Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowongil, Nowon Gu, Seoul, 139-706, Republic of Korea,
Skeletal Radiol. 2013 Dec;42(12):1673-81. doi: 10.1007/s00256-013-1714-4. Epub 2013 Aug 31.
We compared the diagnostic performance of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and (99 m)Tc-methylene diphosphonate bone scintigraphy (BS) for the detection of bone metastasis in osteosarcoma.
We retrospectively reviewed 206 patients with stage II-IV osteosarcoma treated with surgery and chemotherapy as well as at least one paired PET/CT and BS scan (defined as an examination). PET/CT and BS images were interpreted separately. When analyzing the diagnostic yield of a combination of PET/CT and BS (PET/CT+BS), an examination was considered positive if either PET/CT or BS scored positive. The final diagnosis was obtained from histological findings or clinical follow-up with imaging studies for at least 6 months. Diagnostic performances of PET/CT, BS, and their combinations were calculated.
Out of 833 examinations in 206 patients, 55 with 101 lesions in 38 patients were confirmed as bone metastases. The sensitivity, specificity, and diagnostic accuracy were 95, 98, and 98%, respectively, for PET/CT; 76, 97, and 96%, respectively, for BS; and 100, 96, and 97%, respectively, for PET/CT+BS in an examination-based analysis. Lesion-based analysis demonstrated that the sensitivity of PET/CT+BS (100%) was significantly higher than that of PET/CT (92%) or BS (74%) alone. BS detected significantly less bone metastases in the growth plate region than outside the growth plate region (22 vs. 77%).
PET/CT is more sensitive and accurate than BS for diagnosing bone metastases in osteosarcoma. The combined use of PET/CT and BS improves sensitivity.
我们比较了氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）和锝-亚甲基二膦酸盐骨闪烁扫描（BS）在检测骨肉瘤骨转移中的诊断性能。
我们回顾性分析了 206 例接受手术和化疗治疗且至少有一次配对的 PET/CT 和 BS 扫描（定义为一次检查）的 II-IV 期骨肉瘤患者。PET/CT 和 BS 图像分别进行解读。当分析 PET/CT 和 BS 的组合（PET/CT+BS）的诊断效果时，如果 PET/CT 或 BS 检查结果为阳性，则认为该次检查为阳性。最终诊断通过组织学发现或至少 6 个月的影像学研究进行临床随访获得。计算了 PET/CT、BS 及其组合的诊断性能。
在 206 例患者的 833 次检查中，38 例患者的 101 个病灶中有 55 个被证实为骨转移。在检查基础分析中，PET/CT 的敏感性、特异性和准确性分别为 95%、98%和 98%；BS 分别为 76%、97%和 96%；PET/CT+BS 分别为 100%、96%和 97%。基于病灶的分析表明，PET/CT+BS（100%）的敏感性明显高于 PET/CT（92%）或 BS（74%）单独检测。BS 在生长板区域检测到的骨转移明显少于生长板区域以外（22 比 77%）。
与 BS 相比，PET/CT 对骨肉瘤骨转移的诊断更敏感、更准确。PET/CT 和 BS 的联合使用可提高敏感性。
