A Preliminary Study on Predicting the Bone Rapair Effect of Zoledronic Acid in the Treatment of Breast Cancer Metastasis by 99m Tc-MDP Bone Scan / 医学研究杂志

ABSTRACT

Objective To explore the correlation between the change of CT value of osteolytic bone metastasis after the treatment of zoledronic acid and bone metabolism before treatment in breast cancer patients.Methods Twenty breast cancer patients with osteolytic bone metastases were diagnosed by 99m Tc-MDP bone scintigraphy and 99m Tc-MDP SPECT/CT ( contain 16-slice spiral CT) for the first time entered this study.After treatment of zoledronic acid for 3-12 months with the same method, 99m Tc-MDP bone scintigraphy and 99mTc-MDP SPECT/CT were peformed in the 20 breast cancer patients again with the same CT scan parameters(voltages120kV, tube currents80mA, pitches3.75mm).With using regions of interesting (ROI)technique, the T/NT value of osteolytic bone metastases in the first 99m Tc-MDP bone scintigraphy were measured.The CT value of same ROI before and after zoledronic acid therapy were measured (CT1 and CT2), and the change of CT value (△CT,△CT=CT2-CT1) were calculated.The correlation between them were analyzed. SPSS 16.0 was applied for variance and linear correlation analyses.Results (1)A total of 30 lesions of osteolytic bone metastases were detected in the 20 breast cancer patients by the first 99m Tc-MDP bone scintigraphy and 99m Tc-MDP SPECT/CT.The CT value before therapy was significantly higher than that after therapy(425 ±152HU vs 120 ±73HU, t=9.95, P<0.01).(2)The change of CT value after therapy was positively correlated with and the T/NT value of osteolytic bone metastasis(r=0.907, P<0.01).(3)The change of CT value of positive lesions after therapy was significantly higher than that of negative lesions by 99mTc-MDP bone scan(W=15,P=0.001). Conclusion 99m Tc-MDP bone scintigraphy provides an effective method to predict the efficacy of zoledronic acid for breast cancer pa-tients with osteolytic bone metastases.The breast cancer patients with high bone metabolism should be recommended zoledronic acid thera-py, conversely should not be recommended.