| 99mTc-MDP骨显像预测唑来膦酸治疗乳腺癌骨转移的骨修复效果的初步研究 |
| 投稿时间：2014-07-11 修订日期：2014-09-04 点此下载全文 |
| 引用本文：李晓敏,张万春,安彩霞.99mTc-MDP骨显像预测唑来膦酸治疗乳腺癌骨转移的骨修复效果的初步研究[J].医学研究杂志,2015,44(7):77-80 |
| DOI：
10.11969/j.issn.1673-548X.2015.07.022 |
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| 基金项目:山西省卫生厅科研基金资助项目(201201048) |
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| 中文摘要:目的 探讨99mTc-MDP骨显像对唑来膦酸治疗乳腺癌溶骨性骨转移病灶的骨修复效果的预测作用。方法 20例乳腺癌患者首次通过99mTc-MDP平面骨显像及SPECT/CT同机融合诊断为溶骨性骨转移,经过3~6个月双膦酸盐治疗后,复查骨显像及SPECT/CT同机融合显像,肉眼观察病灶变化情况,并测量相同病灶的疗前靶/非靶比值(T/NT)及治疗前后CT值变化(△CT),使用T/NT及△CT分别定量骨显像病灶骨显像浓聚程度及治疗后修复程度,分析二者相关性,并比较浓聚病灶与非浓聚病灶的△CT值,采用SPSS 16.0软件进行统计学分析,两样本之间比较采用t检验或Wilcoxon检验,两变量间相关性分析用线性相关分析法进行。结果 1治疗前共发现30处溶骨性骨转移病灶,治疗后病灶CT值水平(425±152HU)高于治疗前(120±73HU),差异有统计学意义(t=9.95,P<0.01);2相关性分析示△CT、疗前T/NT呈高度正相关(r=0.907,P<0.01),即骨显像越浓聚,CT值增高幅度越大,治疗疗效越好;3骨显像浓聚组与非浓聚组患者△CT值的差异有统计学意义(W=15,P=0.001),浓聚组治疗前后△CT值明显高于非浓聚组。结论 99mTc-MDP 骨显像在乳腺癌溶骨性骨转移唑来膦酸骨修复效果具有一定的预测作用,可作为疗前筛选的重要手段。 |
| 中文关键词:乳腺癌 肿瘤转移 唑来膦酸 放射性核素显像 MDP |
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| A Preliminary Study on Predicting the Bone Rapair Effect of Zoledronic Acid in the Treatment of Breast Cancer Metastasis by 99mTc-MDP Bone Scan |
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| Abstract:Objective To explore the correlation between the change of CT value of osteolytic bone metastasis after the treatment of zoledronic acid and bone metabolism before treatment in breast cancer patients. Methods Twenty breast cancer patients with osteolytic bone metastases were diagnosed by 99mTc-MDP bone scintigraphy and 99mTc-MDP SPECT/CT (contain 16-slice spiral CT)for the first time entered this study. After treatment of zoledronic acid for 3-12 months with the same method, 99mTc-MDP bone scintigraphy and 99mTc-MDP SPECT/CT were peformed in the 20 breast cancer patients again with the same CT scan parameters(voltages: 120kV, tube currents: 80mA, pitches:3.75mm). With using regions of interesting (ROI)technique, the T/NT value of osteolytic bone metastases in the first 99mTc-MDP bone scintigraphy were measured. The CT value of same ROI before and after zoledronic acid therapy were measured(CT1 and CT2), and the change of CT value (△CT, △CT=CT2-CT1) were calculated. The correlation between them were analyzed. SPSS 16.0 was applied for variance and linear correlation analyses. Results (1)A total of 30 lesions of osteolytic bone metastases were detected in the 20 breast cancer patients by the first 99mTc-MDP bone scintigraphy and 99mTc-MDP SPECT/CT. The CT value before therapy was significantly higher than that after therapy(425±152HU vs 120±73HU, t=9.95, P<0.01).(2)The change of CT value after therapy was positively correlated with and the T/NT value of osteolytic bone metastasis(r=0.907, P<0.01). (3)The change of CT value of positive lesions after therapy was significantly higher than that of negative lesions by 99mTc-MDP bone scan(W=15,P=0.001).Conclusion 99mTc-MDP bone scintigraphy provides an effective method to predict the efficacy of zoledronic acid for breast cancer patients with osteolytic bone metastases. The breast cancer patients with high bone metabolism should be recommended zoledronic acid therapy, conversely should not be recommended. |
| keywords:Breast cancer Neoplasm metastasis Zoledronic acid Radionuclide imaging MDP |
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