平面骨扫描、单光子发射计算机断层扫描（SPECT）及（18）F标记的氟化钠正电子发射断层扫描（PET）对新诊断肺癌临床价值的前瞻性评估

Prospective evaluation of the clinical value of planar bone scans, SPECT, and (18)F-labeled NaF PET in newly diagnosed lung cancer.

作者信息

Schirrmeister H, Glatting G, Hetzel J, Nüssle K, Arslandemir C, Buck A K, Dziuk K, Gabelmann A, Reske S N, Hetzel M

机构信息

Department of Nuclear Medicine, University of Ulm, Ulm, Germany.

出版信息

J Nucl Med. 2001 Dec;42(12):1800-4.

PMID:11752076

Abstract

UNLABELLED

Previous studies have shown that vertebral bone metastases (BM) not seen on planar bone scintigraphy (BS) might be present on (18)F-fluoride PET scans or at MRI. Therefore, we evaluated the effect of SPECT or (18)F-labeled NaF PET ((18)F PET) imaging on the management of patients with newly diagnosed lung cancer.

METHODS

Fifty-three patients with small cell lung cancer or locally advanced non-small cell lung cancer were prospectively examined with planar BS, SPECT of the vertebral column, and (18)F PET. MRI and all available imaging methods, as well as the clinical course, were used as reference methods. BS with and without SPECT and (18)F PET were compared using a 5-point scale for receiver operating characteristic (ROC) curve analysis.

RESULTS

Twelve patients had BM. BS produced 6 false-negatives, SPECT produced 1 false-negative, and (18)F PET produced no false-negatives. The area under the ROC curve was 0.779 for BS, 0.944 for SPECT, and 0.993 for (18)F PET. The areas under the ROC curve of (18)F PET and BS complemented by SPECT were not significantly different, and both tomographic methods were significantly more accurate than planar BS. As a result of SPECT or (18)F PET imaging, clinical management was changed in 5 patients (9%) or 6 patients (11%), respectively.

CONCLUSION

As indicated by the area under the ROC curve analysis, (18)F PET is the most accurate whole-body imaging modality for screening for BM. Routinely performed SPECT imaging is practicable, is cost-effective, and improves the accuracy of BS.

摘要

未标记

先前的研究表明，平面骨闪烁显像（BS）未显示的椎体骨转移（BM）可能在（18）F - 氟化物PET扫描或MRI上出现。因此，我们评估了SPECT或（18）F标记的NaF PET（（18）F PET）成像对新诊断肺癌患者治疗管理的影响。

方法

对53例小细胞肺癌或局部晚期非小细胞肺癌患者进行前瞻性检查，包括平面BS、脊柱SPECT和（18）F PET。MRI及所有可用的成像方法以及临床病程用作参考方法。使用五点量表对有和没有SPECT及（18）F PET的BS进行受试者操作特征（ROC）曲线分析比较。

结果

12例患者有骨转移。BS产生6例假阴性，SPECT产生1例假阴性，（18）F PET未产生假阴性。BS的ROC曲线下面积为0.779，SPECT为0.944，（18）F PET为0.993。（18）F PET和由SPECT补充的BS的ROC曲线下面积无显著差异，两种断层成像方法均比平面BS显著更准确。由于SPECT或（18）F PET成像，分别有5例（9%）或6例（11%）患者的临床管理发生了改变。