18F-FDG PET/CT imaging versus dynamic contrast-enhanced CT for staging and prognosis of inflammatory breast cancer
18F-FDG PET/CT imaging versus dynamic contrast-enhanced CT for staging and prognosis of inflammatory breast cancer
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DOI：
10.1007/s00259-013-2405-z
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发表时间：
2013-08-01
影响因子：
9.1
通讯作者：
Alberini, Jean-Louis
中科院分区：
文献类型：
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作者：
Champion, Laurence;Lerebours, Florence;Alberini, Jean-Louis
炎症性乳腺癌（IBC）是乳腺癌中最具侵袭性的类型，预后较差。局部区域分期基于动态对比增强（DCE）CT或MRI。本研究的目的是比较FDG PET/CT和DCE CT在IBC局部分期中的表现，并评估其各自的预后价值。研究组包括50名在我们机构接受FDG PET/CT和DCE CT扫描（中位间隔5 +/-9天）的IBC女性（中位年龄：51 +/-11岁）。CT增强参数为净最大增强、净早期增强和灌注。PET/CT扫描显示所有原发肿瘤均存在FDG高摄取。PET/CT和DCE CT对乳腺肿瘤定位的一致率为92%。原发肿瘤SUVmax与CT增强参数无明显相关性（p > 0.6）。PET/CT和DCE CT结果与皮肤浸润的相关性较差（kappa = 0.19）。在47例患者中发现了同侧腋窝FDG摄取增加的病灶（中位数SUV：7.9 +/- 5.4），而在43例患者中，在DCE CT上观察到腋窝淋巴结肿大。腋窝淋巴结受累的结果具有相当好的相关性（kappa = 0.55）。PET/CT扫描发现19例患者（38%）转移，无进展生存期显著短于无远处病变患者（p = 0.01）。在原发性肿瘤中，使用SUVmax为5的临界值，观察到高和中等肿瘤FDG摄取对生存率的影响无统计学显著差异（p = 0.7和0.9），或在DCE CT上的高和低肿瘤增强之间（p > 0.8）.FDG PET/CT成像提供了关于局部区域受累的额外信息，并允许检测远处转移，同样的全身手术肿瘤的FDG摄取或CT增强参数没有相关性，也没有发现有任何预后价值。
Inflammatory breast cancer (IBC) is the most aggressive type of breast cancer with a poor prognosis. Locoregional staging is based on dynamic contrast-enhanced (DCE) CT or MRI. The aim of this study was to compare the performances of FDG PET/CT and DCE CT in locoregional staging of IBC and to assess their respective prognostic values.The study group comprised 50 women (median age: 51 +/- 11 years) followed in our institution for IBC who underwent FDG PET/CT and DCE CT scans (median interval 5 +/- 9 days). CT enhancement parameters were net maximal enhancement, net early enhancement and perfusion.The PET/CT scans showed intense FDG uptake in all primary tumours. Concordance rate between PET/CT and DCE CT for breast tumour localization was 92 %. No significant correlation was found between SUVmax and CT enhancement parameters in primary tumours (p > 0.6). PET/CT and DCE CT results were poorly correlated for skin infiltration (kappa = 0.19). Ipsilateral foci of increased axillary FDG uptake were found in 47 patients (median SUV: 7.9 +/- 5.4), whereas enlarged axillary lymph nodes were observed on DCE CT in 43 patients. Results for axillary node involvement were fairly well correlated (kappa = 0.55). Nineteen patients (38 %) were found to be metastatic on PET/CT scan with a significant shorter progression-free survival than patients without distant lesions (p = 0.01). In the primary tumour, no statistically significant difference was observed between high and moderate tumour FDG uptake on survival, using an SUVmax cut-off of 5 (p = 0.7 and 0.9), or between high and low tumour enhancement on DCE CT (p > 0.8).FDG PET/CT imaging provided additional information concerning locoregional involvement to that provided by DCE CT on and allowed detection of distant metastases in the same whole-body procedure. Tumour FDG uptake or CT enhancement parameters were not correlated and were not found to have any prognostic value.