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Patients with bone metastatic neoplasms who had undergone baseline bone SPECT\/CT scanning before Sr-89 therapy (148\u00a0MBq Sr-89 chloride by an intravenous injection for each patient) between July 2011 and July 2018 were included. Bone SPECT\/CT images were assessed by two readers independently. Associations between imaging features and therapeutic efficacy were obtained via multivariate logistic regression analysis. Of 231 patients analyzed, 50 (21.6%) had NRC at baseline. Of 31 patients who experienced poor therapeutic efficacy, 29 (93.5%) had NRC. In multivariate logistic regression analysis baseline NRC independently predicted poor therapeutic efficacy. The sensitivity of NRC for predicting poor therapeutic efficacy was 93.5%, specificity was 89.5%, positive predictive value was 58.0%, and negative predictive value was 98.9%. RCZLs were detected in17 patients (7.4%), of whom 14 experienced poor Sr-89 therapeutic efficacy. The sensitivity of the presence of RCZLs for predicting poor therapeutic efficacy was 45.2%, specificity was 98.5%, positive predictive value was 82.4%, and negative predictive value was 92.1%. After adjusting for age, bone metabolism and lesion type, the significant independent predictors of poor Sr-89 therapeutic efficacy were presence of NRC (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and RCZL (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). NRC and RCZL on baseline bone SPECT\/CT are reliable independent predictors of poor Sr-89 therapeutic efficacy in patients with bone metastasis. These associations may facilitate the administration of more effective therapeutic interventions.<\/jats:p>","DOI":"10.1038\/s41598-020-78372-5","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T11:02:35Z","timestamp":1606993355000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Added value of hybrid SPECT with CT imaging for predicting poor therapeutic efficacy of 89Sr in patients with bone metastasis"],"prefix":"10.1038","volume":"10","author":[{"given":"Ben","family":"Meng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Longlan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoliang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,12,3]]},"reference":[{"key":"78372_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/cbr.2013.1549","volume":"29","author":"G Rubini","year":"2014","unstructured":"Rubini, G., Nicoletti, A., Rubini, D. & Asabella, A. 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