Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, 400030, China.
Key Laboratory for Biorheological Science and Technology of Ministry of Education (Chongqing University), Chongqing University Cancer Hospital, Chongqing, China.
Sci Rep. 2020 Dec 3;10(1):21207. doi: 10.1038/s41598-020-78372-5.
To utilize single-photon emission computed tomography/computed tomography (SPECT/CT) scanning to investigate the usefulness of nerve root compression (NRC) and radioactive cold zone lesions (RCZLs) for predicting poor therapeutic efficacy of strontium-89 chloride (Sr-89) in patients with bone metastasis. Patients with bone metastatic neoplasms who had undergone baseline bone SPECT/CT scanning before Sr-89 therapy (148 MBq Sr-89 chloride by an intravenous injection for each patient) between July 2011 and July 2018 were included. Bone SPECT/CT images were assessed by two readers independently. Associations between imaging features and therapeutic efficacy were obtained via multivariate logistic regression analysis. Of 231 patients analyzed, 50 (21.6%) had NRC at baseline. Of 31 patients who experienced poor therapeutic efficacy, 29 (93.5%) had NRC. In multivariate logistic regression analysis baseline NRC independently predicted poor therapeutic efficacy. The sensitivity of NRC for predicting poor therapeutic efficacy was 93.5%, specificity was 89.5%, positive predictive value was 58.0%, and negative predictive value was 98.9%. RCZLs were detected in17 patients (7.4%), of whom 14 experienced poor Sr-89 therapeutic efficacy. The sensitivity of the presence of RCZLs for predicting poor therapeutic efficacy was 45.2%, specificity was 98.5%, positive predictive value was 82.4%, and negative predictive value was 92.1%. After adjusting for age, bone metabolism and lesion type, the significant independent predictors of poor Sr-89 therapeutic efficacy were presence of NRC (p < 0.001) and RCZL (p = 0.001). NRC and RCZL on baseline bone SPECT/CT are reliable independent predictors of poor Sr-89 therapeutic efficacy in patients with bone metastasis. These associations may facilitate the administration of more effective therapeutic interventions.
利用单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）扫描来研究神经根压迫（NRC）和放射性冷区病变（RCZLs）对锶-89 氯化物（Sr-89）治疗骨转移患者疗效不佳的预测价值。纳入 2011 年 7 月至 2018 年 7 月期间接受 Sr-89 治疗前进行基线骨 SPECT/CT 扫描的骨转移肿瘤患者。由两位读者独立评估骨 SPECT/CT 图像。通过多变量逻辑回归分析获得影像学特征与治疗效果之间的关联。在分析的 231 名患者中，50 名（21.6%）在基线时存在 NRC。在 31 名治疗效果不佳的患者中，有 29 名（93.5%）存在 NRC。在多变量逻辑回归分析中，基线 NRC 独立预测治疗效果不佳。NRC 预测治疗效果不佳的敏感性为 93.5%，特异性为 89.5%，阳性预测值为 58.0%，阴性预测值为 98.9%。17 名患者（7.4%）检测到 RCZLs，其中 14 名患者 Sr-89 治疗效果不佳。RCZLs 存在预测治疗效果不佳的敏感性为 45.2%，特异性为 98.5%，阳性预测值为 82.4%，阴性预测值为 92.1%。在校正年龄、骨代谢和病变类型后，NRC（p<0.001）和 RCZL（p=0.001）是 Sr-89 治疗效果不佳的显著独立预测因子。基线骨 SPECT/CT 上的 NRC 和 RCZL 是骨转移患者 Sr-89 治疗效果不佳的可靠独立预测因子。这些关联可能有助于实施更有效的治疗干预措施。
