CAJ | 학술논문

目的评价18F-脱氧葡萄糖(FDG)PET/CT检测恶性肿瘤骨转移的应用价值.方法回顾性分析经18F-FDG PET/CT诊断的689例恶性肿瘤患者的资料,按颈椎、胸椎、腰椎、骶尾椎、骨盆、肩胛骨和锁骨、长骨、胸骨、肋骨及颅骨将机体骨骼分为10个区域,记录每个区域的骨转移情况.根据同机CT进一步区分转移灶的病变性质(破骨性或成骨性),比较同机CT、18F-FDG PET及18F-FDG PET/CT诊断骨转移的灵敏度、特异性及准确性.计算阳性病灶的最大标准摄取值(SUVmax).患者不同性别间年龄差异采用x2检验,诊断率的比较采用McNemar检验.结果共有91例患者442个区域被确定有骨转移,PET/CT诊断骨转移患者的灵敏度、特异性和准确性分别为94.5%(86/91)、97.8%(585/598)和97.4%(671/689),高于同机CT的79.1%(72/91),91.8%(549/598)和90.1%(621/689)(X2=20.049,148.890,168.792,P=0.000);PET/CT诊断病灶骨转移的灵敏度、特异性和准确性分别为95.0%(420/442),97.2%(455/468)和96.2%(875/919),高于同机CT的81.0%(358/442),90.4%(423/468)和85.8%(781/910)(X2=98.673,125.691,220.375,P=0.000).同机CT共诊断出99个成骨性和197个破骨性病变.PET真阳性病灶SUVmax为6.7±3.0,假阳性病灶SUVmax为3.7±1.3(X2=463.120,P=0.000);成骨性病变SUVmax为4.9±2.0,破骨性病变SUVmax为7.4±3.1(X2=327.175,P:0.000).结论同机cT和18F-FDG PET图像的结合提高了PET/CT诊断恶性肿瘤骨转移的能力;同机CT能精确定位病变,并可区分转移病灶的成骨或破骨性质.
목적 평개18F-탈양포도당(FDG)PET/CT검측악성종류골전이적응용개치.방법 회고성분석경18F-FDG PET/CT진단적689례악성종류환자적자료,안경추、흉추、요추、저미추、골분、견갑골화쇄골、장골、흉골、륵골급로골장궤체골격분위10개구역,기록매개구역적골전이정황.근거동궤CT진일보구분전이조적병변성질(파골성혹성골성),비교동궤CT、18F-FDG PET급18F-FDG PET/CT진단골전이적령민도、특이성급준학성.계산양성병조적최대표준섭취치(SUVmax).환자불동성별간년령차이채용x2검험,진단솔적비교채용McNemar검험.결과 공유91례환자442개구역피학정유골전이,PET/CT진단골전이환자적령민도、특이성화준학성분별위94.5%(86/91)、97.8%(585/598)화97.4%(671/689),고우동궤CT적79.1%(72/91),91.8%(549/598)화90.1%(621/689)(X2=20.049,148.890,168.792,P=0.000);PET/CT진단병조골전이적령민도、특이성화준학성분별위95.0%(420/442),97.2%(455/468)화96.2%(875/919),고우동궤CT적81.0%(358/442),90.4%(423/468)화85.8%(781/910)(X2=98.673,125.691,220.375,P=0.000).동궤CT공진단출99개성골성화197개파골성병변.PET진양성병조SUVmax위6.7±3.0,가양성병조SUVmax위3.7±1.3(X2=463.120,P=0.000);성골성병변SUVmax위4.9±2.0,파골성병변SUVmax위7.4±3.1(X2=327.175,P:0.000).결론 동궤cT화18F-FDG PET도상적결합제고료PET/CT진단악성종류골전이적능력;동궤CT능정학정위병변,병가구분전이병조적성골혹파골성질.
Objective The aim of this retrospective study was to understand the role of18F-fluorodeoxyglueose (FDG) PET/CT in detecting bone metastasis in various cancers. Methods Six hundred and eighty-nine cancer patients who had 18 F-FDG PET/CT were included. The diagnosis of bone metastasis was based on matched findings of FDG-avid lesion on PET and characteristic morphological changes on CT. The sensitivity, specificity and accuracy of CT, and PET/CT were calculated and the results were statistically analyzed ( McNemar test). Results Ninety-one patients with 442 regions were diagnosed to have bone me-tastases. On patient base analysis, the sensitivity, specificity, and accuracy of hybrid CT for detecting bone metastases were 79.1% ( 72/91 ) , 91.8 % ( 549/598 ) , 90.1% ( 621/689 ) and were 94.5% (86/91), 97.8% (585/598), 97.4% (671/689) for PET/CT (X2=20.049,148.890,168.792, all P=0.000). On lesion base analysis, the sensitivity, specificity, and accuracy of hybrid CT for detecting bone metastases were 81.0% (358/442), 90.4% (423/468), 85.8% (781/910) and were 95.0% (420/442), 97.2% (455/468), 96.2% (875/910) for PET/CT (X2=98.673,125.691, 220.375, all P= 0.000). The maximum standardized uptake value ( SUVmax) of PET true positive and false positive lesions were 6.7±3.0 and 3.7±1.3 respectively (X2 =463.120, P =0.000). The SUVmaxof osteoblastic and osteolytic lesions were4.9±2.0 and7.4±3.1, respectively (X2 =327. 175, P=0.000). Conclusions It is worth noting that 18F-FDG PET/CT is a novel tool to evaluate bone metastasis and its performances due to the combina-tion of PET and CT. Hybrid CT has a high value in providing precise location of the metastatic sites.