^(18)F-FDG符合线路SPECT/CT显像对乳腺癌腋窝淋巴结转移的诊断价值  

Diagnostic Value of ^(18)F-FDG Coincidence SPECT/CT Imaging for Axillary Lymph Node Metastasis in Breast Cancer

作　　者：陈鹏[1] 汪瑞[2] 刘永[1] 陆武[1] 宋长祥[1] 杜鹏[1] 

机构地区：[1]连云港市第一人民医院核医学科,江苏连云港222002 [2]连云港市第一人民医院甲乳外科,江苏连云港222002

出　　处：《中国医学影像学杂志》2013年第1期16-19,共4页Chinese Journal of Medical Imaging

摘　　要：目的探讨18F-FDG符合线路SPECT/CT显像半定量分析法预测乳腺癌腋窝淋巴结转移的最佳阈值。资料与方法以58例行腋窝淋巴结清扫术的乳腺癌患者为研究对象,18F-FDG符合线路SPECT/CT测量腋窝淋巴结(L)与对侧相应部位腋窝本底(B)最大放射性计数比值(L/B值)。以病理为"金标准",通过ROC曲线建立预测乳腺癌腋窝淋巴结转移的最佳阈值,将最佳阈值下的判定结果与病理结果行一致性检验。结果 58例患者共检测到119枚与手术区匹配的淋巴结(直径≥8mm)。L/B值的ROC曲线下面积为0.938,最佳阈值为2.22。采用L/B值≥2.22预测腋窝淋巴结转移的灵敏度、特异度、阳性预测值、阴性预测值分别为88.9%、97.9%、98.5%、85.2%,与病理诊断的一致性较好(Kappa=0.862,P<0.05)。结论采用L/B值≥2.22作为预测直径≥8mm的腋窝淋巴结转移的标准具有较高的准确性,可用于腋窝淋巴结转移的评估。Purpose To investigate the optimal threshold of ^18F-FDG coincidence SPECT/CT imaging using semiquantitative analysis method in the prediction of axillary lymph node metastasis in breast cancer. Materials and Methods Fifty-eight patients with breast cancer confirmed by axillary lymph node dissection were enrolled. Maximum radioactive count ratio （L/B value） of axillary lymph node （L） and the corresponding areas of contralateral axillary background （B） were measured by the ^18F-FDG coincidence SPECT/CT. ROC curve was established to predict the optimal threshold of axillary lymph node metastasis in breast cancer, and Kappa analysis was used to do consistency test of judgment results under optimal threshold and pathologic findings （gold standard）. Results 119 lymph nodes in 58 patients matched with operation area （ ≥ 8 mm diameter） were detected. The area under the ROC curve of L/B value was 0.938, the optimum threshold value was 2.22. Sensitivity, specificity, positive predictive value, and negative predictive value, using L/B ≥ 2,22 to predict axillary lymph node metastases as judge of malignant and pathological diagnosis criteria （Kappa=0.862, P〈0.05）, were 88.9%, 97.9%. 98.5% and 85.2%, respectively. Conclusion It has higher accuracy for the threshold of the L/ B ≥ 2.22 as a predictor of axillary lymph node metastasis （ ≥ 8 mm diameter）, and it can be used for the assessment of axillary lymph node metastasis.

关 键 词：乳腺肿瘤 淋巴转移 体层摄影术 发射型计算机 单光子 氟脱氧葡萄糖F18 x线计算机 

分 类 号：R737.9[医药卫生—肿瘤] R730.42[医药卫生—临床医学]