The Diagnostic Value of <sup>99m</sup>Tc-MDP Bone Scan and Computed Tomography for Bone Metastases of Breast Cancer: a Systematic Review_Journal of Biomedical Engineering

Authors：

YUYanxia ,  KUANGAnren

Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

KUANGAnren, Email: Kuanganren@263.net

Keywords：

bone scan; computed tomography; bone metastases; breast cancer

DOI：

10.7507/1001-5515.20140103

Video：

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According to the inclusion and exclusion criteria, we searched for relevant original articles in some big Chinese and English databases.The qualities of the studies were evaluated with QUADAS quality assessment tool. A software program, Meta-disc, was used to obtain the pooled estimates and heterogeneity test for sensitivity, specificity, SROC curve, and so on. Finally the 17 article were included. On a per-patient basis, the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (LR+), negative likelihood ratio (LR-), diagnostic odds ratio (DOR), Q^*, SROC area under curve for ^99mTc-MDP bone scan and computed tomography (CT) were 0.87 and 0.99, 0.81 and 0.98, 3.88 and 13.86, 0.2 and 0.03, 27.73 and 612.17, 0.8418 and 0.9732, 0.9097 and 0.9952, respectively. On a per-focus basis, the pooled SEN, SPE, LR+, LR-, DOR, Q^*, SROC area under curve for ^99mTc-MDP bone scan was 0.86, 0.97, 13.32, 0.16, 102.4, 0.8944, 0.9528, respectively. For CT, only 1 article were included. This paper demonstrate: whether ^99mTc-MDP or CT both have high diagnostic efficiency for bone metastase of breast cancer.

Citation： YUYanxia, KUANGAnren. The Diagnostic Value of ^99mTc-MDP Bone Scan and Computed Tomography for Bone Metastases of Breast Cancer: a Systematic Review. Journal of Biomedical Engineering, 2014, 31(3): 552-557. doi: 10.7507/1001-5515.20140103 Copy

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24.	VAN DEN BOSSCHE B, DHAENINCK E, DE WINTER F, et al. ^99mTc depreotide scan compared with ^99mTc-MDP bone scintigraphy for the detection of bone metastases and prediction of response to hormonal treatment in patients with breast cancer[J].Nucl Med Commun,2004,25(8):787-792.
25.	PENNY F W, MARIE E W, ANNE WS R,et al.QUADAS评价:一种用于诊断性研究的质量评价工具(修订版)[J].中国循证医学杂志, 2007, 7(7):531-536.
26.	王荣福,李少林.核医学教师用书[M].北京:人民卫生出版社,2008.
27.	ELL P J,GAMBHIR S S.Nuclear medicine in clinical diagnosis and treatment[M].3rd ed.ELSEVIER,2004.
28.	WU T H, HUANG Y H, LEE J J, et al.Radiation exposure duringtransmission measurements:comparison between CT- and ger-manium-based techniques with a current pet scanner[J]. Eur J Nucl Med Mol Imaging,2004,31(1):38-43.

