Venkitaraman R, Cook G J R, Dearnaley D P, Parker C C, Khoo V, Eeles R, Huddart R A, Horwich A, Sohaib S A
Academic Uro-oncology Unit, Royal Marsden Hospital, Downs Road, Sutton, Surrey, UK.
J Med Imaging Radiat Oncol. 2009 Jun;53(3):241-7. doi: 10.1111/j.1754-9485.2009.02070.x.
Whole-body MRI is an effective method for evaluating the entire skeletal system in patients with metastatic disease. This study aimed to compare whole-body MRI and radionuclide bone scintigraph in the detection of skeletal metastases in patients with prostate cancer. Patients with prostate cancer at high risk of skeletal metastasis with (i) prostate-specific antigen of > or =50 ng/mL; (ii) composite Gleason score of > or =8 with prostate-specific antigen of >20 ng/mL; or (iii) node-positive disease were enrolled in this prospective study before systemic treatment was initiated. Whole-body MR images and bone scans of 39 patients were analysed. Seven patients had bone metastases on bone scans, while seven patients had skeletal metastases by whole-body MRI, with concordant findings only in four patients. Compared with the 'gold standard', derived from clinical and radiological follow-up, the sensitivity for both bone scans and MRI was 70%, and the specificity for both was 100%. Magnetic resonance imaging detected 26 individual lesions compared with 18 lesions on bone scans. Only eight lesions were positive on both. Bone scans detected more rib metastases, while MRI identified more metastatic lesions in the spine. Whole-body MRI and radionuclide bone scintigraphy have similar specificity and sensitivity and may be used as complementary investigations to detect skeletal metastases from prostate cancer.
全身磁共振成像（MRI）是评估转移性疾病患者整个骨骼系统的有效方法。本研究旨在比较全身MRI和放射性核素骨扫描在检测前列腺癌患者骨转移方面的效果。具有以下情况之一的前列腺癌骨转移高危患者被纳入这项前瞻性研究：（i）前列腺特异性抗原≥50 ng/mL；（ii）Gleason评分≥8且前列腺特异性抗原>20 ng/mL；或（iii）淋巴结阳性疾病，在开始全身治疗之前入组。分析了39例患者的全身MR图像和骨扫描结果。7例患者骨扫描显示有骨转移，7例患者全身MRI显示有骨转移，仅4例患者结果一致。与临床和影像学随访得出的“金标准”相比，骨扫描和MRI的敏感性均为70%，特异性均为100%。磁共振成像检测到26个单独病灶，而骨扫描检测到18个病灶。两者均呈阳性的病灶仅8个。骨扫描检测到更多肋骨转移，而MRI发现脊柱的转移病灶更多。全身MRI和放射性核素骨扫描具有相似的特异性和敏感性，可作为检测前列腺癌骨转移的互补性检查方法。
