The value of 99mTc-MDP bone imaging semi-quantitative analysis in differential diagnosis of benign and malignant lesions in the prostate cancer patients

Objectives To study the clinical value of the evaluation of therapeutic efficiency and differential diagnosis of benign and malignant lesions in prostate cancer patients with bone metastases, in the use of 99mTc-MDP SPECT whole body and SPECT/CT partial tomographic fusion bone imaging semi-quantitative analysis technology respectively.

Methods Analysis the results of bone scans and other clinical data about 34 hospitalized Prostate cancer bone metastasis-positive patients, who had accepted 99mTc-MDP bone imaging at the department of Nuclear Medicine in the First Clinical Hospital of Shanxi Medical University from September 2013 to December 2015. With the pathological examination, review follow-up and other imaging study findings as a reference, analyzing the correlation of imaging agent uptake degree on the 99mTc-MDP whole body bone imaging and prostate cancer-specific antibody (PSA) in 34 Prostate cancer patients. By ROIs technology, we studied the differences of images agent uptake degree (tumour / nontumour, T/NT) among the malignant lesions in Positive patients with bone metastases of prostate cancer and benign lesions in bone metastasis-negative patients and normal bone tissue in normal control group in the tomography fusion imaging. Besides, using the ROC curve to obtain the cutoff between benign and malignant lesions on 99mTc-MDP SPECT /CT partial tomographic fusion bone imaging.

Results PSA of Prostate cancer bone metastasis-positive patients is significantly higher than negative patients. The degree of the imaging agent uptake on the 99mTc-MDP whole body bone imaging and prostate cancer-specific antibody (PSA) ratio has correlation in 34 patients. The correlation coefficient r is 0.356. Differences of the imaging agent uptake levels in 99mTc-MDP SPECT local tomography are statistically significant (Bonferoni correction, P <0.0167) among the groups, which are benign lesions, malignant lesions and normal bone tissue. On the prostate cancer metastases, the area under the ROC curve of imaging agent intake degree is 0.969. When taking 2.94 as the cutoff of the imaging agent intake level (T/NT), sensitivity and specificity are: 88% and 97.5%.

Conclusions Differences of PSA are statistically significant in Positive patients with bone metastases of prostate cancer and bone metastasis-negative patients. Along with the increasing of malignant lesions’ imaging agent uptake degree on 99mTc-MDP SPECT whole body bone imaging, the level of serum PSA increases gradually. The imaging agent uptake levels among the malignant lesions in Positive patients with bone metastases of prostate cancer and benign lesions in bone metastasis-negative patients and normal control group of normal bone tissue in 99mTc-MDP SPECT partial tomographic fusion bone imaging is significantly different, and the author believes that T/NT蠅2.94 is much better for the differentiation of benign and malignant lesions. 99mTc-MDP bone imaging semi-quantitative analysis combines with PSA is expected to make a early definite diagnosis of prostate cancer bone metastases specifically, aiding to select reasonable treatment plans and getting More accurate treatment effects and prognosis.