Comparison of 18F Fluoride PET/CT and 99mTc-MDP Bone Scan in the Detection of Skeletal Metastases in Urinary Bladder Carcinoma
Comparison of 18F Fluoride PET/CT and 99mTc-MDP Bone Scan in the Detection of Skeletal Metastases in Urinary Bladder Carcinoma
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DOI：
10.1097/rlu.0b013e31828da5cc
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发表时间：
2013-08-01
影响因子：
10.6
通讯作者：
Mittal, Bhagwant Rai
中科院分区：
文献类型：
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作者：
Chakraborty, Dhritiman;Bhattacharya, Anish;Mittal, Bhagwant Rai
目的：本研究的目的是比较 F-18-氟化物 PET/CT 和 Tc-99m-MDP 骨显像在检测膀胱癌骨骼转移方面的效果。 患者和方法：在这项前瞻性研究中，48 名膀胱癌患者（44 名男性和 4 名女性患者，年龄 35-80 岁）接受了 Tc-99m-MDP 平面和 SPECT/CT 骨扫描 (BS)，然后在 48 小时内进行 F-18 氟化物 PET/CT。将每种技术诊断的骨转移与基于对比增强 CT、MRI、骨骼调查、临床随访和组织学相关性的最终诊断进行比较。结果：F-18-氟化物 PET/CT 识别出骨转移，并在 48 名患者中的 17 名 (35%) 中改变了治疗方法。 Tc-99m-MDP平面BS的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为82.35%、64.51%、56%、86.95%和70.83%； Tc-99m-MDP SPECT/CT 的准确率分别为 88.23%、74.19%、65.21%、92% 和 79.16%； F-18氟化物PET/CT的诊断率和诊断率分别为100%、87.09%、80.95%、100%和91.66%。 Tc-99m-MDP平面BS与F-18氟化物PET/CT之间的一致性较好（kappa = 0.42），SPECT/CT与F-18氟化物PET/CT之间的一致性非常好（kappa = 0.74）。结论：F-18氟化物PET/CT在检测骨转移方面具有更高的敏感性、特异性、阳性预测值、阴性预测值和准确性。 在膀胱癌中优于传统的 Tc-99m-MDP 平面 BS。与平面 BS 相比，SPECT/CT 改善了所有这些参数，并且可以作为检测高危患者骨骼转移的经济有效的筛查程序。
Aim: The aim of this study was to compare F-18-fluoride PET/CT and Tc-99m-MDP bone scintigraphy in the detection of skeletal metastases in urinary bladder carcinoma.Patients and Methods: In this prospective study, 48 patients with urinary bladder carcinoma (44 male and 4 female patients, aged 35-80 years) underwent Tc-99m-MDP planar and SPECT/CT bone scan (BS) followed by F-18-fluoride PET/CT within 48 hours. Skeletal metastasis diagnosed on each of these techniques was compared against a final diagnosis based on contrast-enhanced CT, MRI, skeletal survey, clinical follow-up, and histological correlation.Results: F-18-fluoride PET/CT identified bony metastases and changed the management in 17 of 48 patients (35%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Tc-99m-MDP planar BS were 82.35%, 64.51%, 56%, 86.95%, and 70.83%; of Tc-99m-MDP SPECT/CT were 88.23%, 74.19%, 65.21%, 92%, and 79.16%; and of F-18-fluoride PET/CT were 100%, 87.09%, 80.95%, 100%, and 91.66%, respectively. Fair agreement between Tc-99m-MDP planar BS and F-18-fluoride PET/CT (kappa = 0.42) and excellent agreement between SPECT/CT and F-18-fluoride PET/CT (kappa = 0.74) were found.Conclusions: F-18-fluoride PET/CT has higher sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in detecting bone metastases in urinary bladder carcinoma than conventional Tc-99m-MDP planar BS. SPECT/CT improves all these parameters compared with planar BS and may serve as a cost-effective screening procedure for the detection of skeletal metastases in high-risk patients.