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Objective: To explore the diagnostic value and efficiency of using whole body bone scintigraphy (WBS) combined with the levels of tumor markers to evaluate non-small cell lung cancer (NSCLC) patients with bone metastases. Methods: One-hundred and eighty-five cases of NSCLC, confirmed by pathology or cytological examination from January 2014 to June 2016, were emrolled from the Affiliated Tumor Hospital of Guangxi Medical University. WBS and test results of tumor markers, such as serum carcinoembryonic antigen (CEA), serum carbohydrate antigen (CA125), and cytokeratin CK19 (CYFRA21-1), were analyzed. WBS results were assessed by the Soloway classification criteria and divided into four grades: Correlations between WBS classification and the levels of tumor mark-ers were determined with Spearman correlation analyses. Results: Seventy-eight of the 185 NSCLC patients had bone metastases (a rate of 42.16%). The sensitivity and specificity of WBS were 91.02%(71/78) and 85.98%(92/107), respectively. The CEA, CA125, and CYFRA21-1 levels in bone metastases patients were higher than those in NSCLC patients without bone metastases (P＜0.05). In the 78 patients with bone metastases, there were seven cases of EOD0 (8.98%), 39 cases of EOD1 (50%), 17 cases of EOD2 (21.8%), and 15 cases of EOD3 (19.2%). The correlations between WBS grade and CEA, CA125, and CYFRA21-1 levels were: rs=0.579, 0.274, and 0.327, respectively (P＜0.05). The combined WBS and tumor marker diagnostic performance was significantly better than either alone (AUC=0.922), and their sensitivity and specificity increased (92.3%and 86.0%, respectively). Conclusions: WBS shows high clinical efficacy in the diagnosis of NSCLC with bone metastases. Furthermore, it can be used as a screening test for bone metastases of NSCLC, which has important clinical implications. WBS combined with CEA, CA125, and CYFRA21-1 examination improves the detection rate of NSCLC bone metastases, thereby enhancing its clinical utility.
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Objective To evaluate the role of (99)Tc(m)-MDP SPECT/CT bone fusion imaging in diagnosis and treatment strategy establishment of patients with bone metastatic malignancy.Methods Retrospective study was carried out on 66 patients (55 patients with primary malignant tumors,11 patients with primary benign bone disease) chosen from 117 patients who had undergone whole body bone scintigraphy and SPECT/CT fusion imaging examination.Comparison was carried out on diagnostic efficacy for bone metastases and changes of treatment between SPECT/CT fusion imaging and other anatomical imaging (CT and/or MR).Cases excluded are extensive bone metastases and no final diagnosis of patients.Results For diagnosis of patient with bone metastasis and bone metastasis lesion,the sensitivity of SPECT/CT fusion imaging was (90.62％,93.88％),specificity (79.41％,89.47％) and accuracy (84.84％,90.97％),while sensitivity of simple anatomical imaging was (59.38％,51.02％),specificity (94.11％,94.73％) and accuracy (77.27％,79.86％),with a significant difference (P ＜ 0.05).SPECT/CT fusion imaging changed 30.31％ (20/66) the patient's treatment plan,while 16.67％ (11/66) for simple anatomical imaging,with a significant difference (P ＜ 0.05).Conclusions SPECT/CT fusion imaging could increase the accuracy of diagnosis of bone metastases and have an important role in establishing the treatment strategy.
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Objective To investigate the clinical value of bone metabolism biochemical marker N-MID,TP1NP and beta-CTx combined with whole body bone scintigraphy in early diagnosis of bone metastasis of tumor.Methods The concentration of the 3 markers were measured by the electrochemical luminescence analysis method in 30 cases of healthy control group and 210 cases of patients with malignant tumor,which were divided into non bone metastasis group(45 cases) and bone metastasis group(165 cases).The bone metastasis group were divided into 4 grades(0-grade Ⅲ) by Soloway classification according to whole body bone imaging.Results The levels of serum N-MID,TP1NP and beta-CTx in 165 malignant tumor patients with bone metastasis were significantly higher than in 45 malignant tumor patients with bone metastasis and in 30 healthy control group,the difference was statistically significant(P<0.05).With the increase of the number of metastatic lesions in the bone metastasis group,the serum levels of N-MID,TP1NP,and beta-CTx were increased gradually,and they were positively correlated with the progression of the disease.According to the analysis of ROC curve,the cut-off value,sensitivity and specificity in the diagnosis of tumor bone metastasis were 17.59 ng/mL,70.3％,88.9％ for serum N-MID,43.04 ng/mL,78.2％,95.6％ for TP1NP,and 0.48 ng/mL,73.9％,93.3％ for beta-CTx.Under the ROC curve(AUC) was 0.831 for serum N-MID,0.890 for TP1NP,and 0.869 for beta-CTx.The sensitivity and specificity of three bone metabolic markers in the diagnosis of bone metastasis of malignant tumor were significantly higher.Conclusion Bone metabolism biochemical markers:Serum N-MID,TP1NP and beta-CTx for diagnosis of bone metastasis of malignant tumor are sensitive,accurate and simple,which can significantly improve the efficiency of diagnosis of bone metastasis,and can be combined with whole-body bone scintigraphy in early diagnosis of bone metastasis with malignant tumor.
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Multiple extramedullary (soft tissue) plasmacytoma is a rare neoplasm of plasma cells. This is a case of a 63-year-old male who presented with back pain and a one month history of a painful, progressively growing mass at the right anterior chest wall. Since radiographs and computed tomography of the chest showed lytic lesions on the ribs and L4 compression deformity, the patient was referred for whole body bone scintigraphy to evaluate the remainder of the skeleton. Bone scintigraphy revealed osteoblastic lesions and osteolytic lesions in the thoracic cage. Diagnosis of plasmacytoma was established by biopsy and confirmation of microscopic characteristics and immunohistochemical staining.