.[doi:10.3760/cma.j.issn.1673-4114.2017.03.001]
　Zhang Dan,Zhang Bin,Deng Shengming,et al.Clinical value of 18F-FDG PET/CT in follow-up of postoperative breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2017,41(6):159.[doi:10.3760/cma.j.issn.1673-4114.2017.03.001]
[18]张雪辉,杨贵生,肖国有.乳腺癌骨转移的影像学诊断进展[J].国际放射医学核医学杂志,2017,41(4):278.[doi:10.3760/cma.j.issn.1673-4114.2017.04.008]
　Zhang Xuehui,Yang Guisheng,Xiao Guoyou.Imaging for diagnosis of bone metastases in breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2017,41(6):278.[doi:10.3760/cma.j.issn.1673-4114.2017.04.008]

备注/Memo

备注/Memo:
收稿日期:2014-07-30。
基金项目:江苏省徐州市科技计划项目(XMl38097)
通讯作者:刘海娜(Email:zlyywyf@163.com)
更新日期/Last Update: 1900-01-01