The Value Of ^99mTc-MDP SPECT/CT In Assessing Spinal Solitary Lesion Of Patients With Non-small Cell Lung Cancer

Purpose:To evaluate the diagnostic value of ^99mTc-MDP SPECT/CT in detecting spinal solitary metastasis lesions of Non-small Cell Lung Cancer?NSCLC?and to compare the differential diagnostic value of ^99mTc-MDP SPECT/CT with SPECT planar scanning,SPECT tomography and CT scanning in diagnosing spinal solitary lesions of patients with NSCLC.Analyzing the diagnostic value of the detection methods in different location cite,different identifications of the spinal solitary lesion and different pathological types of primary lesions in NSCLC.Materials and methods:189 NSCLC patients with an abnormal ^99mTc-MDP SPECT/CT image were included.^99mTc-MDP SPECT planar scanning,SPECT tomography,SPECT/CT imaging and CT scanning were assessed for the presence of bone metastasis using a five-point grading system.According to the histopathological examination or follow-up of the spinal lesion,all lesions were divided into metastases negative group and metastases positive group.Diagnostic value of the detection methods in detecting bone metastases were evaluated.Result:Among the 189 patients,138 cases of lesions were diagnosed as metastases and 51 were benign.Lesions located in the cervical vertebra,thoracic vertebra,lumbar vertebra and sacral vertebra was 22,104,59 and 4,respectively.Lesions lied in vertebral body,vertebral arch and other appendix of vertebra was 125,52,12,respectively.Adenocarcinomax and squamous cell carcinoma of the lung was 136 and53,respectively.The lesions were divided into osteolytic lesions?n=49?,mixed lesions?n=94?and osteoblastic lesions?n=46?according to the imaging features.The accuracy of ^99mTc-MDP SPECT/CT?93.65%?was significantly higher than that of SPECT planar scanning,SPECT tomography and CT scanning?66.14%,71.96%,72.49%,respectively??P<0.05?.The sensitivity of ^99mTc-MDP SPECT tomography?78.26%?was significantly higher than that of CT scanning?66.67%??P<0.05?.The specificity of CT scanning?88.24%?was significantly higher than that of ^99mTc-MDP SPECT?54.90%??P<0.05?.For the metastases located in the cervical vertebra,thoracic vertebra or lumbar vertebra,the accuracy of ^99mTc-MDP SPECT/CT?95.45%,91.35%,96.61%,respectively?was significantly higher than that of ^99mTc-MDP SPECT planar scanning?63.64%,68.27%,64.41%,respectively?,SPECT tomography?72.73%,73.08%,71.19%,respectively?and CT scanning?77.27%,69.23%and76.27%,respectively??P<0.05?.For the metastases lied in vertebral arch or in vertebral body,the accuracy of ^99mTc-MDP SPECT/CT?94.23%,93.60%,respectively?was significantly higher than that of ^99mTc-MDP SPECT planar scanning?71.15%,64.00%,respectively?,SPECT tomography?76.92%,70.40%,respectively?and CT scanning?67.31%,74.40%,respectively??P<0.05?.For the patients with adenocarcinomax or squamous cell carcinoma of the lung,the accuracy of ^99mTc-MDP SPECT/CT?92.65%,94.34%,respectively?was significantly higher than that of^99mTc-MDP SPECT planar scanning?66.91%,64.15%,respectively?,SPECT tomography?72.79%,69.81%,respectively?and CT scanning?72.06%,73.58%,respectively??P<0.05?.For the osteoblastic metastases,osteolytic metastases and mixed metastases,the accuracy of ^99mTc-MDP SPECT/CT?91.30%,83.67%,97.87%,respectively?was significantly higher than that of ^99mTc-MDP SPECT planar scanning?65.22%,51.02%,74.47%,respectively?,SPECT tomography?69.57%,59.18%,79.79%,respectively?and CT scanning?67.39%,81.63%,70.21%,respectively??P<0.05?.Conclusion:^99mTc-MDP SPECT tomography have a high sensitivity in diagnosing spinal solitary lesions of patients with NSCLC,particularly for the osteoblastic metastases or mixed metastases,and CT scanning have a high specificity particularly for the osteolytic metastases.The sensitivity,specificity and accuracy of ^99mTc-MDP SPECT/CT were at the highest level.