Department of Nuclear Medicine, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128 Genoa, Italy.
Eur J Radiol. 2012 Oct;81(10):2632-8. doi: 10.1016/j.ejrad.2011.12.020. Epub 2012 Jan 9.
So far, no studies comparing (18)F-Fluoride-PET/CT and MDCT for the detection of bone metastases are available. We compared the accuracy of (18)F-Fluoride-PET/CT (MDCT: 3.75 mm thickness-image-reconstruction), whole-body Multi-Detector-CT (MDCT: 1.25 mm thickness-image-reconstruction) and (18)F-Fluoride-PET/MDCT (MDCT: 1.25 mm thickness-image-reconstruction) in identifying bone metastases in breast cancer patients.
We studied 39 breast cancer patients for bone metastases. Imaging was performed on an integrated PET/MDCT-system; CT images were reconstructed at 3.75 mm and 1.25 mm thickness. Two nuclear medicine physicians and one radiologist interpreted blindly (18)F-Fluoride-PET/CT, (18)F-Fluoride-PET/MDCT and MDCT. MDCT at 12 months served as the standard of reference.
Overall, 662 bone lesions were detected in our analysis. Of these, 542 were malignant and 120 were benign according to the standard of reference. (18)F-Fluoride-PET/CT detected 491 bone metastases, 114 (23%) of which displayed no clear morphological changes on MDCT, whereas MDCT detected 416 bone metastases, 39 (9.3%) of which showed no (18)F-Fluoride-PET uptake. Overall sensitivity and specificity were: 91% and 91%, respectively, for (18)F-Fluoride-PET/CT, and 77% and 93% for MDCT. The integrated assessment of (18)F-Fluoride-PET/MDCT yielded sensitivity and specificity values of 98% and 93%, respectively.
(18)F-Fluoride-PET/MDCT has higher diagnostic accuracy than (18)F-Fluoride-PET/CT and MDCT for the evaluation of bone metastases in breast cancer.
目前，尚无比较（18）F-氟代脱氧葡萄糖-PET/CT 和 MDCT 检测骨转移的研究。我们比较了（18）F-氟代脱氧葡萄糖-PET/CT（MDCT：3.75mm 层厚图像重建）、全身多排 CT（MDCT：1.25mm 层厚图像重建）和（18）F-氟代脱氧葡萄糖-PET/MDCT（MDCT：1.25mm 层厚图像重建）在识别乳腺癌患者骨转移中的准确性。
我们研究了 39 例乳腺癌患者的骨转移情况。在集成的 PET/MDCT 系统上进行影像学检查；CT 图像在 3.75mm 和 1.25mm 层厚下重建。两名核医学医师和一名放射科医师对（18）F-氟代脱氧葡萄糖-PET/CT、（18）F-氟代脱氧葡萄糖-PET/MDCT 和 MDCT 进行了盲法解读。12 个月的 MDCT 作为参考标准。
在我们的分析中，总共检测到 662 个骨病变。其中，根据参考标准，542 个为恶性，120 个为良性。（18）F-氟代脱氧葡萄糖-PET/CT 检测到 491 个骨转移灶，其中 114 个（23%）在 MDCT 上无明显形态学改变，而 MDCT 检测到 416 个骨转移灶，其中 39 个（9.3%）无（18）F-氟代脱氧葡萄糖摄取。（18）F-氟代脱氧葡萄糖-PET/CT 的总体敏感性和特异性分别为 91%和 91%，MDCT 的敏感性和特异性分别为 77%和 93%。（18）F-氟代脱氧葡萄糖-PET/MDCT 的综合评估敏感性和特异性分别为 98%和 93%。
（18）F-氟代脱氧葡萄糖-PET/MDCT 对乳腺癌骨转移的评估比（18）F-氟代脱氧葡萄糖-PET/CT 和 MDCT 具有更高的诊断准确性。
