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目的探讨常规SPECT/CT断层融合显像诊断高危前列腺癌患者骨转移的价值。方法前瞻性连续的收集53例初诊为高危前列腺癌的患者进行常规全身骨显像(WBS)及SPECT/CT断层融合显像;对所有患者病灶的WBS、SPECT/CT图像进行定性分析,计算WBS、SPECT/CT显像诊断前列腺癌骨转移的准确率。结果符合纳入标准的患者46例,20例患者共85个病灶确诊为骨转移;以患者为单位,SPECT/CT的诊断准确率为89.13%(41/46),明显高于WBS(27/46,58.70%;χ~2=11.05,P=0.001),SPECT/CT诊断骨转移的灵敏度为90.00%(18/20),高于WBS[35.00%(7/20);χ~2=12.91,P<0.001];以病灶为单位SPECT/CT诊断的准确率为97.84%(136/139),高于WBS[70.50%(98/139);χ~2=38.99,P<0.001],SPECT/CT诊断骨转移的灵敏度为100%(85/85),高于WBS[89.41%(76/85);χ~2=9.50,P=0.002]。结论常规SPECT/CT断层融合显像能早期发现、准确诊断高危前列腺癌患者的骨转移。
Objective To investigate the value of conventional SPECT / CT fusion imaging in the diagnosis of bone metastases in high-risk prostate cancer patients. Methods 53 patients with newly diagnosed high-risk prostate cancer were prospectively and consecutively performed conventional whole body bone imaging (WBS) and SPECT / CT fusion imaging. The WBS and SPECT / CT images of all the patients were qualitatively analyzed and the WBS , SPECT / CT imaging diagnosis of prostate cancer bone metastasis accuracy. Results Forty-six patients were eligible for inclusion and 85 lesions were diagnosed as bone metastases in 20 patients. The diagnostic accuracy of SPECT / CT was 89.13% (41/46), which was significantly higher than that of WBS (27/46 , 58.70%; χ ~ 2 = 11.05, P = 0.001). The sensitivity of SPECT / CT in diagnosis of bone metastasis was 90.00% (18/20), higher than that of WBS [35.00% P <0.001]. The diagnostic accuracy of SPECT / CT was 97.84% (136/139), higher than that of WBS [70.50% (98/139); χ ~ 2 = 38.99, P <0.001] The sensitivity of CT in the diagnosis of bone metastasis was 100% (85/85), higher than that of WBS [89.41% (76/85); χ ~ 2 = 9.50, P = 0.002]. Conclusion Conventional SPECT / CT fusion imaging can detect early and accurately diagnose bone metastases in high-risk prostate cancer patients.