【摘要】 目的 探讨放射性核素骨显像和血清前列腺特异抗原（PSA），碱性磷酸酶（ALP），骨特异性碱性磷酸酶（BAP）测定在前列腺癌骨转移诊断中的价值。 方法 回顾性分析2006年10月-2009年10月50例前列腺癌（PCa）患者骨显像结果及PSA、ALP、BAP测定结果。 结果 50例Pca患者骨显像阳性率为70.0%。35例Pca骨转移患者分布在PSAgt;20.0 ng/mL时占97.1%，BAPgt;20.1 μg/L时占88.6%，ALPgt;130.0 μg/L时占94.3%。血清PSA、ALP、BAP水平随着放射性核素骨显像分级的增高而逐步增高，呈高度正相关。 结论 放射性核素骨显像仍然是目前诊断PCa骨转移的主要方法；PSA、ALP、BAP亦是重要的辅助诊断指标；PSAgt;20.0 ng/mL时，患者应常规行全身骨显像检查。【Abstract】 Objective To explore the clinical value of radionuclide bone scintigraphy and measurements of serum prostate-specific antigen (PSA), alkaline phosphatase (ALP) and bone-specific alkaline phosphatase (BAP) in the diagnosis of bone metastasis in prostate cancer (PCa) patients from October 2006 to October 2009. Methods The results of bone scintigraphy, serum PSA, ALP and BAP were analyzed retrospectively in 50 PCa patients. Results The positive rate of bone scintigraphy was 70.0% in 50 PCa patients. In 35 patients with PCa bone metastasis, 97.1% of them were PSAgt;20.0 ng/mL, 88.6% were BAPgt;20.1 μg/L, and 94.3% were ALPgt;130.0 μg/L. The serum levels of PSA, ALP and BAP were increased step by step along with the advancement of bone metastatic grading from M0 to M3. They were significantly positively correlated. Conclusion Radionuclide bone scintigraphy is a major method in the diagnosis of bone metastasis in PCa patients currently. PSA, ALP and BAP are also important auxiliary diagnostic markers. Patients with the level of PSAgt;20.0 ng/mL should take a routine whole-body examination of bone scintigraphy.
摘要:目的:探讨血清CA153和BAKP在乳腺癌骨转移显像诊断中的应用。方法:对92例乳腺癌患者的核素骨显像结果、血清CA153和BAKP结果进行回顾性研究。结果:①血清CA15-3和B-AKP的值随着骨转移分期的增高而逐步升高,且差异显著(Plt;0. 01);②血清CA15-3和B-AKP与骨转移的数目呈正相关;③血清CA15-3gt;25 U/mL时,骨转移的阳性率为63.3%,血清CA15-3lt;25 U/mL时,骨转移的阴性预测值为94. 5%;血清B-AKPgt;20 U/L时,骨转移的阳性率为59. 6%时,骨转移的阴性预测值为73.5%;当血清CA15-3lt;25 U/mL同时B-AKPlt;20 U/L时,骨转移的阴性预测值为100%。结论:血清CA15-3和BAKP测定在乳腺癌骨显像诊断中具有重要的应用价值。Abstract: Objective: To evaluate the diagnosis value of serum CA153 and BAKP measurements for scanning bone metastatic images in patients with mammary Cancer. Methods: Retrospective study on the bone scan images and serum CA153 (with CLIA) and bone alkaline phosphatase (BAKP, with ELISA) levels were performed in 92 patients with confirmed mammary gland cancer. Results: ①The serum levels of CA153 and BAKP were increased step by step along with the advancement of bone metastatic grading from M0 to M3 with significant difference between values in successive gradings (Plt;0. 01).②The levels of CA153 and BAKP were significantly positively correlated. ③With serum CA153gt;25 U/mL the positive rate of bone metastasiswas 63.2%, with CA153lt;25 U/mL the negativepredictive value of bone metastasis was 94.5%, with BAKPgt;20 U/L,the positive rate of bone metastasis was 596%, with BAKPlt;20 U/L, the negative predictive value of bone metastasis was 73. 5%.However with Serum CA153lt;25 U/mL and BAKPlt;20 U/L, the negative predictive value of bone metastasis was100%. Conclusion: The combined measurement of the serum CA153 and BAKP levels would play an important role for diagnosis of bone scan images in patients with prostate cancer.
