18F-FDG PET/CT在乳腺癌腋窝淋巴结转移上的诊断价值

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Abstract Objective: The purpose of this study was to evaluate the diagnostic performance of 18F-FDG PET/CT in axillary lymph node(ALN) metastasis of patients with breast cancer. Methods: We retrospectively analysed the clinical and PET/CT data of 48 breast cancer patients who were pathologically proven． The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated respectively according to the pathological results. Receiver-operating-characteristic(ROC) curve was used to find out the cut-off value of imaging parameters for diagnosing ALN metastasis. Besides, χ2 test was used to assess the diagnostic values of PET/CT in invasive ductal carcinoma(IDC) and invasive lobular carcinoma(ILC). Results: Of the 48 breast cancer patients, 29 patients had pathologically confirmed ALN metastasis. In person and lesion unit, the sensitivity, specificity, positive predicted value, negative predicted value and accuracy of PET/CT were 86.21%, 84.21%, 89.23%, 80.00%, 85.52% and 61.68%, 98.26%, 94.96%, 82.81%, 85.55% respectively. No statistical difference was found between the diagnostic values of PET/CT in ALN metastasis in IDC and ILC patients. ROC curve showed that the cut-off values of the short axis and SUVmax of ALN for predicting metastasis were 6.5 mm (sensitivity was 66.82%, specificity was 89.30%, accuracy was 81.49%) and 1.1(sensitivity was 91.12%, specificity was 95.27%, accuracy was 93.83%) respectively, in which SUVmax had the better relationship with metastasis of ALN. Assess all the ALN again according to the standards of short axis≥6.5 cm and SUVmax≥1.1 simutaneously, the sensitivity, specificity and accuracy were 50.46%, 99.00% and 82.14%. Conclusion: The specificity and accuracy of 18F-FDG PET/CT in predicting ALN metastasis in breast cancer patients are relatively high, as well as the sensitivity in patient unit, while in lesion unit, the sensitivity is relatively low. The diagnostic values of PET/CT in ALN metastasis of IDC and ILC patients have no statistical difference. We consider that the standard of SUVmax=1.1 had the best prognostic value, which might be used as an optimal criteria.

Key words： Breast neoplasms Neoplasm metastasis Lymph nodes Fluorodeoxyglucose F18; Positron-emission tomography; Tomography, X-ray computed

Received: 27 August 2015

PACS:	Ｒ737.9
	Ｒ817.4
	Ｒ814.42

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	Articles by authors
	LI Xue-yan1
	DUAN Yu2
	YU Li-juan1

Cite this article:

LI Xue-yan1,DUAN Yu2,YU Li-juan1. Diagnostic value of 18F-FDG PET/CT in axillary lymph node metastasis in breast cancer[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(4): 243-247.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2016/V27/I4/243

[1]李霓，郑荣寿，张思维，等. 中国城乡女性乳腺癌发病趋势分析和预测[J]．中华预防医学杂志，2012，48（8）：703-707．
[2]王若珺，初明，岑雨捷，等. 新生淋巴管与乳腺癌淋巴管转移相关性的研究进展[J]. 生理科学进展，2014，45（1）：49-54.
[3]吴孟超，吴在德，黄家驷，等. 外科学[M]． 7版．北京：人民卫生出版社，2008：1160-1161.
[4]范铁，欧阳涛，李金锋，等. 前哨淋巴结阴性原发性乳腺癌患者免除腋淋巴结清扫安全性分析[J]. 中华医学杂志，2013，93（40）：3220-3222.
[5]戴文静，张伟，辛军，等. 18F-FDG PET/CT对乳腺癌及其区域淋巴结转移的诊断价值[J]. 中国临床医学影像杂志，2013，24（11）：8-11.
[6]Taira N, Ohsumi S, Takabamke D, et al. Determination of indication for sentinel lymph node biopsy in clinical node-negative breast cancer using preoperative 18F-fluoredeoxyglucuse positron emission tomography computed tomography fusion imaging[J]． J Clin Oncol, 2009, 39(1): 16-21．
[7]Kim J, Lee J, Chang E, et al． Selective sentinel node plus additional non-sentinel node biopsy based on an FDG PET/CT scan in early breast cancer patients, sing1e institutional experience[J]． World J Surg, 2009, 33(5): 943-949．
[8]Cooper KL, Harnan S, Meng Y, et al. Positron emission tomography(PET) for assessment of axillary lymph node status in early breast cancer: a systematic review and meta-analysis[J]. Eur J Surg Oncol, 2011, 37(3): 187-198.
[9]Rautiainen S, Kononen M, Sironen R, et al. Preoperative axillary staging with 3.0T breast MRI: clinical value of diffusion imaging and apparent diffusion coefficient[J]. PLoS One, 2015, 10(3): e0122516.
[10]唐立岷，马超. 18F-FDG PET/CT在诊断浸润性乳腺癌和淋巴结转移中的价值[J]. 上海交通大学学报：医学版，2012，32（6）：761-765.
[11]Vranjesevic D, Filmorrt JE, Meta J, et al． Whole-body(18)F-FDG-PET and conventional imaging for predicting outcome in predicting outcome in previously treated breast cancer patients[J]． J Nucl Med, 2002, 43(3): 325-329．
[12]Jung NY, Kim SH, Kim SH, et al. Effectiveness of Breast MRI and 18F-FDG PET/CT for the Preoperative Staging of Invasive Lobular Carcinoma versus Ductal Carcinoma[J]． J Breast Cancer, 2015, 18(1): 63-72.