18F-FDG符合线路显像在乳腺癌诊断中的初步应用

目的研究18F-FDGSPECT/CT符合线路正电子显像在鉴别乳腺肿块性质和乳腺癌术前淋巴结转移分期中的应用价值。方法22例有乳腺肿块的女性患者行SPECT/CT符合线路18F-FDG显像,患者禁食6h以上,肘静脉注射18F-FDG185MBq～296MBq。静注60min后开始发射和X线CT透射扫描,然后进行符合线路PET连续采集30min。图像经X线衰减校正和有序子集最大期望值法(COSEM)叠代重建后,得到横断面、冠状面、矢状面三维断层图像及CT与FDGSPECT的融合图像。结果22例患者均通过手术切除治疗并获得病理结果。其中,乳腺癌16例,乳腺良性肿瘤6例。FDGSPECT诊断乳腺癌的敏感度、特异性和准确度分别是93.75%、100%和95.45%,明显高于乳腺X射线摄片。16例乳腺癌患者,15例FDGSPECT分期与临床手术分期一致。利用SPECT/CT仪所配备的定位CT,15例乳腺癌患者的病灶可准确定位。结论SPECT/CT符合线路18F-FDG显像在乳腺癌的诊断、转移灶定位以及临床分期方面具有重要的临床应用价值。

Preliminary applications of 18F- FDG coincidence imaging in the diagnosis of breast carcinoma

Objective To investigate the applied value of SPECT/CT coincidence 18F-FDG imaging in the differentiation of benign and malignant breast masses and in the staging of lymph node metastases.Methods Twenty-two femal patients with breast tumor underwent SPECT/CT coincidence 18F-FDG imaging when they fasled for more than 6 hours. Emission and X-ray CT thansmission tomography scans were performed within 60 minutes after intravenous injection of 185 to 296 MBq 18F-FDG.After X-ray attenuation correction and COSEM reconstruction,axial,sagittal and coronal three-dimensional images and CT to FDG.SPECT fusion images were gotten. Results All 22 patients underwent surgical resection and then obtained pathological diagnosis,of them,16 cases were breast carcinoma and other 6 cases were benign breast tomor.The sensitivity, specificity and accuracy of FDG SPECT for diagnosing breast carcinoma were 93.75 % ,100 % and 95.45 % ,respectively,which were significantly higher than those of breast X-ray photography.Among 16 patients with breast carcinom,preoperative staging in 15 cases was well coresponding to operative findings.The carcinous lesions in 15 cases could be accurately located by X-ray CT equipped with SPECT/CT.Conclusion SPECT/CT coincidence 18F-FDG imaging has important utility in the diagnosis, metastasis localization and clinical staging of breast carcinoma.