【關鍵詞】 惡性腫瘤；骨掃描；99mTc -亞甲基二磷酸鹽；澳門
Clinical value of 99mTc-MDP bone scan for malignant tumor patients in Macau
IU Kuok-wai, MA Lin-feng, KUOK Weng-nam, LEI Chi-weng, CHAO Kahou, TANG Quan, CHEANG Kan-sun, XIE Xue-bin
Imaging diagnostic center, Kiang Wu hospital, Macau
Objective In view of Macau’s population composition is different from other regions, and so far there is no related literature of 99mTc-MDP bone scan for malignant tumor patients in Macau are reported. The purpose of this study was to investigate clinical value of 99mTc-MDP bone scan for malignant tumor patients among Macau’s population.
Methods Retrospectively analyze 389 patients with malignant tumors having bone scan during the period from 2005 to 2010 in Macau. The data, which was the top five of incidence rate in this group, was analyzed. The SPECT(SPECT/CT) images of each case were read by the physicians who had the clinical experience with both radiology and nuclear medicine, and then picked out the positive cases to follow up. The diagnosis was verified by the combination of pathology, imaging or clinical follow-ups. We got the bone metastases detection accuracy of different malignances by bone scan as well as its anatomical distribution. Therefore, the clinical value of 99mTc-MDP bone scan was obtained.
Results The top five numbers of tumors among 389 cases of bone scan were 160 cases of breast cancer, nasopharyngeal carcinoma in 56 cases, 52 cases of prostate cancer, lung cancer in 36 cases, 15 cases of colorectal cancer. The cases of bone scan showed bone metastases and have follow-up results were 23 cases of breast cancer, nasopharyngeal carcinoma in 22 cases, 24 cases of prostate cancer, lung cancer in 22 cases, 9 cases of colorectal cancer, respectively. The accuracy of bone scan in revealing bone metastases in breast cancer was 91.3%, NPC 61.5%, 66.7% of prostate cancer, lung cancer 90.9%, 88.9% of colorectal cancer. The common sites of bone metastases were: spine> pelvis> ribs> limbs and skull in the prostate cancer, lung cancer and colorectal cancer, spine> ribs> pelvis> limbs in the breast cancer and nasopharyngeal cancer, but the skull is the most common site of local invasion in nasopharyngeal carcinoma.
Conclusion The common tumor patients undergone bone scans are breast cancer, nasopharyngeal cancer, prostate cancer, lung cancer and colorectal cancer. The higher accuracy of bone metastases detection by bone scan is breast cancer, lung cancer and colorectal cancer, and the most common metastasis site is spine. The second metastasis predilection site of breast cancer is rib. Bone scan has important clinical value of M staging for breast cancer, lung cancer, colorectal cancer and other malignant tumors.
[Key Words] Malignant tumor; Skeletal scintigraphy; 99mTc-MDP; Macau