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SPECT/CT骨定量SUVmax分析在老年前列腺癌骨转移中的鉴别诊断价值

翟威豪 何薇

翟威豪, 何薇. SPECT/CT骨定量SUVmax分析在老年前列腺癌骨转移中的鉴别诊断价值[J]. 分子影像学杂志, 2021, 44(6): 983-987. doi: 10.12122/j.issn.1674-4500.2021.06.20
引用本文: 翟威豪, 何薇. SPECT/CT骨定量SUVmax分析在老年前列腺癌骨转移中的鉴别诊断价值[J]. 分子影像学杂志, 2021, 44(6): 983-987. doi: 10.12122/j.issn.1674-4500.2021.06.20
ZHAI Weihao, HE Wei. Differential diagnosis value of SPECT/CT bone quantitative SUVmax analysis in the bone metastases of elderly prostate cancer patients[J]. Journal of Molecular Imaging, 2021, 44(6): 983-987. doi: 10.12122/j.issn.1674-4500.2021.06.20
Citation: ZHAI Weihao, HE Wei. Differential diagnosis value of SPECT/CT bone quantitative SUVmax analysis in the bone metastases of elderly prostate cancer patients[J]. Journal of Molecular Imaging, 2021, 44(6): 983-987. doi: 10.12122/j.issn.1674-4500.2021.06.20

SPECT/CT骨定量SUVmax分析在老年前列腺癌骨转移中的鉴别诊断价值

doi: 10.12122/j.issn.1674-4500.2021.06.20
详细信息
    作者简介:

    翟威豪,技师,E-mail: weihaozhai@hotmail.com

    通讯作者:

    何薇,硕士,主任医师,E-mail: heweixu@hotmail.com

Differential diagnosis value of SPECT/CT bone quantitative SUVmax analysis in the bone metastases of elderly prostate cancer patients

  • 摘要:   目的  探讨SPECT/CT骨定量分析获得最大标准摄取值(SUVmax)对老年前列腺癌骨转移的鉴别诊断价值。  方法  回顾性分析2019年1~12月我院158例确诊前列腺癌患者的99mTc-MDP SPECT/CT骨显像资料。对异常放射性浓聚灶及182个正常椎体行SPECT/CT检查及骨定量分析,比较良恶性病灶与正常椎体之间SUVmax的差异性。选取2019年1~4月46例患者的144个异常浓聚灶,通过绘制ROC曲线得到SUVmax的最佳临界值;选取2019年5~12月293个异常浓聚灶,使用SUVmax的最佳临界值比较SPECT/CT骨定量分析与常规SPECT/CT的诊断效能。  结果  以病理或随访作为判断标准,所有老年前列腺癌患者共437个异常浓聚灶(恶性254个,良性183个),恶性病灶的SUVmax明显高于良性病灶(43.93±19.09 vs 15.26±6.81,P < 0.01)和正常椎体(6.54±1.19,P < 0.01)。通过ROC曲线得到SUVmax≥19.2为诊断恶性病灶的最佳临界值,常规SPECT/CT与SPECT/CT骨定量诊断的准确度、敏感度、特异性、阳性预测率、阴性预测率分别为81.6%和94.5%、93.0%和96.5%、65.2%和91.7%、79.2%和94.3%、86.8%和94.9%,SPECT/CT骨定量诊断的准确度、特异性、阳性预测率和阴性预测率均明显高于常规SPECT/CT。  结论  SPECT/CT骨定量分析在老年前列腺癌骨转移的鉴别诊断中具有重要临床应用价值,具有临床应用的潜力。

     

  • 图  1  利用自动VOI技术测量病灶SUV及体积信息

    Figure  1.  Using automatic VOI software to measure the standard uptake value and volume.

    图  2  骨转移良恶性病灶SUVmax ROC曲线

    Figure  2.  The ROC curve of the SUVmax between malignant and benign lesions.

    表  1  前列腺癌患者骨转移病灶分布

    Table  1.   Distribution of bone metastases in prostate cancer patients (n)

    病灶分布 恶性病灶 良性病灶 合计
    脊柱 94 75 169
    肋骨 42 34 76
    骨盆 106 72 178
    胸骨 8 0 8
    四肢 4 2 6
    下载: 导出CSV

    表  2  常规SPECT/CT、SPECT/CT骨定量诊断结果与金标准对比

    Table  2.   Comparison of the results of conventional SPECT/CT, SPECT/CT quantitative analysis and the gold standard (n)

    诊断结果 常规SPECT/CT 合计 SPECT/CT骨定量 合计
    恶性 良性 恶性 良性
    病理或随访 恶性 160 12 172 166 6 172
    良性 42 79 121 10 111 293
    合计 202 91 293 176 117 293
    下载: 导出CSV

    表  3  常规SPECT/CT与SPECT/CT骨定量诊断效能对比

    Table  3.   Comparison of the diagnostic efficiency of conventional SPECT/CT and SPECT/CT quantitative analysis (%)

    诊断方式 准确度 敏感度 特异性 阳性预测率 阴性预测率
    常规SPECT/CT 81.6 93 65.2 79.2 86.8
    SPECT/CT骨定量 94.5 96.5 91.7 94.3 94.9
    下载: 导出CSV
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出版历程
  • 收稿日期:  2021-09-03
  • 网络出版日期:  2022-01-05
  • 刊出日期:  2021-11-20

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