在确定骨活检部位方面，[18F]FDG PET/CT 优于 CT：随机对照临床试验。

IF 3.5 2区医学 Q2 ONCOLOGY

Cancer Imaging Pub Date : 2024-11-24 DOI:10.1186/s40644-024-00804-6

Yujie Chang, Yifeng Gu, Shunyi Ruan, Shengyu Xu, Jing Sun, Zhiyuan Jiang, Guangyu Yao, Zhiyu Wang, Hui Zhao

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引用次数: 0

摘要

背景：骨活检是诊断骨转移的金标准。然而，对于确定穿刺部位的最佳成像检查，临床上尚未达成共识：我们比较了[18F]FDG PET/CT 和 CT 在检测骨转移方面的性能，以达到最高的活检效率。这项登记在册的前瞻性研究共纳入了273名在2020年1月至2021年3月期间接受治疗的骨转移患者。患者被随机分配接受[18F]FDG PET/CT或CT检查，以确定骨活检前的穿刺部位。比较了两种成像检测的准确性、敏感性、特异性、二次活检率、诊断时间和成本效益：结果：[18F]FDG PET/CT 组检测骨转移灶的准确性和灵敏度明显高于 CT 组（97.08% 对 90.44%，98.76% 对 92.22%；P 18F]FDG PET/CT 组 2.19% 对 5.15%；P 18F]FDG PET/CT 为 18.33 ± 2.08 天，明显短于 CT 组的 21.28 ± 1.25 天（P < 0.05）。18F] FDG PETCT 的费用为 11428.35 元，CT 的费用为 13287.52 元；增量费用为 1859.17 元。与CT相比，[18F]FDG PET/CT在确定可疑骨转移的骨活检部位方面具有更好的性能和成本效益：该前瞻性研究于2018-04-10注册，注册号为ChiCTR1800015540。

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[¹⁸F]FDG PET/CT performs better than CT in determining the bone biopsy site : randomized controlled clinical trial.

Background: Bone biopsy is the gold standard for diagnosing bone metastases. However, there is no clinical consensus regarding the optimal imaging test for determining the puncture site.

Methods: We compared the performance of [¹⁸F]FDG PET/CT with CT in detecting bone metastases to achieve the highest biopsy efficiency. This registered prospective study enrolled 273 patients with bone lesions who were treated between January 2020 and March 2021. Patients were randomly assigned to undergo [¹⁸F]FDG PET/CT or CT to determine the puncture site before bone biopsy. The accuracy, sensitivity, specificity, second biopsy rate, diagnostic time and cost-effectiveness of the two imaging tests were compared.

Results: The accuracy and sensitivity of [¹⁸F]FDG PET/CT group in detecting bone metastases were significantly higher than CT group(97.08% vs. 90.44%, 98.76% vs. 92.22%, P < 0.05). The second biopsy rate was significantly lower in the [¹⁸F]FDG PET/CT group (2.19% vs. 5.15%; P < 0.05). The diagnostic time of [¹⁸F]FDG PET/CT was 18.33 ± 2.08 days, which was significantly shorter than 21.28 ± 1.25 days in CT group ( P < 0.05). The cost of [¹⁸F] FDG PETCT is 11428.35 yuan, and the cost of CT is 13287.52 yuan; the incremental cost is 1859.17 yuan. SUVmax > 6.3 combined with ALP > 103 U/L showed a tendency for tumor metastases with an AUC of 0.901 (95%CI 0.839 to 0.946, P < 0.001).

Conclusion: [¹⁸F]FDG PET/CT has better performance and cost-effectiveness than CT in determining the bone biopsy site for suspect bone metastases.

Trial registration: The prospective study was registered on 2018-04-10, and the registration number is ChiCTR1800015540.

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来源期刊

Cancer Imaging ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

7.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology. The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include: Breast Imaging Chest Complications of treatment Ear, Nose & Throat Gastrointestinal Hepatobiliary & Pancreatic Imaging biomarkers Interventional Lymphoma Measurement of tumour response Molecular functional imaging Musculoskeletal Neuro oncology Nuclear Medicine Paediatric.