18F FDG PET/CT 与 99m Tc MDP 骨闪烁成像在乳腺癌患者转移性骨病成像中的对比;根据血清标记物解决差异。

IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Nuclear Medicine Communications Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI:10.1097/MNM.0000000000001888
Hatem Nasr, Nejoud Alnajashi, Hussein Farghaly, Abdullah Alqarni
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引用次数: 0

摘要

目的:评估 18F- 氟脱氧葡萄糖(FDG)PET/计算机断层扫描(CT)与 99mTc MDP 骨扫描在评估乳腺癌患者转移性骨病时与血清标志物的关系:我们回顾了 37 例乳腺癌骨转移患者(平均年龄为 55.38 ± 13.08 岁)的 PET/CT 研究和骨扫描结果。为了评估转移性骨负担,我们使用了 PET/CT (PMS)和骨扫描(BMS)得出的半定量评分。我们使用McNemar检验比较两种模式的病灶检测情况,并使用接收器操作特征分析确定血清CA 15-3的临界值,该值最能预测PET/CT比骨扫描的附加值:在 13 例患者(35.1%)中,PET/CT 发现了更多病灶或更高强度的病灶,而只有 4 例患者(10.8%)在骨扫描中发现了更突出的病灶(P = 0.049)。PET/CT 上发现的其他病变主要是溶骨性病变或髓样病变(早期)。骨扫描中摄取较高的病变大多呈硬化性(晚期)。CA 15-3 与 PMS 呈正相关(r = 0.386;P = 0.018),但与 BMS 无关(r = -0.027;P = 0.874)。然而,血清碱性磷酸酶与 PMS(r = 0.389;P = 0.017)和 BMS(r = 0.363;P = 0.027)均呈正相关。与骨扫描相比,CA 15-3值>47 U/ml最能预测PET/CT的其他发现(曲线下面积=0.708;P=0.0261):结论:FDG PET/CT 可在早期发现转移性骨病变。结论:FDG PET/CT 可在较早阶段发现骨转移病灶,CA 15-3 较高可预测 PET/CT 上较高的转移负荷,但在骨扫描上则不然。骨扫描的特异性较低,可能是由于漏诊了早期病变和检测到愈合硬化病变的持续摄取。
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18 F FDG PET/CT versus 99m Tc MDP Bone scintigraphy in imaging of metastatic osseous disease in breast cancer patients; Solving the discrepancies in light of serum markers.

Aim: To assess the performance of 18 F-fluorodeoxyglucose (FDG) PET/computed tomography (CT) versus 99m Tc MDP bone scan in assessment of metastatic osseous disease in breast cancer patients in relation to serum markers.

Material and methods: We reviewed PET/CT studies and bone scans for 37 patients (mean age of 55.38 ± 13.08 years) with metastatic breast cancer to bone. To assess metastatic osseous burden, we used semiquantitative scores derived from PET/CT (PMS) and bone scans (BMS). We used McNemar test to compare lesion detection between both modalities and receiver operator characteristic analysis to define the cutoff value of serum CA 15-3 that best predicts additional value for PET/CT over bone scan.

Results: In 13 patients (35.1%), more lesions or higher-intensity lesions were detected on PET/CT, while only 4 patients (10.8%) had more prominent lesions on bone scans ( P = 0.049). Additional lesions seen on PET/CT are predominantly osteolytic or medullary (early phase). Most lesions with higher uptake on bone scans appear sclerotic (late phase). CA 15-3 was positively correlated to PMS ( r = 0.386; P = 0.018) but not to BMS ( r = -0.027; P = 0.874). However, serum alkaline phosphatase was positively correlated to both PMS ( r = 0.389; P = 0.017) and BMS ( r = 0.363; P = 0.027). CA 15-3 value of >47 U/ml best predicted additional findings on PET/CT compared to bone scans (area under the curve = 0.708; P = 0.0261).

Conclusion: FDG PET/CT detects metastatic osseous lesions during an earlier phase. A higher CA 15-3 predicts a higher metastatic burden on PET/CT but not on bone scan. Bone scans are less specific, likely by missing early lesions and detecting persistent uptake in healing sclerotic lesions.

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来源期刊
CiteScore
2.20
自引率
6.70%
发文量
212
审稿时长
3-8 weeks
期刊介绍: Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.
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