背景：作者評估鎝-99m-MDP平面頭顱骨骼掃描對於鼻咽癌患者顱底病灶之檢測能力並探此探出一有效應用平面或單光子電腦斷層題頭骨掃描之策略，同時亦評估乳凸骨攝取增加時對判讀平面頭顱骨骼掃描之影響。
方法：117位鼻咽癌患者接受全身與兩側頭顱平面骨骼掃描及頭顱單光子電腦斷層骨骼掃描，掃描結果由三位醫師各自判讀後就各人對顱底與乳凸骨在頭顱兩側平面骨骼掃描及頭顱單光子電腦斷層骨骼掃描上之判讀結果加以比較，去異存同以求得一致的結論，最後再以單光子電腦斷層骨骼掃描之結果為準來評估平面頭顱骨骼掃描檢測顱底病變之能力及乳凸骨攝取增加時對其判讀之影響。
結果：頭顱兩側平面骨略掃描對於檢測顱底病變之敏感性為78%，特異性為77%，準確性為78%，陽性預測值為94%，陰性預測值為45%。
結論：我們建議平面頭顱骨骼掃描之結果為陰性或不確定的鼻咽癌患者進一步接受頭顱單光子電腦斷層掃描以求準確。結果為陽性者若無特別需求則可免。此外，乳凸骨攝取增加不影響平面頭顱骨骼掃描之判讀。

Background: The authors evaluated the performance of 99m Tc-MDP planar skull bone scan in detecting basal skull lesions in patients with naspharyngeal carcionma, proposed a strategy for effective use of planar and SPECT skull bone scan in the imaging of NPC patients, and evaluated the influence of increased mastoid bone uptake on the interpretation of planar skull bone scans.
Mehods: One hundred and seventeen patients with nasopharyngeal carcinoma underwent whole body, bilateral planar skull, and skull SPECT bone scans. The findings for the skull base and mastoid bone on planar and SPECT images as interpreted by three nuclear medicine physicians from different hospitals were compared to reach a consensus. The SPECT consensus was then used as the final result for performance evaluation of the planar images.
Results: The planar skull bone scan had a sensitivity of 78%, a specificity of 77%, an accuracy of 78%, a positive predictive value of 94%, and a negative predictive predictive value of 45%. The consensus results and performance between the patients with and without mastoid lesions showed no significant statistical differences.
Conclusion: We recommend NPC patients with negative or equivocal findings on planar skull bone scan undergo skull SPECT for further evaluation while those with positive findings may save the SPECT for further evaluation while those undergo skull SPECT for further evaluation while those with positive findings may save the SPECT unless otherwise indicated. Increased uptake in mastoid bone does not adversely affect the reading of planar skull bone scan.