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用于乳腺癌检测的新诊断技术。

New diagnostic techniques for breast cancer detection.

作者信息

Singh Vineeta, Saunders Christobel, Wylie Liz, Bourke Anita

机构信息

University of Western Australia, School of Surgery, QEII Medical Centre, Perth 6009, Australia.

出版信息

Future Oncol. 2008 Aug;4(4):501-13. doi: 10.2217/14796694.4.4.501.

Abstract

Breast imaging has made huge advances in the last decade, and along with newer techniques to diagnose primary breast cancer, many novel methods are being used and look promising in detecting distant metastasis, recurrent disease and assessing response to treatment. Full-field digital mammography optimizes the lesion-background contrast and gives better sensitivity, and it is possible to see through the dense tissues by altering computer windows; this may be particularly useful in younger women with dense breasts. The need for repeat imaging is reduced, with the added advantage of reduced radiation dose to patients. Computer-aided detection systems may help the radiologist in interpretation of both conventional and digital mammograms. MRI has a role in screening women at high risk for breast cancer. It also aids in cancer management by assessing response to treatment and can help in deciding appropriate surgery by providing accurate information on the extent of the tumor. Newer diagnostic techniques such as sestamibi scans, optical imaging and molecular diagnostic techniques look promising, but need more investigation into their use. Their roles will appear clearer in coming years, and they may prove to be of help in further investigating lesions that are indeterminate on standard imaging. Other upcoming techniques are contrast-enhanced mammography and tomosynthesis. These may give additional information in indeterminate lesions, and when used in screening they aid in reducing recall rates, as shown in recent studies. PET/computed tomography has a role in detecting local disease recurrence and distant metastasis in breast cancer patients.

摘要

在过去十年中,乳腺成像取得了巨大进展。除了用于诊断原发性乳腺癌的新技术外,许多新方法也正在被用于检测远处转移、复发性疾病以及评估治疗反应,并且前景看好。全场数字化乳腺摄影优化了病灶与背景的对比度,提高了敏感性,通过改变计算机窗口可以穿透致密组织;这对于乳房致密的年轻女性可能特别有用。减少了重复成像的需求,同时还降低了患者的辐射剂量。计算机辅助检测系统有助于放射科医生解读传统和数字化乳腺摄影图像。磁共振成像在筛查乳腺癌高危女性方面发挥着作用。它还通过评估治疗反应辅助癌症管理,并通过提供肿瘤范围的准确信息帮助确定合适的手术方案。新型诊断技术如锝-99m甲氧基异丁基异腈扫描、光学成像和分子诊断技术前景看好,但在其应用方面还需要更多研究。它们的作用在未来几年将更加明确,可能有助于进一步研究标准成像中不确定的病灶。其他即将出现的技术是对比增强乳腺摄影和断层合成摄影。这些技术可能会为不确定的病灶提供更多信息,并且如最近的研究所示,用于筛查时有助于降低召回率。正电子发射断层显像/计算机断层扫描在检测乳腺癌患者的局部疾病复发和远处转移方面发挥着作用。

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