Al-Bulushi Naima K, Abouzied Mohei-Eldin
aDepartment of Nuclear Medicine, Royal Hospital, Muscat, Oman bDepartment of Radiology, Nuclear Medicine Section, King Faisal Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Nucl Med Commun. 2016 Jun;37(6):583-8. doi: 10.1097/MNM.0000000000000479.
The aim of this study was to evaluate the efficacy of fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) compared with bone scan in detecting bone metastases in patients with head and neck cancer.
A total of 319 patients with head and neck cancer were identified in our database who had undergone F-FDG PET/CT, from January 2006 until June 2007. Of them 156 patients (age range 15-100 years) met our inclusion criteria - namely, biopsy-proven head and neck cancer, and bone scan and F-FDG PET/CT within 30 days. Comparison was made on a lesion-by-lesion analysis. MRI, multidetector CT, and the clinical course of the patients were our references.
F-FDG PET/CT identified (n=213) bone lesions in 18 patients, in addition to distant metastases in solid organs such as the liver and lung, lymphadenopathy above and below the diaphragm, and adrenal glands in 12 patients. However, bone scan identified (n=198) 16 patients. Bone scan missed two patients with confirmed bone metastases by means of biopsy in one patient and radiologically in the second. F-FDG PET/CT showed true-positive results in 18 patients, whereas bone scan showed true-positive results in 16 patients. F-FDG PET/CT showed true-negative results in 138 patients, whereas bone scan showed true-negative results in 134 patients. F-FDG PET/CT showed no false-positive or false-negative results. However, bone scan had two false-positive and two false-negative results. The overall sensitivity, specificity, and accuracy was 100% for F-FDG PET/CT and 88, 98, and 96%, respectively, for bone scan.
F-FDG PET/CT is superior to Tc-methylene diphosphonate bone scan in detecting bone metastases in head and neck cancer.
本研究旨在评估氟-18氟脱氧葡萄糖（F-FDG）PET/计算机断层扫描（CT）与骨扫描相比，在检测头颈部癌患者骨转移方面的疗效。
在我们的数据库中，共识别出319例在2006年1月至2007年6月期间接受过F-FDG PET/CT检查的头颈部癌患者。其中156例患者（年龄范围15 - 100岁）符合我们的纳入标准，即经活检证实的头颈部癌，且在30天内进行了骨扫描和F-FDG PET/CT检查。通过逐个病变分析进行比较。MRI、多排CT以及患者的临床病程作为我们的参考依据。
F-FDG PET/CT在18例患者中发现了（n = 213）骨病变，此外还在12例患者中发现了肝脏、肺等实体器官的远处转移、膈上下淋巴结病变以及肾上腺病变。然而，骨扫描在16例患者中发现了（n = 198）骨病变。骨扫描漏诊了2例经活检证实有骨转移的患者，其中1例通过活检确诊，另1例通过放射学检查确诊。F-FDG PET/CT在18例患者中显示为真阳性结果，而骨扫描在16例患者中显示为真阳性结果。F-FDG PET/CT在138例患者中显示为真阴性结果，而骨扫描在134例患者中显示为真阴性结果。F-FDG PET/CT未显示假阳性或假阴性结果。然而，骨扫描有2例假阳性和2例假阴性结果。F-FDG PET/CT的总体敏感性、特异性和准确性分别为100%，而骨扫描分别为88%、98%和96%。
在检测头颈部癌骨转移方面，F-FDG PET/CT优于锝-亚甲基二膦酸盐骨扫描。
