Holm Jorun, Ahangarani Farahani Ziba, Gerke Oke, Baun Christina, Falch Kirsten, Grubbe Hildebrandt Malene
Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark.
Research Unit of Clinical Physiology and Nuclear Medicine, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark.
Diagnostics (Basel). 2020 Nov 28;10(12):1021. doi: 10.3390/diagnostics10121021.
The purpose was to investigate the interrater agreement of FDG-PET/CT and bone scintigraphy for diagnosing bone recurrence in breast cancer patients. A total of 100 women with suspected recurrence of breast cancer underwent planar whole-body bone scintigraphy with [99mTc]DPD and FDG-PET/CT. Scans were evaluated independently by experienced nuclear medicine physicians and the results for one modality were blinded to the other. Images were visually interpreted using a 4-point assessment scale (0 = no metastases, 1 = probably no metastases, 2 = probably metastases, 3 = definite metastases). Out of 100 women, 22 (22%) were verified with distant recurrence, 18 of these had bone involvement. The proportions of agreement between readers were 93% (86.3-96.6) for bone recurrence with FDG-PET/CT and 47% (37.5-56.7) for bone recurrence with planar bone scintigraphy. The strengths of agreement between readers for diagnosing bone recurrence was 'almost perfect' with FDG-PET/CT and was 'fair' with planar bone scintigraphy according to Cohen's kappa value of 0.82 (0.70-0.95) and 0.28 (0.18-0.39), respectively. Interrater agreement yielded improved reproducibility with FDG-PET/CT versus with bone scintigraphy when diagnosing recurrence with bone metastasis in this patient cohort.
目的是研究氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（FDG-PET/CT）和骨闪烁显像在诊断乳腺癌患者骨转移复发方面的阅片者间一致性。共有100例疑似乳腺癌复发的女性接受了[99mTc]二膦酸盐（DPD）平面全身骨闪烁显像和FDG-PET/CT检查。扫描结果由经验丰富的核医学医师独立评估，一种检查方式的结果对另一种检查方式的评估者保密。图像采用4分评估量表进行视觉解读（0 = 无转移，1 = 可能无转移，2 = 可能有转移，3 = 肯定有转移）。100例女性中，22例（22%）被证实有远处转移复发，其中18例有骨转移。FDG-PET/CT诊断骨转移复发时阅片者间的一致性比例为93%（86.3 - 96.6），平面骨闪烁显像诊断骨转移复发时阅片者间的一致性比例为47%（37.5 - 56.7）。根据科恩kappa值分别为0.82（0.70 - 0.95）和0.28（0.18 - 0.39），FDG-PET/CT诊断骨转移复发时阅片者间的一致性强度为“几乎完美”，平面骨闪烁显像时为“一般”。在该患者队列中，诊断骨转移复发时，与骨闪烁显像相比，FDG-PET/CT的阅片者间一致性具有更高的可重复性。
