Utility of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Fusion Imaging for Prediction of Metastasis to Sentinel and Nonsentinel Nodes in Patients with Clinically Node-Negative Breast Cancer
Utility of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Fusion Imaging for Prediction of Metastasis to Sentinel and Nonsentinel Nodes in Patients with Clinically Node-Negative Breast Cancer
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DOI：
10.1245/s10434-020-08269-0
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发表时间：
2020-03-02
影响因子：
3.7
通讯作者：
Tsuda, Hitoshi
中科院分区：
文献类型：
--
作者：
Yamagishi, Yoji;Yamasaki, Tamio;Tsuda, Hitoshi
目的。f -18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描融合成像（F-18-FDG PET/CT）是乳腺癌的重要诊断工具。原发肿瘤的最大标准化摄取值（SUVmax）已被评估用于预测临床淋巴结阴性（cNO）患者前哨淋巴结（SN）和非SN转移。患者和方法。对414例cNO患者行F-18-FDG PET/CT检查。评估以下参数：60 min时的SUVmax （SUVmax1）、120 min时的SUVmax （SUVmax2）、SUVmax1与SUVmax2之间的变化百分比（Delta SUVmax%）、SN转移灶最大大小（SN meta大小）、转移性SN与总SN之比或SN比（SNR）。评估这些是否是SN转移的危险因素。回顾性探讨这些参数与SN和/或非SN转移状态的关系，以预测非SN转移。所有SUV参数均与病理T因子（pT）、核分级、淋巴浸润（Ly）、Ki-67标记指数显著相关。在多因素分析中，pT和Ly是SN转移的独立预测因素。在SN meta阳性病例中，SN meta大小、SNR和Delta SUVmax%在单因素分析中是非SN转移的预测因子，前两者在多因素分析中是独立的预测因子。SUVmax2和Delta SUVmax%联合检测是非sn转移的独立预测因子（P = 0.0312），预测非sn转移阴性的概率高（92.3%）。在cNO乳腺癌患者中，原发肿瘤的SUV参数与病理特征相关。联合SUVmax2和Delta SUVmax%可能有助于预测非sn转移。
Purpose. F-18-Fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (F-18-FDG PET/CT) is an important diagnostic tool in breast cancer. The utility of maximum standardized uptake values (SUVmax) of primary tumors has been evaluated to predict sentinel node (SN) and non-SN metastasis in clinically node-negative (cNO) patients.Patients and Methods. F-18-FDG PET/CT was performed on 414 cNO patients. The following parameters were evaluated: SUVmax at 60 min (SUVmax1), SUVmax at 120 min (SUVmax2), percent change between SUVmax 1 and SUVmax2 (Delta SUVmax%), SN metastasis foci maximum size (SN meta size), and ratio of metastatic SNs to total SNs or SN ratio (SNR). It was assessed whether these were risk factors for SN metastasis. The relationship between these parameters and the status of SN and/or non-SN metastasis was retrospectively explored to predict non-SN metastasis.Results. All SUV parameters significantly correlated with pathological T factor (pT), nuclear grade, lymphatic invasion (Ly), and Ki-67 labeling index. On multivariate analysis, pT and Ly were independent predictive factors for SN metastasis. In SN meta-positive cases, SN meta size, SNR, and Delta SUVmax% were predictors for non-SN metastasis on univariate analyses, and the former two were independent predictors on multivariate analysis. The combination of SUVmax2 and Delta SUVmax% was an independent predictor of non-SN metastasis (P = 0.0312) and was associated with prediction of non-SN metastasis negative status with high probability (92.3%).Conclusions. In patients with cNO breast cancer, SUV parameters of the primary tumor were correlated with pathological features. The combination of SUVmax2 and Delta SUVmax% may be useful for predicting non-SN metastasis.