18F-FDG PET/CT显像对乳腺癌术后复发及转移的诊断价值

目的探讨18F-脱氧葡萄糖正电子发射体层摄影术(FDG PET)/CT显像对乳腺癌术后复发、转移的诊断价值。方法对乳腺癌术后患者104例进行全身18F-FDG PET/CT显像检查。复发或转移灶依据手术或活组织病理学检查、多种影像学检查及临床随访确诊,随访时间大于6个月。结果 104例患者中,肿瘤复发、转移52例。以患者为单位计算,18F-FDG PET/CT诊断乳腺癌术后复发和(或)转移的灵敏度为100%,特异性为98.1%,准确性为99.0%,阳性预测值为98.1%,阴性预测值为100%。以病灶为单位计算,18F-FDG PET/CT诊断乳腺癌术后复发和(或)转移的灵敏度为98.3%,特异性为75.0%,准确性为96.8%,阳性预测值为98.3%,阴性预测值为75.0%1。8F-FDG PET/CT显像使8例(15.4%)患者改变了临床再分期,其中7例提高了临床再分期、1例降低了临床再分期。结论 18F-FDG PET/CT对乳腺癌术后复发和(或)转移的诊断具有重要临床价值。

18F-FDG PET/CT in detection of recurrence and metastasis of breast cancer

Objective To evaluate the value of positron emission tomography/computed tomography(PET/CT)with 18F-fluoro-deoxy-glucose(18F-FDG)in detecting recurrence and metastasis of breast cancer.Methods18F-FDG PET/CT was studied in 104 patients with breast cancer after surgery.The diagnosis of recurrent tumor and(or)metastasis was based on pathologic examination,multi-modality imagings and clinical follow-up for more than 6 months.The diagnostic competent of PET/CT was assessed by comparing with the clinical findings.ResultsIn total 104 patients,recurrent and(or)metastasis tumors were proved in 52 patients.By the patient-based unit,the sensitivity,specificity,accuracy,positive predictive value and negatice predictive value of PET/CT in detecting recurrent tumor and/or metastasis were 100%,98.1%,99.0%,98.1% and 100%,respectively.By the lesions-based unit,the sensitivity,specificity,accuracy,positive predictive value and negatice predictive value of PET/CT were 98.2%,75.0%,96.8%,98.3%and 75.0%,respectively.18F-FDG PET/CT changed 8 patients(15.4%)in the re-staging,with upstaging in 7 patients and down-staging in one patient.Conclusion18F-FDG PET/CT has an important clinical value in the detection of recurrent tumor and/or metastasis of breast cancer.