ObjectiveUtilizing PDCA circulation to enhance the quality of single photon emission computed tomography (SPECT) in whole body bone scan (WBS). MethodsBased on a retrospective analysis of the quality of WBS in the first half of year 2012, advices and measurements to improve the quality were implemented by the technologists. In the following half year of 2012, monthly evaluation of the WBS quality were carried out to further improve the quality by focusing on fine details of the patient positioning, radiopharmaceuticals injection and image processing, etc. ResultsBy utilization of PDCA circulation, WBS quality in the latter half year of 2012 constantly improved. Further more, effective and improved technical procedures were extracted from scattered individual experience, which was expected to improve the WBS quality effectively in the long run. ConclusionApplication of PDCA circulation in SPECT in whole body bone scan improves the image quality, because it not only brings better communication and understanding between patients and physicians/technologists, but also enables better patient preparations and individualized procedures based on standard protocols.
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.
This paper is aimed to assess the diagnostic value of MRI versus 99Tcm-methylene diphosphonate (99Tcm-MDP) bone scan (BS) for osseous metastases in patients with prostate cancer. The computer-based retrieval was conducted on PubMed, EMBASE, EBSCO, Web of Knowledge, the Cochrane Library and Ovid data bases to search for trials about diagnosing osseous metastases of prostate cancer with MRI and 99Tcm-MDP BS. Selected with time acceptance and time exclusion criteria, the data quality were evaluated with QUADAS quality assessment tool and collected. We used the Meta-Disc software to conduct meta-analysis, and then calculated the pooled sensitivity, specificity and diagnostic odds ratio (DOR), drew the summary receiving operating characteristic (SROC) curve, and measured the area under curve (AUC) and Q* value. Then five studies were included, involving 353 patients. The pooled sensitivity of MRI and BS was 0.95 (95% CI 0.90~0.98) and 0.67 (95% CI 0.58~0.75), respectively. The pooled specificity was 0.97 (95% CI 0.94~0.99) and 0.88 (95% CI 0.83~0.91), respectively. The pooled DOR was 402.99 (95% CI 119.05~1 364.15) and 23.85 (95% CI 1.32~431.48), respectively. The AUC was 0.990 1 and 0.624 1, respectively. The Q* was 0.958 7 and 0.593 8. It can well be concluded that MRI is more effective than 99Tcm-MDP BS in the diagnosis of osseous metastases in patients with prostate cancer.
ObjectiveTo investigate the effects of the operation of nuclear medicine technologists on the quality and efficiency of whole-body bone imaging with single-photon emission computed tomography (SPECT). MethodsWe collected all the data from patients who underwent whole-body bone imaging with SPECT in the whole year of 2012 in Department of Nuclear Medicine, West China Hopsital of Sichuan University.From January to June 2012, no intervention was made.Between July and December 2012, a formal training including vein puncture, image processing, and post image processing improving was made for the technologists on the operation of whole-body bone scan.The difference in incidence rate of artifacts between the first and second half of the year was analyzed by χ2 test. ResultsIn all the 12 424 whole-body bone scan patients, the first and second six months had respectively 5 920 and 7 186.And the artifacts incidence rates were 15.6% vs.8.9%(χ2=137.483, P < 0.001).In addition, the daywork efficiency was highly improved by 16.7%(48.5 patients/day vs.56.6 patients/day). ConclusionThe operation of the nuclear medicine technologists not only affects the quality of whole-body bone imaging but also improves the work efficiency.