Objective To use meta-analysis method to assess the efficacy of fluorine-18fluorode-oxyglucose positron emission tomography/computed tomography (PET/CT) (18F-FDG-PET/CT) scan and 99Tcm-methylene diphosphonate (99Tcm-MDP) bone scan (BS) on early diagnosis of bone metastases of cancer. Methods Computer-based retrieval was conducted on MEDLINE, PubMed, EMbase, Ovid, and The Cochrane Library (from their establishment to 2010) to search reports about diagnosing bone metastases of cancer with 18FDG-PET/CT and 99Tcm-MDP Bone Scan. Three reviewers independently selected the studies according to the inclusion and exclusion criteria, collected the data, and evaluated the quality. MetaDisc software was adopted to conduct meta-analyses. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated, the summary receiving operating characteristic (SROC) curve was drawn, and the areas under the curve (AUC) and Q were measured. Results Five studies were included. The results of meta-analyses showed that the pooled sensitivity of 18FDG-PET/CT and 99Tcm-MDP BS in the diagnosis of bone metastases was 0.95 (95%CI 0.90 to 0.97) and 0.77 (95%CI 0.71 to 0.83), respectively; the pooled specificity was 0.98 (95%CI 0.97 to 0.99) and 0.90 (95%CI 0.88 to 0.92), respectively; the pooled DOR was 602.81 (95%CI 214.07 to 1697.51) and 41.37 (95%CI 8.15 to 210.05), respectively; the AUC was 0.984 2 and 0.901 7, respectively; and the Q index was 0.945 4 and 0.833 1, respectively. Conclusion The 18F-FDG PET/CT is more effective than the 99Tcm-MDP bone scan in the early diagnosis of bone metastases in cancer.
Objective To study the cl inical characteristics of sacrum echinococcosis disease so as to provide a basis for its diagnosis and treatment. Methods Between July 1999 and August 2010, 14 cases of sacrum echinococcosis disease were treated and the cl inical data were analysed retrospectively. There were 6 males and 8 females with an average age of 28.7 years (range, 16-58 years). The median disease duration was 5.7 years (range, 6 months to 11 years). Twelve cases came from cattle area or had a history of close contact with dogs and sheep; 12 patients had a history of lung or l iver hydatid disease. The main clinical symptoms were lumbosacral and lower extremity pain, one or both lower extremities and perineal hypoesthesia, the gradual dysfunction of both lower extremities and neurogenic bladder and bowel, and decreased force of urination. The imaging examination showed multicystic bone erosion. The Casoni test was performed in 10 cases and the results were positive in 8 cases. The eight immunoserology markers of hydatidosis were detected in 4 cases, and the results were all positive. After entire debridement of the focus, defects were repaired with autogenous bone, allogeneic bone, artificial bone, or bone cement, and then albendazole was used as a routine treatment for 3 months. Results Incisions healed by first intention, and no compl ication occurred. All patients were followed up 6 months to 11 years with a median time of 5.7 years. The preoperative cl inical symptoms were rel ieved. Eight cases recurred at 6 months to 3 years after operation; after debridement (3 times in 5 and 5 times in 1) and the lesions marginal resection with a high-speed burr (2 cases), the symptoms were relieved in different degrees without recurrence. No hydatid disease occurred and spreaded. Conclusion The cl inical manifestation of sacrum is not typical, which is easy to be misdiagnosed. MRI is helpful to diagnosis sacrum echinococcosis disease; serological examination is the major method of identification diagnosis, and surgery is the main treatment method.