[1]张高潮,马丽,寇莹,等.99Tcm-tetrofosmin SPECT诊断肺部肿瘤的临床价值[J].国际放射医学核医学杂志,2015,39(4):303-307.[doi:10.3760/cma.j.issn.1673-4114.2015.04.007]
　Zhang Gaochao,Ma Li,Kou Ying,et al.Clinical value of 99Tcm-tetrofosmin SPECT in the diagnosis of lung neoplasms[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(4):303-307.[doi:10.3760/cma.j.issn.1673-4114.2015.04.007]
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
39
期数:
2015年第4期
页码:
303-307
栏目:
出版日期:
2015-07-25

文章信息/Info

Title:
Clinical value of 99Tcm-tetrofosmin SPECT in the diagnosis of lung neoplasms
作者:
张高潮;  马丽;  寇莹;  陈正福;  宋晏;  徐金亮
汉中三二○一医院核医学科, 汉中, 723000
Author(s):
Zhang Gaochao;  Ma Li;  Kou Ying;  Chen Zhengfu;  Song Yan;  Xu Jinliang
Department of Nuclear Medicine, the 3201 Hos-pital of Hanzhong, Hanzhong 723000, China
关键词:
肺肿瘤; 99Tcm-tetrofosmin; 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:
Lung neoplasms; 99Tcm-tetrofosmin; Tomography;  emission-computed;  single-photon; Tomography;  X-ray computed
DOI:
10.3760/cma.j.issn.1673-4114.2015.04.007
摘要:
目的 探讨99Tcm-tetrofosmin (99Tcm-TF) SPECT亲肿瘤显像诊断肺部肿瘤的临床价值。方法 收集在我科进行99Tcm-TF肺亲肿瘤显像的患者41例;所有患者均在治疗前一周行胸部CT检查及99Tcm-TF SPECT肺亲肿瘤显像。对照最终结果,评价两种方法鉴别肺肿瘤病变性质的诊断效能。以肿瘤3 cm大小为界,分≥3 cm组和<3 cm组,评价99Tcm-TF SPECT显像在两组中的诊断效能。结果 99Tcm-TF SPECT肺亲肿瘤显像的灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为66.7%、35.7%、56.1%、66.7%和35.7%;CT肺扫描的灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为92.6%、50.0%、78.0%、78.1%和77.8%。CT较99Tcm-TF SPECT的灵敏度(χ2=5.594,P<0.05)和准确率(χ2=4.473,P<0.05)高,而特异度两者间的差异无统计学意义,(χ2=0.583,P>0.05)。同时,肿瘤≥3 cm和<3 cm组中,99Tcm-TF检查肺肿瘤的灵敏度、特异度、准确率分别为78.9%、25.0%、69.6%和37.5%、40.0%、38.9%,而两组的特异度差异无统计学意义(χ2=0.28,P>0.05),灵敏度(χ2=4.352,P<0.05)和准确率(χ2=3.858,P<0.05)有差异。结论 CT对于肺癌诊断有一定的价值,相比而言,99Tcm-TF的诊断价值有限。临床医生在行该项检查之前需经过筛选才有可能提高其临床价值。
Abstract:
Objective To explore the clinical value of 99Tcm-tetrofosmin (99Tcm-TF) in the diagnosing of lung neoplasms.Methods 99Tcm-TF lung affinity tumor imaging data from 41 patients in our department were retrospectively reviewed.Chest computer tomography (CT) and 99Tcm-TF SPECT lung affinity tumor imaging were performed within one week before treatment.Diagnostic efficiency of the two methods in identifying lung neoplasm characteristics were evaluated by comparing final diagnosis results.Cases were grouped into tumor sizes,as follows:not less than 3 cm and less than 3 cm with a 3 cm threshold.The diagnostic efficiencies of 99Tcm-TF SPECT imaging of the two groups were compared.Results The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of 99Tcm-TF imaging in diagnosing lung neoplasm were 66.7%,35.7%,56.1%,66.7% and 35.7%,respectively,whereas the corresponding values for chest CT scanning were 92.6%,50.0%,78.0%,78.1% and 77.8%.Thus,CT was more sensitive (χ2=5.594,P<0.05) and accurate (χ2=4.473,P<0.05) than 99Tcm-TF SPECT imaging,but was not specific (χ2=0.583,P>0.05).The sensitivity,specificity,and accuracy of 99Tcm-TF imaging for the group with a size of not less than 3 cm were 78.9%,25.0%,and 69.6%,whereas the corresponding values for the group with less than 3 cm size were 37.5%,40.0%,and 38.9%,respectively.No significant difference was found in specificity (χ2=0.28,P>0.05) between the two groups,but sensitivity (χ2=4.352,P<0.05) and accuracy (χ2=3.858,P<0.05) were significantly different between the groups.Conclusions CT was superior in diagnosing lung cancer compared with 99Tcm-TF.The value of 99Tcm-TF may be improved when clinical doctors screen the proper patients.

