骨闪烁显像的短时间单光子发射计算机断层扫描（SPECT）图像能否提高对骨外恶性肿瘤患者胸椎孤立性病变评估的诊断价值？
Do short-time SPECT images of bone scintigraphy improve the diagnostic value in the evaluation of solitary lesions in the thoracic spine in patients with extraskeletal malignancies?
作者信息
Kobayashi Kana, Okuyama Chio, Kubota Takao, Nakai Takako, Ushijima Yo, Nishimura Tsunehiko
机构信息
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
出版信息
Ann Nucl Med. 2005 Oct;19(7):557-66. doi: 10.1007/BF02985048.
OBJECTIVE
Single photon emission computed tomography (SPECT) images provide many details of the anatomical structure. Also about bone scintigraphy, there are many reports of the improvement of diagnosis by SPECT images. Although SPECT is useful, it requires much time. So to perform SPECT for all cases is difficult in the clinical situation. Recently, due to technical improvements in gamma cameras, we can get SPECT images in a short time. We examined diagnosis of solitary hot spots of thoracic spine in cancer patients using short-time SPECT. And we considered whether short-time SPECT contributes to the precise diagnosis of the lesion.
MATERIAL AND METHODS
We performed bone scintigraphy image acquisition and both planar and short-time SPECT of the chest. Short-time SPECT was acquired in 6 minutes. We selected 36 cases with malignancy, whose bone scintigraphy demonstrated a solitary accumulation hot spot in the thoracic spine. Three experienced radiologists in nuclear medicine and 4 beginners diagnosed the images. They interpreted planar, short-time SPECT and maximum intensity projection (MIP) view of the chest of each case. The observers' response data were analyzed with receiver operating characteristic (ROC) curve analysis.
RESULTS
Of the three types of images, the Az (the area under ROC curve) values of short-time SPECT were the highest in all the observers except for only one beginner. Compared with experienced observers, beginners scored lower Az values of short-time SPECT. MIP images were constructed using SPECT data, but the Az values of MIP images were not higher than those of planar images. As to diagnosis, beginners tended to interprete most of the accumulations as metastatic lesions.
CONCLUSION
Short-time SPECT can be helpful to some degree, but to provide greater benefit, the observers require considerable exercise and experience.
目的
单光子发射计算机断层扫描（SPECT）图像可提供解剖结构的许多细节。关于骨闪烁显像，也有许多关于SPECT图像改善诊断的报道。尽管SPECT很有用，但它需要大量时间。因此，在临床情况下对所有病例进行SPECT检查很困难。最近，由于伽马相机的技术改进，我们可以在短时间内获得SPECT图像。我们使用短时间SPECT检查癌症患者胸椎孤立性热点的诊断。并且我们考虑了短时间SPECT是否有助于病变的精确诊断。
材料与方法
我们进行了骨闪烁显像图像采集以及胸部的平面和短时间SPECT检查。短时间SPECT在6分钟内完成采集。我们选择了36例恶性肿瘤患者，其骨闪烁显像显示胸椎有孤立性积聚热点。三名经验丰富的核医学放射科医生和四名初学者对图像进行诊断。他们对每个病例的胸部平面、短时间SPECT和最大强度投影（MIP）视图进行解读。观察者的反应数据采用受试者操作特征（ROC）曲线分析进行分析。
结果
在三种类型的图像中，除了一名初学者外，短时间SPECT的Az（ROC曲线下面积）值在所有观察者中都是最高的。与经验丰富的观察者相比，初学者短时间SPECT的Az值得分较低。MIP图像是使用SPECT数据构建的，但MIP图像的Az值不高于平面图像。关于诊断，初学者倾向于将大多数积聚解释为转移病变。
结论
短时间SPECT在一定程度上可能有帮助，但为了提供更大的益处，观察者需要大量的练习和经验。
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