Hwang Anna, Rashid Sana, Shi Selina, Blew Ciara, Levine Mark, Saha Ashirbani
Department of Radiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada.
Department of Radiology, University of Ottawa, 75 Laurier Ave E, Ottawa, ON K1N 6N5, Canada.
Curr Oncol. 2025 May 23;32(6):300. doi: 10.3390/curroncol32060300.
To investigate associations between 18F-FDG-PET/CT semiquantitative and radiomic features with pathologic axillary lymph node (ALN) status in stages I-III breast cancer patients. A search was conducted across MEDLINE, EMBASE, and CENTRAL databases. Quality assessment was performed with QUADAS-2 and the radiomics quality score (RQS). Descriptive statistical analysis was performed. Most studies were retrospective cohort studies (27/28) and reported only on semiquantitative features (26/28). Most studies were at high risk of bias in patient selection (22/28) and feature extraction (26/28). Semiquantitative features included maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG). Although associations between tumour semiquantitative features and ALN status were reported, the mean/median reported values of tumour SUVmax (3.2-8.6 vs. 2.4-9.4), MTV (2.7-19.2 vs. 1.9-10.5), and TLG (10.6-59.3 vs. 5.6-29.6) in ALN+ vs. ALN- patients were inconsistent between studies. Fourteen studies reported a significantly higher ALN SUVmax in ALN+ patients. Two studies developed models using tumour radiomic features with high accuracy for predicting ALN metastases (81.2% and 80%) but scored low on the RQS. Feature-based analysis of PET/CT demonstrates potential for predicting pathologic ALN status in breast cancer patients. However, establishing a clinically meaningful relationship requires higher quality evidence.
研究I-III期乳腺癌患者中18F-FDG-PET/CT半定量和影像组学特征与腋窝淋巴结（ALN）病理状态之间的关联。检索了MEDLINE、EMBASE和CENTRAL数据库。使用QUADAS-2和影像组学质量评分（RQS）进行质量评估。进行了描述性统计分析。大多数研究为回顾性队列研究（27/28），且仅报告了半定量特征（26/28）。大多数研究在患者选择（22/28）和特征提取（26/28）方面存在高偏倚风险。半定量特征包括最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。尽管报告了肿瘤半定量特征与ALN状态之间的关联，但不同研究中ALN阳性与ALN阴性患者的肿瘤SUVmax（3.2 - 8.6 vs. 2.4 - 9.4）、MTV（2.7 - 19.2 vs. 1.9 - 10.5）和TLG（10.6 - 59.3 vs. 5.6 - 29.6）的报告均值/中位数不一致。14项研究报告ALN阳性患者的ALN SUVmax显著更高。两项研究使用肿瘤影像组学特征开发了预测ALN转移的高精度模型（81.2%和80%），但在RQS上得分较低。基于PET/CT特征的分析显示了预测乳腺癌患者ALN病理状态的潜力。然而，建立具有临床意义的关系需要更高质量的证据。