参考文献/References:

[1] 党国际. 99mTc-MIBI肺显像、多排螺旋CT和肿瘤标志物检测对肺癌的诊断价值[J]. 肿瘤研究与临床, 2009, 21(3):172-177.
[2] 王辉, Maurea S, Ciro M, 等. 99Tcm-tetrofosmin肺癌显像的临床研究(与18F-FDG PET对比)[J]. 中华核医学杂志, 1999, 19(1):8-10.
[3] Spanu A, Schillaci O, Pirina P, et al. 99mTc-tetrofosmin SPECT in solitary pulmonary nodule evaluation[J]. Oncol Rep, 2006, 16(4):763-769.
[4] Kao CH, ChangLai SP, Shen YY, et al. Technetium-99m-tetrofosmin SPECT imaging of lung masses:a negative study[J]. J Nucl Med, 1997, 38(7):1015-1019.
[5] 黄代娟, 张永学, 赵峰, 等. 99mTc-tetrofosmin SPECT诊断肺部肿瘤和纵隔淋巴结转移的临床价值[J]. 中国肺癌杂志, 2007, 10(1):25-28.
[6] Ohtake E. SPECT imaging with technetium-99m-tetrofosmin for pulmonary nodules[J]. J Nucl Med, 1998, 39(11):2016-2017.
[7] Schillaci O, Picardi V, Scopinaro F. Technetium-99m-tetrofosmin SPECT imaging of lung lesions:a not-so-negative study[J]. J Nucl Med, 199839(10):1830.
[8] Filippi L, Santoni R, Nicolì P, et al. Intracranial tumors after radia-tion therapy:role of 99mTc-tetrofosmin SPECT/CT with a hybrid camera[J]. Cancer Biother Radiopharm, 2009, 24(2):229-235.
[9] Sathekge M, Maes A, D’ Asseler Y, et al. Nuclear medicine imaging in tuberculosis using commercially available radiopharmaceuticals[J]. Nucl Med Com, 2012, 33(6):581-590.
[10] Huang D, Zhao F, Zhang Y. The clinical usefulness of 99mTc-Tetrofosmin scintigraphy in thediagnosis of lung neoplasmas and mediastinai lymphoid node involvement[J]. J Huazhong Univ Sci Technolog Med Sci, 2008, 28(5):608-612.
[11] Schillaci O, Spanu A, Madeddu G. 99mTc sestamibi and 99mTc tetrofos-min in oncology:SPECT and fusion imaging in lung cancer, malig-nant lymphomas and brain tumors[J]. Q J Nucl Med Mol Imaging, 2005, 49(2):133-144.

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备注/Memo

备注/Memo:
收稿日期:2014-12-11。
通讯作者:马丽,Email:yangyi_198855@sina.com
更新日期/Last Update: 1900-01-01