1. 薛建军,杨爱民,胡国瑛,等.乳癌及肺癌骨显像772例临床分析[J].陕西医学杂志,2003,32(1):32-35.
2. 王兴斌,李文勇,陈勇.乳腺癌骨转移的ECT、CT影像学评价[J].医学影像学杂志,2009,19(1):123-124.
3. YIN J J, POLLOCK C B, KELLY K. Mechanisms of cancer metastasis to the bone[J]. Cell Res, 2005, 15(1):57-62.
4. 汪长银.^99mTc-MDP骨显像对乳腺癌骨转移特征的评价分析[J].中华肿瘤防治杂志,2010,17(13):1015-1017.
5. 沈军瑾.SPECT检测肺癌骨转移的临床分析[J].实用癌症杂志,2011,26(1):86-90.
6. 张天嵩,钟文昭.Meta-DiSc软件在诊断试验Meta分析中的应用[J].循证医学,2008,8(2):97-108.
7. ZAMORA J, ABRAIRA V, MURIEL A, et al.Meta-DiSc:a software for meta-analysis of test accuracy data[J].BMC Med Res Methodol, 2006, 6:31.
8. UEMATSU T, YUEN S, YUKISAWA S, et al. Comparison of FDG PET and SPECT for detection of bone metastases in breast cancer[J].AJR Am J Roentgenol,2005,184(4):1266-1273.
9. HAHN S, HEUSNER T, KUMMEL S, et al. Comparison of FDG-PET/CT and bone scintigraphy for detection of bone metastases in breast cancer[J]. Acta Radiol,2011,52(9):1009-1014.
10. 侯先存,周青,李智勇,等.18F hPET/CT与Tc-99m-MDP骨显像探测乳腺癌骨转移的对比研究[J].中国临床医学影像杂志, 2010, 21(3):197-200.
11. PICCARDO A, ALTRINETTI V, BACIGALUPO L, et al. Detection of metastatic bone lesions in breast cancer patients:Fused (18)F-Fluoride-PET/MDCT has higher accuracy than MDCT. Preliminary experience[J].Eur J Radiol,2012,81(10):2632-2638.
12. ABE K, SASAKI M, KUWABARA Y, et al. Comparison of (18)FDG-PET with Tc-99m-HMDP scintigraphy for the detection of bone metastases in patients with breast cancer[J]. Annals of Nuclear Medicine,2005,19(7):573-579.
13. GALLOWITSCH H J, KRESNIK E, GASSER J,et al. F-18 fluorodeoxyglucose positron-emission tomography in the diagnosis of tumor recurrence and metastases in the follow-up of patients with breast carcinoma:a comparison to conventional imaging[J].Invest Radiol,2003,38(5):250-256.
14. SCHIRRMEISTER H, GUHLMANN A, KOTZERKE J, et al. Early detection and accurate description of extent of metastatic bone disease in breast cancer with fluoride ion and positron emission tomography[J]. J Clin Oncol,1999,17(8):2381-2389.
15. ENGELHARD K, HOLLENBACH H P, WOHLFART K, et al. Comparison of whole-body MRI with automatic moving table technique and bone scintigraphy for screening for bone metastases in patients with breast cancer[J].Eur Radiol,2004,14(1):99-105.
16. 张春燕,高树兴,刘晓杰,等.18F-FDG联合^99mTc-MDP显像在乳腺癌术后随访中的应用[J]. 中国肿瘤临床,2008,35(18):1032-1034.
17. 王警建,崔尊社,李娜,等.全身MRI和骨扫描诊断乳腺癌骨转移比较[J].湖北医药学院学报,2011,30(5):458-460.
18. PETREN-MALLMIN M, ANDREASSON I, NYMAN R, et al. Detection of breast cancer metastases in the cervical spine[J].Acta Radiol,1993,34(6):543-548.
19. ALTEHOEFER C, GHANEM N, HOGERLE S, et al. Comparative detectability of bone metastases and impact on therapy of magnetic resonance imaging and bone scintigraphy in patients with breast cancer[J].Eur J Radiol,2001,40(1):16-23.
20. BRISTOW A R, AGRAWAL A, EVANS A J, et al. Can computerised tomography replace bone scintigraphy in detecting bone metastases from breast cancer? A prospective study[J].Breast,2008,17(1):98-103.
21. NAKAI T, OKUYAMA C, KUBOTA T, et al.Pitfalls of FDG-PET for the diagnosis of osteoblastic bone metastases in patients with breast cancer[J].Eur J Nucl Med Mol Imaging,2005,32(11):1253-1258.
22. OHTA M, TOKUDA Y, SUZUKI Y, et al. Whole body PET for the evaluation of bony metastases in patients with breast cancer:comparison with 99Tcm-MDP bone scintigraphy[J].Nucl Med Commun,2001,22(8):875-879.
23. PRIOR J O, BARGHOUTH G, DELALOYE J F, et al. The value of bone marrow scintigraphy using Tc-99m monoclonal antigranulocyte antibodies in complement to bone scintigraphy in detecting bone metastases from primary breast cancer[J].Nucl Med Commun,2003,24(1):29-36.
24. VAN DEN BOSSCHE B, DHAENINCK E, DE WINTER F, et al. ^99mTc depreotide scan compared with ^99mTc-MDP bone scintigraphy for the detection of bone metastases and prediction of response to hormonal treatment in patients with breast cancer[J].Nucl Med Commun,2004,25(8):787-792.
25. PENNY F W, MARIE E W, ANNE WS R,et al.QUADAS评价:一种用于诊断性研究的质量评价工具(修订版)[J].中国循证医学杂志, 2007, 7(7):531-536.
26. 王荣福,李少林.核医学教师用书[M].北京:人民卫生出版社,2008.
27. ELL P J,GAMBHIR S S.Nuclear medicine in clinical diagnosis and treatment[M].3rd ed.ELSEVIER,2004.
28. WU T H, HUANG Y H, LEE J J, et al.Radiation exposure duringtransmission measurements:comparison between CT- and ger-manium-based techniques with a current pet scanner[J]. Eur J Nucl Med Mol Imaging,2004,31(1):38-43.

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The Diagnostic Value of ^99mTc-MDP Bone Scan and Computed Tomography for Bone Metastases of Breast Cancer: a Systematic Review