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[18F-FDG-PET/CT对疑似乳腺癌复发患者的诊断和治疗影响]

[Diagnostic and therapeutic impact of 18F-FDG-PET/CT in patients with suspected breast cancer recurrence].

作者信息

Palomar Muñoz A, García Vicente A M, Talavera Rubio M P, Pilkington Woll J P, Poblete García V M, Bellón Guardia M E, León Martín A, Cordero García J M, Soriano Castrejón A

机构信息

Servicio de Medicina Nuclear, Hospital General de Ciudad Real, Ciudad Real, España.

出版信息

Rev Esp Med Nucl. 2010 May-Jun;29(3):100-8. doi: 10.1016/j.remn.2010.02.004. Epub 2010 Apr 13.

Abstract

Breast cancer is a tumor with high prevalence in our environment. Thus, it is essential to make an early diagnosis in both the primary disease and its recurrence, given the high mortality of the cases with the advanced disease. Our study has aimed to evaluate the impact of (18)F-FDG-PET/CT in patients with suspected breast cancer recurrence and their therapeutic management. This study analyzed the PET/CT of 70 patients with a background of breast cancer and suspicion of recurrence, either because of elevation of tumor markers (n=28), doubtful findings on other imaging techniques (n=56) and/or suspicious symptoms (n=1). All the patients underwent a standard FDG-PET study acquired in combination with low-dose CT. The studies were considered pathological in 34 of the 70 patients, with 29 true positive, 32 true negative, 5 false positive and 4 false negative results. The final diagnosis was established either by histopathologic confirmation (n=17), other imaging techniques (n=26) and/or clinical radiological follow-up (n=27, mean 12.7 months). The sensitivity, specificity, positive predictive value and negative predictive values obtained were 87.8%, 86.4%, 85.2% and 88.8%, respectively. Therapeutic management was modified in 41% of the patients. In conclusion, PET/CT is a technique with high diagnostic yield in patients with suspected breast cancer recurrence.

摘要

乳腺癌是一种在我们所处环境中发病率较高的肿瘤。鉴于晚期病例的高死亡率,对原发性疾病及其复发进行早期诊断至关重要。我们的研究旨在评估(18)F-FDG-PET/CT对疑似乳腺癌复发患者及其治疗管理的影响。本研究分析了70例有乳腺癌病史且疑似复发患者的PET/CT情况,这些患者疑似复发的原因包括肿瘤标志物升高(n = 28)、其他成像技术检查结果可疑(n = 56)和/或可疑症状(n = 1)。所有患者均接受了与低剂量CT联合进行的标准FDG-PET检查。70例患者中有34例检查结果被判定为病理性,其中真阳性29例,真阴性32例,假阳性5例,假阴性4例。最终诊断通过组织病理学确认(n = 17)、其他成像技术(n = 26)和/或临床影像学随访(n = 27,平均12.7个月)确定。所获得的灵敏度、特异度、阳性预测值和阴性预测值分别为87.8%、86.4%、85.2%和88.8%。41%的患者治疗管理方案发生了改变。总之,PET/CT对疑似乳腺癌复发患者具有较高的诊断价值。

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