| Zhu Haisheng,Wang Rensheng,Yan Haolin,Huang Junhua,Chen Mingdong,Wu Lunqing,Que Lilin,Liang Leifeng.Clinical value of 99Tcm-MDP SPECT/CT in diagnosing skull base bone involvement of nasopharyngeal carcinoma[J].Chinese Journal of Radiological Medicine and Protection,2017,37(2):132-137 |
| Clinical value of 99Tcm-MDP SPECT/CT in diagnosing skull base bone involvement of nasopharyngeal carcinoma |
| Received:September 06, 2016 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.02.009 |
| KeyWords:Nasopharyngeal neoplasms Skull Tomography Emission-computed Single-photon 99Tcm-methylene diphosphonate |
| FundProject: |
| Author Name | Affiliation | E-mail | | Zhu Haisheng | Department of Oncology, Yulin First People's Hospital, Sixth Affiliated Hospital of Guangxi Medical University, Yulin 537000, China | | | Wang Rensheng | Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China | ylzhuhaisheng@163.com | | Yan Haolin | Department of Oncology, Yulin First People's Hospital, Sixth Affiliated Hospital of Guangxi Medical University, Yulin 537000, China | | | Huang Junhua | Department of Nuclear Medicine, Yulin First People's Hospital, Sixth Affiliated Hospital of Guangxi Medical University, Yulin 537000, China | | | Chen Mingdong | Department of Radiology, Yulin First People's Hospital, Sixth Affiliated Hospital of Guangxi Medical University, Yulin 537000, China | | | Wu Lunqing | Department of Oncology, Yulin First People's Hospital, Sixth Affiliated Hospital of Guangxi Medical University, Yulin 537000, China | | | Que Lilin | Department of Oncology, Yulin First People's Hospital, Sixth Affiliated Hospital of Guangxi Medical University, Yulin 537000, China | | | Liang Leifeng | Department of Oncology, Yulin First People's Hospital, Sixth Affiliated Hospital of Guangxi Medical University, Yulin 537000, China | |
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| Abstract:: |
| Objective To evaluate the diagnostic value of 99Tcm-methylene diphosphonate(MDP)SPECT/CT in skull base bone involvement (SBBI) of nasopharyngeal carcinoma (NPC).Methods Whole-body and skull-base tomography 99Tcm-MDP SPECT/CT and MRI were applied in 165 untreated NPC patients. The radioactive counts within a region of interest (ROI) of suspected SBBI (L) were delineated from the sagittal plane of SPECT images. The radioactive counts within a same size ROI of upper cervical vertebra C1 to C3(S) were also analyzed. The ratio of L and S (L/S) was calculated. L/S > 1 indicates SBBI.MRI data was used as a standard control. The results were double-blind compared and evaluated.In addition, SBBI was further analyzed in different regions,includingthe clivus and petrous apex region of the skull base, the base of sphenoid bone and sphenoid sinus region, the Pterygoid process and lamina lateralis and lamina medialis region. Results The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and κ value for SBBI detection by SPECT/CT were 96.74%(89/92), 72.60%(53/73), 86.06%(142/165), 81.65%(89/109), 94.64%(53/56) and 0.711, respectively. The area under the ROC (receiver operating characteristic) curve (AUC) was 0.847, which showed statistically significant difference (Z=12.436, P<0.01). In the SBBI evaluation by SPECT/CT for different regions, the positive predictive value of SPECT/CT for SBBI detection in the clivus and petrous apex region of the skull base was significantly higher than that in the base of sphenoid bone, sphenoid sinus region, the pterygoid process, lamina lateralis and lamina medialis region (91.67% vs. 30.00%,14.29%) Conclusions 99Tcm-MDP SPECT/ CT could be used for the detection of nasopharyngeal SBBI, especially in the clivus and petrous apex region of the skull base. The test results were highly consistent with the MRI findings. |
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