Clinical Implication Of Three Phase Bone Scan In Detecting The Lesions Of Tumors

Purpose:During the compare of three-phase bone scan, early phase scan and delayed bone scan, we evaluated the merits of these scans in detecting the lesions of carcinoma of bone and soft tissues, and want to find a simple and quick method to improve the sensitive of bone scans.Method: Patient selection: In this study, we chose 54 patients who had suffered tumors, involved in this study, 34 males and 20 females, mean age 14 to 82 years, mean age is 59.40±14.59, who were having an regional pain which caused by benign or malignant carcinoma that diagnosed by CT,X-ray in 12 patients; ECT in 6 patients; endoscopies and the pathologic diagnosis after operation in 36 patients. Among them lung cancer 19, breast cancer 7 and other cancer 28. Image method: Using two head SPECT made by ADAC Co., after acquiring the images of blood phase and blood pool phase, acquired the convertional delayed bone scan. The conditions are window wide 20%, energy peak 140KeV,matrix 256×256. The imaging were acquired simultaneously from both anterior and posterior views, after a bolus injection of 1110MBq technetium-99m-labelled methylene diphosphonate (MDP), blood phase contains 40 frames and 3 seconds per frame, blood pool phase contains 6 frames and 1minute per frame, delayed phase was performed 2.5 hour later. Sets: According to the results of three-phase bone scan, the patients were divided into 2 groups: normal and abnormal groups. The abnormal group includes early phase positive, delay positive and all three phase positive sets. The comparing among the 3 sets were analyzed by chi-square test and other statistic means. Results: In 54 patients, the results were normal in 15 cases, positive in 22 cases, the results in delayed phase were positive in 9 cases, blood flow and blood pool phase showed blood flow changes in 4cases and soft tissue tumors were seen in 4cases. Three phase bone scan was more sensitive than delayed whole body bone scan in detecting the abnormal sites (p＜0.001) . No more abnormal sites were detected in delayed whole body bone scan than in blood flow and blood pool phase(p＞0.05) The sensitivity of detecting tumors in blood flow and blood pool phase, delayed phase were respectively lower than in three phase bone scan (p＜0.001).Conclusion: It is more sensitivity of detecting tumor lesions in three phase bone scan than in delayed phase whole body bone scan and the changes of blood flow and soft tissue can be seen in three phase bone scan. So it is more suitable way to improve the sensitivity of detecting abnormal sites in three-phase bone scan.