■我们的目的是比较68Ga标记的DOTA-伊班膦酸(68Ga-DOTA-IBA)与18F-NaFPET/CT的相对诊断功效,作为检测骨转移的方法癌症类型范围。
■本研究回顾性纳入了与各种潜在恶性肿瘤相关的骨转移患者。所有患者均接受68Ga-DOTA-IBA和18F-NaFPET/CT扫描。使用组织病理学和随访CT或MRI成像结果作为参考标准,至少随访3个月。记录最大标准化摄取值(SUVmax)和骨转移的数量。目标背景比(TBR)与检测率一起计算,灵敏度,特异性,阳性预测值(PPV),负预测值(NPV),68Ga-DOTA-IBA和18F-NaFPET/CT成像对整体和部分原发性实体瘤骨转移的准确性。皮尔逊卡方检验,McNemar测试,进行Kappa检验以评估两种显像剂之间诊断效率的相关性和一致性。进行受试者工作特征曲线(ROC曲线)比较两种显像剂的诊断性能和曲线下面积,确定SUVmax和TBR诊断骨转移的最佳临界值。使用Wilcoxon符号秩检验分析用于检测骨转移的两种显像剂之间的SUVmax和TBR值的差异。P<0.05时,差异有统计学意义。
■本研究共纳入24名患者(13名女性和11名男性),平均年龄52岁(四分位数间距,49-64岁)。检测率,灵敏度,特异性,PPV,NPV,准确度,骨转移瘤68Ga-DOTA-IBA和18F-NaFPET/CT的AUC为81%,90%,62%,95%,43%,88%,0.763,89%,99%,59%,95%,89%,95%,分别为0.789。两种成像方法无显著性差异(P<0.01)。两种显像剂的诊断结果之间存在显着相关性(X2=168.43,P<0.001)和很强的一致性(Kappa=0.774,P<0.001)。22例骨转移患者68Ga-DOTA-IBA和18F-NaF显像测得的病灶SUVmax值分别为5.1±5.4和19.6±15.1,差异具有统计学意义(P<0.05)。两种成像方法的TBR值分别为5.0±5.0和6.7±6.4,差异具有统计学意义(P<0.05)。68Ga-DOTA-IBA和18F-NaF曲线的SUVmax的AUC分别为0.824和0.862,差异无统计学意义(P=0.490)。68Ga-DOTA-IBA和18F-NaF的TBR的AUC没有发现显着差异(0.832对0.890;P=0.248)。亚组分析显示两种显像剂在肺癌和乳腺癌骨转移诊断中具有显著的相关性,诊断结果一致。然而,在前列腺癌骨转移的诊断中,差异有统计学意义(P<0.001),缺乏一致性(P=0.109)。
■68Ga-DOTA-IBA对骨转移病变的诊断功效与18F-NaF相当。这一发现在诊断骨转移和选择恶性肿瘤患者的治疗计划方面具有重要的临床意义。
UNASSIGNED: We aimed to compare the relative diagnostic efficacy of 68Ga-Labeled DOTA-ibandronic acid (68Ga-DOTA-IBA) to that of18F-NaF PET/CT as a mean of detecting bone metastases in patients with a range of cancer types.
UNASSIGNED: This study retrospectively enrolled patients with bone metastases associated with various underlying malignancies. All patients underwent both 68Ga-DOTA-IBA and 18F-NaF PET/CT scans. Histopathology and follow-up CT or MRI imaging results were used as reference criteria, with a minimum follow-up period of 3 months. The maximum Standardized Uptake Value (SUVmax) and number of bone metastases were recorded. The Target-Background Ratio (TBR) was calculated along with the detection rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 68Ga-DOTA-IBA and 18F-NaF PET/CT imaging for overall and partial primary solid tumor bone metastases. Pearson chi-square test, McNemar test, and Kappa test was conducted to assess the correlation and consistency of diagnostic efficiency between the two imaging agents. Receiver Operating Characteristic curve (ROC curve) was performed to compare diagnostic performance and the area under the curve of the two imaging agents, determining optimal critical values for SUVmax and TBR in diagnosing bone metastasis. Differences in SUVmax and TBR values between the two imaging agents for detecting bone metastases were analyzed using the Wilcoxon signed rank test. The difference was statistically significant when P < 0.05.
UNASSIGNED: A total of 24 patients (13 women and 11 men) were included in this study, with a mean age of 52 (interquartile range, 49-64 years). The detection rate, sensitivity, specificity, PPV, NPV, accuracy, and AUC of 68Ga-DOTA-IBA and 18F-NaF PET/CT for bone metastases were 81%, 90%, 62%, 95%, 43%, 88%, 0.763, and 89%, 99%, 59%, 95%, 89%, 95%, 0.789, respectively. There was no significant difference between the two imaging methods (P < 0.01), and there was a significant correlation (X2=168.43, P < 0.001) and a strong consistency (Kappa=0.774,P < 0.001) between the diagnostic results of the two imaging agents. The SUVmax values of lesions measured by 68Ga-DOTA-IBA and 18F-NaF imaging in 22 patients with bone metastasis were 5.1 ± 5.4 and 19.6 ± 15.1, respectively, with statistically significant differences (P<0.05). The TBR values of the two imaging methods were 5.0 ± 5.0 and 6.7 ± 6.4, respectively, with statistically significant differences (P<0.05). The AUC of the SUVmax of 68Ga-DOTA-IBA and 18F-NaF curves were 0.824 and 0.862, respectively, with no statistically significant difference (P=0.490). No significant difference was found in the AUC of the TBR of 68Ga-DOTA-IBA and 18F-NaF (0.832 vs 0.890; P=0.248). Subgroup analysis showed significant correlation between the two imaging agents in the diagnosis of bone metastases in lung cancer and breast cancer, with consistent diagnostic results. However, in the diagnosis of bone metastases in prostate cancer, there was a significant difference (P<0.001) and lack of consistency (P=0.109).
UNASSIGNED: The diagnostic efficacy of 68Ga-DOTA-IBA for bone metastasis lesions is comparable to that of 18F-NaF. This finding holds significant clinical importance in terms of diagnosis of bone metastasis and selecting treatment plans for patients with malignant tumors.