（18）F-氟化物PET/CT在评估和处理引起足踝疼痛的病变方面优于双相骨闪烁扫描的作用。

Role of (18)F-fluoride PET/CT over dual-phase bone scintigraphy in evaluation and management of lesions causing foot and ankle pain.

作者信息

Kim Ji Young, Choi Yun Young, Kim Young Hwan, Park Si-Bog, Jeong Mi Ae

机构信息

Department of Nuclear Medicine, Hanyang University Medical Center, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 133-792, Republic of Korea.

出版信息

Ann Nucl Med. 2015 Apr;29(3):302-12. doi: 10.1007/s12149-014-0942-6. Epub 2014 Dec 30.

DOI:10.1007/s12149-014-0942-6

PMID:25547254

Abstract

OBJECTIVE

The purpose of this study was to assess the potential role of (18)F-fluoride PET/CT over dual-phase bone scintigraphy (DBS) in evaluation and management of lesions causing foot and ankle pain.

METHODS

(99m)Tc-HDP DBS and (18)F-fluoride PET/CT were performed in consecutive patients who visited rehabilitation department due to foot or ankle pain. Focal painful lesions in fore, mid, and hindfoot or ankle, and diffuse pain in foot were evaluated on DBS and (18)F-fluoride PET/CT (conclusive, inconclusive, nonvisible) and lesions on each modality were correlated. The clinical course was followed to see if the results of (18)F-fluoride PET/CT affected the decision of patient management.

RESULTS

Sixty-one painful lesions in 31 patients included 16 forefoot (26.2 %), 11 midfoot (18.0 %), 19 hindfoot (31.2 %), 6 ankle (9.8 %), and 9 diffuse footpain (14.8 %). Forty lesions (40/61, 65.6 %) were detected on DBS, including 21 conclusive diagnostic (21/40, 52.5 %), mainly including hindfoot lesions (n = 11). The inconclusive 19 lesions (19/40, 47.5 %) on DBS showed conclusive diagnostic findings on (18)F-fluoride PET/CT, mainly in fore and midfoot lesions (n = 15). Twenty-one painful lesions (21/61, 34.4 %) which were nonvisible on DBS revealed conclusive diagnostic findings on (18)F-fluoride PET/CT in 7 lesions (7/21, 33.3 %), including 5 hindfoot lesions. Fourteen nonvisible lesions (14/21, 66.7 %) on both modalities included all 9 diffuse painful foot lesions. Patient management was affected by findings of (18)F-fluoride PET/CT in 31 lesions (31/61, 50.8 %).

CONCLUSIONS

(18)F-fluoride PET/CT provided more confirmative diagnostic information in painful foot and ankle over DBS, and influenced patient management in many inconclusive or nonvisible cases on DBS. Increasing role of (18)F-fluoride PET/CT in benign diseases including foot and ankle pain is expected in the near future.

摘要

目的

本研究旨在评估¹⁸F - 氟化物PET/CT相较于双相骨闪烁扫描（DBS）在评估和处理引起足踝疼痛的病变中的潜在作用。

方法

对因足踝疼痛就诊于康复科的连续患者进行⁹⁹ᵐTc - HDP DBS和¹⁸F - 氟化物PET/CT检查。在DBS和¹⁸F - 氟化物PET/CT上评估足前部、中部、后部或踝部的局灶性疼痛病变以及足部的弥漫性疼痛（明确诊断、不明确诊断、未见异常），并将每种检查方式上的病变进行关联分析。跟踪临床病程，观察¹⁸F - 氟化物PET/CT的结果是否影响患者的处理决策。

结果

31例患者中的61个疼痛性病变包括16个足前部病变（26.2%）、11个足中部病变（18.0%）、19个足后部病变（31.2%）、6个踝部病变（9.8%）和9个足部弥漫性疼痛病变（14.8%）。在DBS上检测到40个病变（40/61，65.6%），其中21个为明确诊断（21/40，52.5%），主要包括足后部病变（n = 11）。DBS上不明确的19个病变（19/40，47.5%）在¹⁸F - 氟化物PET/CT上显示为明确诊断结果，主要在足前部和中部病变（n = 15）。DBS上未见异常的21个疼痛性病变（21/61，34.4%）中，7个病变（7/21，33.3%）在¹⁸F - 氟化物PET/CT上显示为明确诊断结果，包括5个足后部病变。两种检查方式上均未见异常的14个病变（14/21，66.7%）包括所有9个足部弥漫性疼痛病变。¹⁸F - 氟化物PET/CT的检查结果影响了31个病变（31/61，50.8%）的患者处理。