18F-FDGPET/CT对原发性乳腺淋巴瘤和乳腺癌的鉴别诊断价值
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周硕,男,主任医师,医学硕士.Email:shuojoe@163.com

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Differentiation of Primary Breast Lymphoma andBreast Cancer with 18F-FDG PET/CT
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    摘要:

    目的 探讨18F-FDG PET/CT显像对原发性乳腺淋巴瘤(PBL)和乳腺癌鉴别诊断的价值。 方法 回顾性分析经手术病理或穿刺活检证实的16例PBL、25例乳腺癌患者的临床资料及18F-FDG PET/CT图像资料。观察18F-FDG PET/CT显像特征,测量病灶最大径、最大标准摄取值(SUVmax)及SUVmax/最大径比值。采用独立样本 t 检验和χ2检验比较两组患者临床资料和影像指标的差别。采用受试者工作特征(ROC)曲线分析两组的SUVmax及SUVmax/最大径比值,确定诊断效能。 结果 双侧及多发病灶更多见于PBL,两组间比较,差别具有统计学意义(χ2=10.28、10.66, P= 0.001、0.010)。PBL组SUVmax、SUVmax/最大径比值分别为(13.02±7.70)和(5.69±3.48),高于乳腺癌组[(7.22±4.63)和(2.43±1.31)],差别均有统计学意义( t =3.02、-4.25, P =0.004、<0.001)。PBL和乳腺癌鉴别诊断的SUVmax、SUVmax/最大径比值阈值分别为4.85和2.85,敏感度分别为93.8%和76.0%,特异度分别为52.0%和75.0%。ROC曲线下面积分别为0.76和0.82。 结论 18F-FDG PET/CT显像结合形态学检查及临床资料有助于PBL和乳腺癌的鉴别诊断,病灶的SUVmax及SUVmax/最大径比值有较高的诊断效能。

    Abstract:

    ObjectiveTo investigate the role of 18F-FDG PET/CT in differnetiating primary breast lymphoma (PBL) from breast cancer in order to improve the correct diagnostic rate of them. Methods 18F-FDG PET/CT images and clinical data of 16 cases of PBL ,25 cases of breast cancer confirmed by pathology were retrospectively analyzed. The manifestations of 18F-FDG PET/CT were observed and the maximum diameter of tumors,the maximal standardized uptake value (SUVmax) and SUVmax/the maximum diamete were measured. Differences of clinical data and imaging indicators between the two groups were compared by using t test and χ2 test. The SUVmax and SUVmax/the maximum diamete values of the two groups were analyzed by using receiver operating characteristic (ROC) curve to determine the optimal threshold and diagnostic efficiency. Results The bilateral and multiple lesions were more common in primary breast lymphoma, the difference was statistically significant (χ2=10.28, 10.66,P=0.001, 0.010). The SUVmax of the PBL and breast cancer groups was (13.02±7.70) and (7.22±4.63) respectively, the difference was statistically significant (t=3.02, P=0.004). The SUVmax/the maximum diamete values of the two groups was (5.69±3.48) and (2.43±1.31) respectively, the difference was statistically significant (t=-4.25, <0.001). On the ROC curve, the sensitivity of SUVmax for the diagnosis of PBL was 93.8%, specificity 52.0% and area under the ROC curve 0.76 with the SUVmax cutoff value of 4.85. The sensitivity of SUVmax/the maximum diamete for the diagnosis of PBL was 76.0%, specificity 75.0% and area under the ROC curve 0.82 with the maximum diameter cutoff value of 2.85. Conclusion 18F-FDG PET/CT has promising potential for the diagnostic differentiation of PBLs and breast cancers. The SUVmax and SUVmax/the maximum diameter of tumors have a high diagnositic performance.

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周硕,林美福,陈文新,陈彩龙,陈国宝.18F-FDGPET/CT对原发性乳腺淋巴瘤和乳腺癌的鉴别诊断价值[J].福建医科大学学报自然版,2021,55(6):79-85

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  • 在线发布日期: 2022-02-17
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