乳腺密度、年龄和更年期状态对正常乳腺摄取^(18)F-FDG的影响

Influence of breast density,age and menopausal status on the uptake of ^(18)F-FDG in normal breast tissue

目的通过SUV评价乳腺密度、年龄和更年期状态对正常乳腺组织摄取18F-FDG的影响。方法 62例经组织学明确诊断的乳腺癌患者,年龄32～79岁,平均(50±11)岁,其中绝经期前36例,绝经期后26例。所有患者均接受18F-FDGPET/CT扫描。根据ACR的BI-RADS标准,40例患者乳腺X线摄片密度(乳腺密度)为3或4级,而22例患者的乳腺密度为1或2级,所有乳腺X线摄片在18F-FDGPET/CT扫描前4周内获得。除了病变乳腺组织,对侧正常的乳腺组织或距离病灶较远的正常的乳腺组织也计算SUV的平均值和峰值。方法是在正常乳腺组织中以12mm×12mm(9个像素)的感兴趣区(ROI)作为18F-FDG最高的摄取区域。统计学方法采用均数间的t检验以及相关分析,P<0.05作为判定是否具有统计学差异的标准。结果高密度乳腺正常组织中SUV的峰值和平均值分别为1.04±0.24和0.87±0.22,低密度乳腺正常组织中SUV的峰值和平均值分别为0.88±0.38和0.75±0.46。高密度正常乳腺组织中SUV的峰值和平均值均明显高于低密度正常乳腺组织(P<0.0005)。SUV峰值的最高值在正常高密度和低密度乳腺组织中分别为2.0和1.5。激素水平(绝经期前后)对SUV的影响不显著(P=0.23)。而且,也没有观察到年龄因素和SUV平均值及峰值间有相关关系(P=0.87)。结论正常乳腺组织中,高密度和低密度的乳腺组织中的SUV值有明显差异。尽管高密度正常乳腺组织中的SUV值较高,但是18F-FDGPET/CT对乳腺癌诊断的准确性不会受到明显影响,因为SUV峰值仍明显低于2.5的阈值;激素水平和年龄因素不会影响正常乳腺组织对18F-FDG的摄取。

Objective To evaluate the influence of breast density,age and menopausal status on the uptake of tSF-FDG in normal breast tissue by SUV. Methods 62 breast cancer patients diagnosed by histology,menopause before 36, menopause after 26, received Js F-FDG PET/CT scan. The average age was （50 ± 11 ） years （ age range 32- 79 years）. According to ACR criteria,40 patients with breast X-ray density（ breast density）of grade 3 or grade 4, and 22 patients with breast density of grade 1 or grade 2. All of these breast X-ray radiography were obtained 4 weeks before the 18F-FDG PET/CT scan. The average and peak of SUV were calculated in the lesions of breast, contralateral normal breast tissue and the normal breast tissue far away from lesions. The SUV were defined in 12 mm x 12 mm（9 pixels） of the ROI as the highest 18F-FDG uptake area in the normal breast tissue. The statistical methods used t-test and correlation analysis,P 〈 O. 05 as the standards of statistical significance. Results The peak and mean SUV of high-density normal breast tissue were 1.04 ±0. 24 and O. 87 ±0. 22,and the low-density were 0. 88 ±0. 38 and 0.75 ±0. 46. The peak and mean SUV of high-density were significantly higher than the low-density （ P 〈 0. 0005 ）. The highest of peak SUV in the high-density and the low-density were 2.0 and 1.5. The influence of hormone levels （ before and after menopause） on the SUV value was not significant （ P = 0. 23 ）. Moreover, there was no correlation between age factor and the mean and peak SUV （ P = 0. 87 ）. Conclusions The significant difference of the SUV was observed between the high-density and low-density of normal breast tissue. Despite in the high density of normal breast tissue,the SUV is higher, but the accuracy of diagnosis of 18F-FDG PET/CT for breast cancer can not be affected significantly, because the peak SUV is still significantly lower than 2. 5 SUV threshold;hormone levels and age factors can not affect 18F-FDG uptake.