Comparative Study On The Diagnostic Efficiency Of SPECT/CT,WBS,CT And MRI In Pelvic Bone Metastases

Objective: To explore the gain effect of Single photon emission computed tomography/Computed Tomography(SPECT / CT)in the diagnosis of local pelvic bone metastases,as well as the advantages and disadvantages of Whole body bone scan(WBS),Computed Tomography(CT)and Magnetic Resonance Imaging(MRI)technology and the analysis of diagnostic efficiency,so as to provide a more objective image basis for clinical diagnosis and prognosis evaluation,explore a more cost-effective image diagnosis mode,and provide a reliable theoretical basis for clinical diagnosis and image diagnosis of systemic bone metastases.Methods:(1)A total of 105 SPECT/CT fusion images were obtained during SPECT examination in the Affiliated Hospital of Youjiang Medical College for Nationalities from July 2019 to December 2021.The pelvic imaging agent was suspected to be concentrated or missing foci,and CT examination and fusion were carried out.(2)From July 2019 to December 2021,120 cases of suspected bone metastases with malignant tumor confirmed by pathological examination or clinical diagnosis in Affiliated Hospital of Youjiang Medical College for Nationalities were collected,including WBS,CT and MRI.(3)To compare the gain effect of SPECT/CT co-fusion in the diagnosis of local pelvic bone metastases by systemic bone imaging alone.(4)Comparison of diagnostic efficacy and imaging characteristics of WBS,CT and MRI for pelvic bone metastases.(5)Comparison of WBS+CT,WBS+MRI,CT+MRI,WBS+CT+MRI combined diagnostic efficacy.(6)To analyze the nature and origin of pelvic bone metastases.Results:(1)In the pelvic lesions of tumor patients,the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of the SPECT/CT fusion image group,Compared with 78.09%,85.07%,65.78%,81.42%,71.42% in SPECT group,92.38%,95.52%,86.84%,92.75%,91.66%,The diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of SPECT/CT fusion image were higher than those of SPECT(P < 0.05).(2)The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of MRI,CT and WBS in the diagnosis of pelvic lesions in tumor patients,MRI group(90.00%,90.58%,88.57%,95.06%,80.00%,CT group(76.66%,74.11%,82.85%,91.30%,56.86%),WBS group(80.83%,87.05%,65.71%,86.04%,67.64%).(3)The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of WBS+CT+MRI,MRI+WBS,MRI+CT,WBS+CT combined diagnosis for pelvic lesions in tumor patients were in WBS+CT+MRI group(97.50%、98.82%、94.28%、97.67%、97.05%),MRI+WBS group(92.50%、95.29%、85.71%、94.18%、88.23%),MRI+CT group(92.50%,94.11%,88.57%,95.23%,86.11%),)WBS+CT group(89.16%、92.94%、80.00%、91.86%、82.35%).(4)The proportion of primary tumors in pelvic area was 62.41%,and the proportion of multiple bone metastases in pelvic bone metastases was 71.14%.Conclusion:(1)SPECT/CT co-fusion has obvious synergistic effect on SPECT diagnosis of pelvic bone metastases in tumor patients.(2)Among the examination techniques for pelvic bone metastases in tumor patients,MRI examination has the best diagnostic efficacy,followed by WBS examination and CT examination.(3)There is little difference between WBS+CT+MRI group,WBS+CT group,WBS+MRI group and CT+MRI group.SPECT/CT and WBS+MRI have high cost performance and can be used as the preferred imaging diagnosis mode.(4)Pelvic bone metastases are mainly multiple bone metastases,and the primary tumor is more likely to originate from pelvis-pelvic area.