Diagnostic performance of a computer-assisted diagnosis system for bone scintigraphy of newly developed skeletal metastasis in prostate cancer patients: search for low-sensitivity subgroups.
发表日期： 2017.04.29 来源：Ann Nucl Med. 2017 Aug;31(7):521-528.
Kazuki Motegi1, Masamichi Koyama1, Takashi Terauchi1, Takeshi Yuasa2 , Junji Yonese2.
1. Department of Nuclear Medicine, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
2. Department of Urology, Cancer Institute Hospital, Tokyo, Japan.
The computer-assisted diagnostic system for bone scintigraphy (BS) BONENAVI is used to evaluate skeletal metastasis. We investigated its diagnostic performance in prostate cancer patients with and without skeletal metastasis and searched for the problems.
使用BS计算226名前列腺癌患者（124名患有骨转移，101名患者没有）的人工神经网络（ANN）值。 进行接受者操作特征曲线分析并且确定灵敏度和特异性（截止ANN = 0.5）。 分析诊断骨转移时的病人情况，计算机断层扫描（CT）类型，疾病程度（EOD）和BS摄取等级。记录假阴性和假阳性结果。
An artificial neural network (ANN) value was calculated in 226 prostate cancer patients (124 with skeletal metastasis and 101 without) using BS. Receiver operating characteristic curve analysis was performed and the sensitivity and specificity determined (cutoff ANN = 0.5). Patient's situation at the time of diagnosis of skeletal metastasis, computed tomography (CT) type, extent of disease (EOD), and BS uptake grade were analyzed. False-negative and false-positive results were recorded.
BONENAVI showed 82% (102/124) of sensitivity and 83% (84/101) specificity for metastasis detection. There were no significant differences among CT types, although low EOD and faint BS uptake were associated with low ANN values and low sensitivity. Patients showed lower sensitivity during the follow-up period than staging work-up. False-negative lesions were often located in the pelvis or adjacent to it. They comprised not only solitary, faint BS lesions but also overlaying to urinary excretion.
BONENAVI with BS has good sensitivity and specificity for detecting prostate cancer's osseous metastasis. Low EOD and faint BS uptake are associated with low sensitivity but not the CT type. Prostate cancer patients likely to have false-negative results during the follow-up period had a solitary lesion in the pelvis with faint BS uptake or lesions overlaying to urinary excretion.
Bone metastasis; Bone scintigraphy; Computer-assisted diagnosis; Prostate cancer