BACKGROUND & AIMS:
OBJECTIVE:To determine whether single photon emission computed tomography (SPECT) is useful in the detection of prostate cancer bone metastases in the lumbar vertebrae.
METHODS:Thirty-nine patients (12 with benign prostatic hyperplasia, 27 with prostate cancer) were considered and submitted to bone SPECT. All of them had increased uptake in lumbar vertebrae on bone scintigraphy. In those with prostate cancer, definitive diagnosis of bone metastases was established by magnetic resonance imaging (MRI). SPECT axial images were classified into five accumulation patterns: mosaic, large hot, diffuse, peripheral, and articular (or pediculate). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of bone SPECT were calculated.
RESULTS:Overall, 116 vertebral lesions (49 metastatic, 67 degenerative) were studied. Mosaic, large hot and diffuse patterns were more frequently associated with metastatic lesions (84.2%, 70.3%, and 63.1% of the cases, respectively). On the other hand, peripheral and articular (or pediculate) patterns were mostly ascribed to degenerative lesions (100% and 87.5% of the cases, respectively). Sensitivity, specificity, PPV and NPV of bone SPECT were 95.9% (47/49), 73.1% (49/67), 72.3% (47/65), and 96.1% (49/51), respectively.
CONCLUSIONS:Bone SPECT provides better accuracy than bone scintigraphy in differential diagnosis of lumbar vertebral lesions from prostate cancer.
背景与目标:
目的:确定单光子发射计算机断层扫描(SPECT)是否可用于检测腰椎中前列腺癌的骨转移。
方法:对39例患者(前列腺良性增生12例,前列腺癌27例)进行了检查并接受了骨SPECT检查。在骨闪烁显像上,所有这些人的腰椎摄取都增加了。在患有前列腺癌的患者中,通过磁共振成像(MRI)可以明确诊断骨转移。 SPECT轴向图像分为五种累积模式:镶嵌,大热,弥散,周围和关节(或有蒂)。计算了骨SPECT的敏感性,特异性,阳性预测值(PPV)和阴性预测值(NPV)。
结果:对116例椎体病变(49例转移性,67例变性)进行了研究。马赛克,大热和弥漫性模式与转移性病变相关性更高(分别为84.2%,70.3%和63.1%)。另一方面,外周和关节(或有蒂)模式主要归因于退行性病变(分别为100%和87.5%)。骨SPECT的敏感性,特异性,PPV和NPV分别为95.9%(47/49),73.1%(49/67),72.3%(47/65)和96.1%(49/51)。
结论:骨SPECT在鉴别诊断前列腺癌腰椎病变方面比骨闪烁显像术具有更好的准确性。