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Diagnostic Value of Whole-Body DWI With Background Body Suppression Plus Calculation of Apparent Diffusion Coefficient at 3 T Versus 18F-FDG PET/CT for Detection of Bone Metastases.

Diagnos t ic全身扩散加权成像 (DWI) Wi t h背景身体抑制Plus计算t离子的Apparen t扩散系数t一t 3 T与 18F-FDG PE T/C T De t ec骨的t离子Me t as t ases。

  • 影响因子:2.91
  • DOI:10.2214/AJR.19.21656
  • 作者列表:"Sun W","Li M","Gu Y","Sun Z","Qiu Z","Zhou Y
  • 发表时间:2020-02-01
Abstract

:OBJECTIVE. The purpose of this study is to evaluate the diagnostic performance of whole-body (WB) DWI with background body suppression (DWIBS) combined with calculation of the apparent diffusion coefficient (ADC) value at 3 T compared with the diagnostic performance of 18F-FDG PET/CT for detecting bone metastases in patients with malignant tumors. SUBJECTS AND METHODS. Thirty-nine consecutive patients with suspected bone metastases underwent both WB DWIBS and FDG PET/CT. Imaging findings were independently interpreted using qualitative and quantitative analyses. Pathologic findings or clinical or radiologic follow-up data were used as the diagnostic reference standard. The sensitivity, specificity, overall accuracy, positive predictive value, and negative predictive value of both modalities were calculated. The ADCs of benign lesions and metastases were compared. RESULTS. A total of 213 metastatic bone segments were confirmed among 39 patients. The sensitivity, specificity, overall accuracy, positive predictive value, and negative predictive value were 93.0%, 87.8%, 89.6%, 79.8%, and 96.0%, respectively, for WB DWIBS and 92.5%, 92.0%, 92.1%, 85.7% and 95.9%, respectively, for FDG PET/CT. The specificity of WB DWIBS in detecting bone metastases was significantly lower than that of FDG PET/CT (p < 0.05), whereas the sensitivity, overall accuracy, positive predictive value, and negative predictive value in detecting bone metastases were not significantly different between WB DWIBS and FDG PET/CT (p > 0.05). The ADCs for benign lesions were significantly higher than those for metastases (p < 0.001). In ROC curve analysis, the AUC value was 0.901. A cutoff ADC value of 920.5 × 10-6 mm2s-1 distinguished benign lesions from bone metastases with a sensitivity of 92.9% and a specificity of 73.4%. CONCLUSION. WB DWIBS coupled with ADC analysis at 3 T is effective for detecting bone metastases.

摘要

: 目的。本研究的目的是结合表观扩散系数 (ADC) 的计算,评估背景体抑制 (DWIBS) 全身 (WB) DWI的诊断性能 3 t与 18F-FDG PET/CT对恶性肿瘤患者骨转移的诊断价值比较。受试者和方法。39 例疑似骨转移的连续患者同时接受了WB DWIBS和FDG PET/CT。使用定性和定量分析独立解释影像学表现。以病理结果或临床或影像学随访资料作为诊断参考标准。计算两种模式的敏感性、特异性、总体准确性、阳性预测值和阴性预测值。比较良性病变和转移瘤的adc。结果。在 39 例患者中,共证实 213 个转移性骨段。WB DWIBS和 93.0% 、 87.8% 、 89.6% 、 79.8% 的灵敏度、特异度、总体准确度、阳性预测值和阴性预测值分别为 96.0% 、 92.5% 、 92.0% 和 92.1%,FDG PET/CT分别为 85.7% 和 95.9%。WB DWIBS检测骨转移的特异性明显低于FDG PET/CT (p <0.05),而灵敏度、总体准确性、阳性预测值、WB DWIBS与FDG PET/CT对骨转移的阴性预测值比较,差异无统计学意义 (p> 0.05)。良性病变的adc值明显高于转移瘤 (p <0.001)。ROC曲线分析中,AUC值为 0.901。ADC值 920.5 × 10-6 的截断值mm2s-1 良性病变和骨转移的鉴别,敏感性为 92.9%,特异性为 73.4%。结论。WB DWIBS联合 3 T ADC分析对骨转移的检测有效。

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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

METHODS:BACKGROUND:National guidelines recommend screening and treatment for cancer-related bone disease and continued monitoring of bone-modifying agents. It is unclear whether a standardized screening tool is utilized to identify eligible patients and ensure appropriate supportive care is implemented. The purpose of this study was to evaluate current prescribing practices and optimize management of bone-modifying agents. METHODS:A retrospective chart review was performed to identify patients who received hormone deprivation therapy or had bone metastases through Hematology/Oncology or Urology clinics from 1 November 2016 to 31 October 2017. The primary endpoints of this study were the incidence of completed baseline dual-energy X-ray absorptiometry (DEXA) scan for patients on hormone deprivation therapy and percent of patients started on a bone-modifying agent for the prevention of skeletal-related events secondary to bone metastasis. Secondary endpoints included percent of patients with dental examinations prior to initiation, adequate calcium and vitamin D supplementation, incidence of osteonecrosis of the jaw or flu-like symptoms and education, and percent of bisphosphonate doses appropriately adjusted based on renal function. RESULTS:A total of 375 patients were assessed for baseline DEXA scans and bone-modifying therapy. Of the 226 patients on hormone deprivation therapy, 111 (49%) patients were appropriately screened with a DEXA scan prior to initiation of hormone deprivation therapy. Among the 149 patients with bone metastases, only 94 (63.1%) patients were started on a bone-modifying agent. CONCLUSIONS:Opportunities have been identified to optimize management of patients with cancer-related bone disease. Implementation of standardized tools may increase the rate of appropriate screening and initiation of bone-modifying therapy when warranted.

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影响因子:2.83
发表时间:2020-01-01
DOI:10.1007/s00520-019-04843-9
作者列表:["Dohzono S","Sasaoka R","Takamatsu K","Hoshino M","Nakamura H"]

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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