Sharma R, Mondal A, Bhatnagar A, Chakravarty K L, Mishra P, Chopra M K, Rawat H S, Kashyap R
Department of Nuclear Medicine, Institute of Nuclear Medicine and Allied Sciences, Delhi, India.
Clin Nucl Med. 1998 Nov;23(11):758-63. doi: 10.1097/00003072-199811000-00008.
The authors present a prospective analysis of Tc-99m MDP and Tc-99m citrate scintigraphy in 108 patients with known malignant or degenerative benign bone disease. Of 108 patients, 59 (group A) had malignant bone disease. The other 49 patients (group B) had degenerative benign bone disease for which the results of Tc-99m MDP scans were positive. In both groups the Tc-99m citrate scan was performed 1 week after the Tc-99m MDP scan. The Tc-99m citrate/Tc-99m MDP lesion-to-background radioisotope uptake ratio (RUR) was calculated for each lesion 3 hours after radionuclide administration. The mean RUR for the malignant lesions was 1.0 +/- 0.484; for the benign lesions, the RUR was 0.29 +/- 0.250. Static imaging was also done for 10 lesions each from the malignant and benign groups at 1, 3, and 24 hours to study the kinetics of Tc-99m citrate. Time-activity curves for malignant lesions showed that the RUR remained high for 24 hours, whereas benign lesions showed a drastic decrease at 3 and 24 hours compared with the 1-hour images. The ratio of Tc-99m citrate to Tc-99m MDP is a promising parameter to differentiate malignant from benign degenerative lesions seen as areas of increased activity on Tc-99m MDP bone scans. The sensitivity and specificity of this technique were 97.8% and 95%, respectively.
作者对108例已知患有恶性或退行性良性骨病的患者进行了锝-99m亚甲基二膦酸盐（Tc-99m MDP）和锝-99m枸橼酸盐闪烁扫描的前瞻性分析。108例患者中，59例（A组）患有恶性骨病。另外49例患者（B组）患有退行性良性骨病，其Tc-99m MDP扫描结果为阳性。两组均在Tc-99m MDP扫描1周后进行Tc-99m枸橼酸盐扫描。在放射性核素给药3小时后，计算每个病灶的Tc-99m枸橼酸盐/Tc-99m MDP病灶与本底放射性同位素摄取比（RUR）。恶性病灶的平均RUR为1.0±0.484；良性病灶的RUR为0.29±0.250。还对恶性和良性组各10个病灶在1、3和24小时进行了静态成像，以研究Tc-99m枸橼酸盐的动力学。恶性病灶的时间-活性曲线显示，RUR在24小时内保持较高水平，而良性病灶在3小时和24小时时与1小时图像相比急剧下降。Tc-99m枸橼酸盐与Tc-99m MDP的比值是区分Tc-99m MDP骨扫描上表现为活性增加区域的恶性与良性退行性病灶的一个有前景的参数。该技术的敏感性和特异性分别为97.8%和95%。
