Diagnostic performance of 18F-fluorodeoxyglucose PET/CT and bone scintigraphy in breast cancer patients with suspected bone metastasis
Diagnostic performance of 18F-fluorodeoxyglucose PET/CT and bone scintigraphy in breast cancer patients with suspected bone metastasis
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DOI：
10.1007/s12282-015-0621-z
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发表时间：
2016-07-01
期刊：
影响因子：
4
通讯作者：
Tokuda, Yutaka
中科院分区：
文献类型：
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作者：
Niikura, Naoki;Hashimoto, Jun;Tokuda, Yutaka
我们前瞻性地比较了PET/CT和BS对疑似乳腺癌骨转移患者的诊断准确性。这项单机构前瞻性研究纳入了2011年9月至2014年3月在东海大学医院接受活检证实的乳腺癌疑似骨转移的连续患者。纳入标准包括怀疑骨转移（骨痛、碱性磷酸酶升高、肿瘤标志物升高或BS怀疑骨转移）。两名核医学医师评估PET/CT和BS图像。30名患者最初参加了这项研究。其中2人因在随访期间拒绝接受影像学检查而被排除在分析之外。最终确诊的10例患者中，PET/CT均成功检出骨转移灶，而BS检出2例。两种方法在检测骨转移方面不高度一致。在28个配对研究中的19个（68%）中，2个（10%）为转移阳性，17个（90%）为阴性。不一致9例（32%）；其中PET/CT阳性、BS阴性2例；5例PET/CT阳性，BS不明确；1例PET/CT阴性，BS阴性；1例PET/CT阴性，BS阴性。我们的结果表明PET/CT对骨转移的诊断优于BS。根据前人和我们的研究结果，PET/CT可以取代BS作为疑似患者骨转移的初始检测方式。
We prospectively compared the diagnostic accuracies of PET/CT and BS in patients with suspected bone metastases from breast cancer.This single-institution prospective study included consecutive patients with suspected bone metastases from biopsy-proven breast cancer seen at Tokai University Hospital between September 2011 and March 2014. Inclusion criteria included suspicions for bone metastases (bone pain, elevated alkaline phosphatase, elevated tumor markers, or suspected bone metastases by BS). Two nuclear medicine physicians evaluated PET/CT and BS images.Thirty patients were initially enrolled in this study. Two were excluded from the analyses because they declined to undergo imaging during follow-up. PET/CT successfully detected bone metastases in all 10 patients finally diagnosed with the condition, whereas BS identified 2. The two methods were not highly concordant in detecting osseous metastases. In 19 of 28 paired studies (68 %), 2 (10 %) were positive for metastasis, and 17 (90 %) were negative. Nine occurrences (32 %) were discordant; of these, 2 were PET/CT positive and BS negative; 5 were PET/CT positive and BS equivocal; one was PET/CT negative and BS equivocal, and one was PET/CT equivocal and BS negative.Our results indicated that PET/CT was superior to BS for the diagnosis of bone metastases. On the basis of the results of previous studies as well as ours, PET/CT could replace BS as the initial modality to detect bone metastases in patients suspected for the condition.