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Bone metastases is a common complication of advanced tumors, more common in prostate cancer, breast cancer and lung cancer. Its occurrence often indicates a decline in the quality of life and survival of shortening, is an important factor leading to death in patients with early diagnosis of bone metastases early and treatment has important clinical significance for improving the survival rate of patients with malignant tumors, to improve the quality of life important, its role is indisputable. Years of clinical application has been confirmed, 99 Tc m -MDP whole body bone scintigraphy is a very sensitive diagnostic bone metastases inspection methods, but the drawback is the poor specificity benign bone lesions, such as: fractures, inflammation, and positive results. PET imaging for the identification of bones benign and malignant lesions, high value, but the check is expensive. Many researchers have tried to find a single photon tumor positive imaging technology for the identification of these lesions, the the as: 99 the Tc m -MIBI imaging 99 < / sup> Tc m (V)-DMSA scintigraphy, but did not get the desired results. The nitroimidazole compounds HL91 imaging agents in recent years developed a new type of hypoxic tissue, studies have shown that selectively stranded at the the tumor hypoxia organization, can be used to determine tissue hypoxia, is a good tumor positive imaging imaging agent. Objective: In this study, bone lesions by 99 the Tc m -HL91 in imaging to explore lack of oxygen Imaging Agent 99 Tc m -HL91 value in the diagnosis of bone metastases. Materials and Methods: 19 cases of bone pain patients, including 12 cases of bone metastases, pathological or clinically confirmed seven cases of bone metastasis, 5 cases of prostate cancer with bone metastasis, the other seven cases confirmed by pathology or clinical bone benign disease which one cases of vertebral hemangioma, bone cyst in two cases, arthritis in 4 cases. All patients first to 99 of Tc m -MDP whole body bone scintigraphy. Two days later for 99 Tc m -HL91 imaging. Cubital vein the injection 99 Tc m -HL91 740 MBq (20 mCi) after 4h Zhu Huanzhe sit on the examining table. Press 99 the Tc m -MDP whole body imaging tips lesion sites (12 patients with cancer of 55 lesions, 11 lesions were benign bone lesions) first ECT scan, step-by-step acquisition, collected every 6 degrees an acquisition matrix of 128 × 128 magnification 1.28 after imaging, CT scan, the scan parameters for 120Kv 2.5mAs thickness of 1cm. Image processing: fault collected data OSEM iterative reconstruction after fusion with CT images of the same plane. Semi-quantitative analysis: the technology outlined interested in the lesion site area, count on the use of computer tomographic images regions of interest (ROI), repeated three times and calculate the mean, denoted by T, compared with the contralateral normal tissue (N), calculated lesions with the proportion of normal tissue radioactivity count ratio (T / N ratio); sensitivity is defined as the transfer of subjects of all bone lesions in positive results, the specificity is defined as the proportion of negative results in the subjects of all benign bone disease lesions. The imaging results were compared with surgery or puncture to obtain the results of pathological and clinical, to judge 99 Tc m -HL91 imaging in the identification of bone metastases and benign bone lesions value. Results: 1. 99 Tc m -HL91 imaging: 99 Tc m -HL91 SPECT imaging range, 12 cases malignant tumor patients with bone metastasis 99 Tc m 55-MDP imaging lesions 99 Tc m - 53 showed abnormal uptake in HL91 imaging, two no concentration, sensitivity was 96.4%; the seven cases benign bone disease 99 Tc m -MDP 11 lesions HL91 SPECT imaging were all negative, a specificity of 100%. 2. T / N ratio 99 Tc m -HL91 tomographic imaging semi-quantitative analysis: 12 cases of malignant tumors of bone metastases in patients with lesions of 1.900 ± 0.342,7 benign bone disease T / N ratio of the lesion to 0.758 ± 0.232, t-test, t = 10.554, P <0.05, significant difference. 3. T / N ratio of different pathological types bone metastasis the the 99 the Tc m -HL91 tomography semi-quantitative analysis: lung cancer and prostate cancer patients with bone metastases were 1.959 ± 0.414,1.823 ± 0.197, t test, t = 1.459, P> 0.05, the difference was not significant meaning. 4. After all the patients injections 99 the Tc m -HL91, no any side effects. Conclusion: 1. 99 Tc m -HL91 Complex scintigraphy is metastatic bone cancer and benign bone disease T / N ratio differences are significant. Prompted the imaging agent hypoxic tissue 99 the Tc m -HL91 Complex as a tumor positive imaging agent in bone metastatic tumor diagnosis exact value, combined with 99 < / sup> the Tc m -MDP imaging can provide a clinical both sensitive and specific for the diagnosis of bone metastases. 2. 99 the Tc m -HL91 imaging agent preparation convenient, economic, non-toxic side effects, suitable for SPECT imaging has broad prospects for clinical application.
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