VALUE OF SEMI-QUANTITATIVE ANALYSIS OF 99mTc-MDP SPECT/CT FUSION IMAGES IN DIAGNOSIS OF BONE METASTASES FROM BREAST CANCER
Objective To investigate the value of semi-quantitative analysis of 99mTc-MDP single photon emission computed tomography/computed tomography (SPECT/CT) fusion images in the diagnosis of bone metastases from breast cancer.Methods Forty-two patients with breast cancer who had a single bone lesion by whole-body 99mTc-MDP bone scintigraphy were enrolled as subjects.All patients underwent SPECT/CT fusion imaging for the single bone lesion.The region-of-interest (ROD technology was used to measure the average radiation doses to bone lesion (T3h) and contralateral healthy bone (N3h) on planar images and SPECT/CT images.Then the ratios of radionuclide uptake,H1 (T3h/N3h) and H2 (T3h/N3h),in planar imaging and SPECT/CT imaging,respectively,were calculated.The receiver operating characteristic (ROC) curve was used to determine the optimal cutoff point H (cutoff) for the diagnosis of breast cancer with a single malignant lesion.The consistency between experi mental and clinical diagnoses was evaluated.Results Using a H1 cutoff of 2.12 measured by the planar semi-quantitative method,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value for the diagnosis of breast cancer with a single bone lesion were 77.3％,66.7％,64.5％,62.5％,and 71.4％,respectively.The consistency between the H1-based planar semi-quantitative method and clinical diagnosis was poor (Kappa=0.329).Using a H2 cutoff of 3.20 by the semi-quantitative SPECT/CT and ROI method,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value for the diagnosis of breast cancer with a single bone lesion were 81.8％,83.3％,80.0％,75.0％,and 85.7％,respectively.The consistency between the H2-based semi-quantitative SPECT/CT and ROI method and clinical diagnosis was satisfactory (Kappa=0.721).Conclusion The H2 value is a semi-quantitative index of SPECT/CT bone tomography in the diagnosis of bone metastases from breast cancer.When the cutoff is set to 3.20,the method shows satisfactory diagnostic efficiency.
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