PET/CT显像与超声成像对乳腺肿瘤良恶性诊断的价值

Clinical diagnosis value of PET/CT and ultrasound imaging in breast tumors

目的研究PET/CT显像和超声成像对乳腺肿瘤临床诊断的价值。方法回顾性分析比较经病理证实的91例乳腺肿瘤患者的^(18)F-氟代脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)PET/CT与乳腺超声图像。测量乳腺肿瘤病灶的最大标准摄取值(maximal standardized uptake value,SUV_(max))和最大长径,利用受试者工作特征(receiver operating characteristic,ROC)曲线计算SUV_(max)和最大长径诊断乳腺肿瘤良恶性的最佳截断界值,比较2种影像技术的诊断效能。结果SUV_(max)为7.02(敏感度为67.1%)和最大长径为22.5 mm(敏感度为56.1%)为乳腺病灶最佳截断界值。SUV_(max)的曲线下区域(area under the curve,AUC)为(0.953±0.022),最大长径的AUC为(0.904±0.034)。^(18)F-FDG PET/CT显像和超声成像对乳腺肿瘤良恶性诊断敏感度、特异度和准确度分别是97.6%、83.3%、95.0%和93.9%、55.6%、87.0%,其中两者间敏感度和准确度诊断一致性比较,差异均具有统计学意义(均P<0.05)。^(18)F-FDG PET/CT检查还发现30例患者有远处病灶。结论^(18)F-FDG PET/CT与超声成像对乳腺肿瘤诊断效能相近,具有良好的一致性。^(18)F-FDG PET/CT在探查远处转移病灶方面具有优势,能够为临床决策提供更好的帮助。

Objective To compare the clinical diagnosis value of ^(18)F-fluorodexyglucose(^(18)F-FDG)PET/CT and ultrasound imaging in breast tumors.Methods ^(18)F-FDG PET/CT and ultrasound images of 91 patients with breast tumors confirmed by pathology were analyzed retrospectively.The maximum standardized uptake value(SUV_(max))and maximum diameter of breast tumor were measured,and receiver operating characteristic(ROC)curve was used to calculate the cut-off values of SUV_(max) and the maximum diameter for the diagnosis of benign and malignant breast tumors.The diagnostic efficiency of ^(18)F-FDG PET/CT and ultrasound were compared.Results ROC curve showed that the cut-off values of the SUV_(max) and maximum diameter for predicting metastasis were 7.02(sensitivity:67.1%)and 22.5 mm(sensitivity:56.1%).The areas under the curves(AUCs)of the SUV_(max) and maximum diameter were(0.953±0.022)and(0.904±0.034).The sensitivity,specificity and accuracy of ^(18)F-FDG PET/CT were 97.6%,83.3%and 95.0%respectively,and 93.9%,55.6%and 87.0%for ultrasound,repectively.The sensitivity and accuracy of diagnosis consistency between the two methods were both statistically significant(both P<0.05).^(18)F-FDG PET/CT found that 30 patients had metastatic lesions.Conclusions ^(18)F-FDG PET/CT and ultrasound are both effective approaches in the diagnosis of breast tumors.^(18)F-FDG PET/CT has advantages in detecting distant metastatic lesions,and can provide better assistance for clinical decision-making.