术前18F-FDG PET/CT上基于体积的乳腺癌代谢参数可预测腋窝淋巴结转移。

Volume-based metabolic parameter of breast cancer on preoperative 18F-FDG PET/CT could predict axillary lymph node metastasis.

作者信息

An Young-Sil, Kang Doo Kyoung, Jung Yongsik, Kim Tae Hee

机构信息

Department of Nuclear Medicine and Molecular Imaging Department of Radiology Department of Surgery, Ajou University School of Medicine, Suwon, Gyeonggi, South Korea.

出版信息

Medicine (Baltimore). 2017 Nov;96(45):e8557. doi: 10.1097/MD.0000000000008557.

DOI:10.1097/MD.0000000000008557

PMID:29137072

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5690765/

Abstract

The purpose of our study was to evaluate the association between metabolic parameters on FDG PET/CT and axillary lymph node metastasis (ALNM) in patients with invasive breast cancer.From January 2012 to December 2012, we analyzed 173 patients with invasive ductal carcinoma (IDC) who underwent both initial breast magnetic resonance imaging (MRI) and F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) examinations. All metabolic parameters were measured from the tumor volume segmented by a gradient-based method. Once the primary target lesion was segmented, maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated automatically by the MIMvista software.Mean age of 173 patients was 49 years. Of 173 patients, 45 (26%) showed ALNM. On univariate analysis, larger tumor size (>2.2 cm; P = .002), presence of lymphovascular invasion (P < .001), higher SUVmax (>2.82; P = .038), higher SUVmean (>1.2; P = .027), higher MTV (>2.38; P < .001), and higher TLG (>3.98; P = .007) were associated with a higher probability of ALNM. On multivariate analysis, presence of lymphovascular invasion (adjusted odds ratio [OR], 11.053; 95% CI, 4.403-27.751; P < .001) and higher MTV (>2.38) (adjusted OR, 2.696; 95% CI, 1.079-6.739; P = .034) maintained independent significance in predicting ALNM. In subgroup analysis of T2/T3 breast cancer, lymphovascular invasion (adjusted OR, 20.976; 95% CI, 5.431-81.010; P < .001) and higher MTV (>2.38) (adjusted OR, 4.906; 95% CI, 1.616-14.896; P = .005) were independent predictors of ALNM. However in T1 breast cancer, lymphovascular invasion (adjusted OR, 16.096; 95% CI, 2.517-102.939; P = .003) and larger SUV mean (>1.2) (adjusted OR, 13.275; 95% CI, 1.233-142.908; P = .033) were independent predictors while MTV was not.MTV may be associated with ALNM in patients with invasive breast cancer, particularly T2 and T3 stages. In T1 breast cancer, SUVmean was associated with ALNM.

摘要

我们研究的目的是评估浸润性乳腺癌患者氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）上的代谢参数与腋窝淋巴结转移（ALNM）之间的关联。2012年1月至2012年12月，我们分析了173例接受了初次乳腺磁共振成像（MRI）和F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）检查的浸润性导管癌（IDC）患者。所有代谢参数均从通过基于梯度的方法分割的肿瘤体积中测量。一旦分割出主要目标病变，MIMvista软件会自动计算最大标准化摄取值（SUVmax）、平均标准化摄取值（SUVmean）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。173例患者的平均年龄为49岁。在173例患者中，45例（26%）出现腋窝淋巴结转移。单因素分析显示，肿瘤较大（>2.2 cm；P = 0.002）、存在淋巴管浸润（P < 0.001）、SUVmax较高（>2.82；P = 0.038）、SUVmean较高（>1.2；P = 0.027）、MTV较高（>2.38；P < 0.001）以及TLG较高（>3.98；P = 0.007）与腋窝淋巴结转移的可能性较高相关。多因素分析显示，淋巴管浸润（校正比值比[OR]，11.053；95%置信区间[CI]，4.403 - 27.751；P < 0.001）和较高的MTV（>2.38）（校正OR，2.696；95% CI，1.079 - 6.739；P = 0.034）在预测腋窝淋巴结转移方面保持独立显著性。在T2/T3期乳腺癌的亚组分析中，淋巴管浸润（校正OR，20.976；95% CI，5.431 - 81.010；P < 0.001）和较高的MTV（>2.38）（校正OR，4.906；95% CI，1.616 - 14.896；P = 0.005）是腋窝淋巴结转移的独立预测因素。然而在T1期乳腺癌中，淋巴管浸润（校正OR，16.096；95% CI，2.517 - 102.939；P = 0.003）和较高的SUVmean（>1.2）（校正OR，13.275；95% CI，1.233 - 142.908；P = 0.033）是独立预测因素，而MTV不是。代谢肿瘤体积可能与浸润性乳腺癌患者的腋窝淋巴结转移相关，尤其是T2和T3期。在T1期乳腺癌中，平均标准化摄取值与腋窝淋巴结转移相关。