Staging the axilla in breast cancer patients with ¹⁸F-FDG PET: how small are the metastases that we can detect with new generation clinical PET systems?
Staging the axilla in breast cancer patients with ¹⁸F-FDG PET: how small are the metastases that we can detect with new generation clinical PET systems?
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DOI：
10.1007/s00259-014-2689-7
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发表时间：
2014-06
影响因子：
9.1
通讯作者：
Aide, Nicolas
中科院分区：
文献类型：
--
作者：
Bellevre, Dimitri;Fournier, Cecile Blanc;Switsers, Odile;Dugue, Audrey Emmanuelle;Levy, Christelle;Allouache, Djelila;Desmonts, C dric;Crouet, Hubert;Guilloit, Jean-Marc;Grellard, Jean-Michel;Aide, Nicolas
点扩散函数 (PSF) 重建提高了 PET 系统整个视场的空间分辨率，并且可以检测比 OSEM 等传统算法更小的转移性沉积物。与 OSEM 重建相比，我们评估了 PSF 重建对乳腺癌患者腋窝分期的定量值和诊断准确性的影响，重点关注淋巴结转移的大小。这是一项在单一转诊中心进行的前瞻性研究，其中 50 名患者在腋窝淋巴结清扫术之前接受了 18F-FDG PET 检查。 PET 数据采用 OSEM 算法和 PSF 重建进行重建，并由测量每个腋窝最大淋巴结转移的病理学家进行盲目分析和验证。该尺寸用于评估 PET 诊断性能。在病理学上，34 名患者 (68%) 有淋巴结受累。总体而言，每个腋窝最大淋巴结转移的中位尺寸为 7 毫米（范围 0.5 – 40 毫米）。 PSF 重建比 OSEM 重建检测到更多涉及的节点 (p = 0.003)。平均 PSF 与 OSEM SUVmax 之比为 1.66 (95% CI 1.01 – 2.32)。对于最大淋巴结转移>7mm的患者，PSF和OSEM重建的敏感性分别为96%和92%；对于最大淋巴结转移≤7mm的患者，PSF和OSEM重建的敏感性分别为60%和40%；对于原发肿瘤≤30mm的患者，PSF和OSEM重建的敏感性分别为92%和69%。 Biggerstaff 图形比较表明，全局 PSF 重建优于 OSEM 重建。 PSF 或 OSEM 重建未检测到淋巴结受累的患者、PSF 但 OSEM 重建未检测到以及两种重建均检测到的最大淋巴结转移的中位尺寸分别为 3、6 和 16 mm (p = 0.0064)。在通过 PSF 重建但未通过 OSEM 重建检测到淋巴结受累的患者中，可检测到的最小转移灶为 1.8 毫米。由于活动恢复更好，在检测≤7 mm 的淋巴结转移方面，PSF 重建的 PET 比 OSEM 重建的 PET 表现更好。然而，其敏感性仍不足以替代手术方法进行腋窝分期。 PET 结合 PSF 重建可用于更安全地对原发肿瘤≤30 毫米且腋窝 PET 结果不显着的患者进行前哨淋巴结活检。本文的在线版本 (doi:10.1007/s00259-014-2689-7) 包含补充材料，可供授权用户使用。
Point spread function (PSF) reconstruction improves spatial resolution throughout the entire field of view of a PET system and can detect smaller metastatic deposits than conventional algorithms such as OSEM. We assessed the impact of PSF reconstruction on quantitative values and diagnostic accuracy for axillary staging of breast cancer patients, compared with an OSEM reconstruction, with emphasis on the size of nodal metastases. This was a prospective study in a single referral centre in which 50 patients underwent an 18F-FDG PET examination before axillary lymph node dissection. PET data were reconstructed with an OSEM algorithm and PSF reconstruction, analysed blindly and validated by a pathologist who measured the largest nodal metastasis per axilla. This size was used to evaluate PET diagnostic performance. On pathology, 34 patients (68 %) had nodal involvement. Overall, the median size of the largest nodal metastasis per axilla was 7 mm (range 0.5 – 40 mm). PSF reconstruction detected more involved nodes than OSEM reconstruction (p = 0.003). The mean PSF to OSEM SUVmax ratio was 1.66 (95 % CI 1.01 – 2.32). The sensitivities of PSF and OSEM reconstructions were, respectively, 96 % and 92 % in patients with a largest nodal metastasis of >7 mm, 60 % and 40 % in patients with a largest nodal metastasis of ≤7 mm, and 92 % and 69 % in patients with a primary tumour ≤30 mm. Biggerstaff graphical comparison showed that globally PSF reconstruction was superior to OSEM reconstruction. The median sizes of the largest nodal metastasis in patients with nodal involvement not detected by either PSF or OSEM reconstruction, detected by PSF but not by OSEM reconstruction and detected by both reconstructions were 3, 6 and 16 mm (p = 0.0064) respectively. In patients with nodal involvement detected by PSF reconstruction but not by OSEM reconstruction, the smallest detectable metastasis was 1.8 mm. As a result of better activity recovery, PET with PSF reconstruction performed better than PET with OSEM reconstruction in detecting nodal metastases ≤7 mm. However, its sensitivity is still insufficient for it to replace surgical approaches for axillary staging. PET with PSF reconstruction could be used to perform sentinel node biopsy more safely in patients with a primary tumour ≤30 mm and with unremarkable PET results in the axilla. The online version of this article (doi:10.1007/s00259-014-2689-7) contains supplementary material, which is available to authorized users.
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影响因子：
9.3
作者：
Song, Bong-Il;Lee, Sang-Woo;Lee, Jaetae
通讯作者：
Lee, Jaetae
DOI：
10.1007/s00259-013-2391-1
发表时间：
2013-07
影响因子：
9.1
作者：
Lasnon, Charline;Desmonts, Cedric;Quak, Elske;Gervais, Radj;Do, Pascal;Dubos-Arvis, Catherine;Aide, Nicolas
通讯作者：
Aide, Nicolas
DOI：
10.1007/s00259-009-1343-2
发表时间：
2010-06
影响因子：
9.1
作者：
Straver, Marieke E.;Aukema, Tjeerd S.;Olmos, Renato A. Valdes;Rutgers, Emiel J. T.;Gilhuijs, Kenneth G. A.;Schot, Margaret E.;Vogel, Wouter V.;Peeters, Marie-Jeanne T. F. D. Vrancken
通讯作者：
Peeters, Marie-Jeanne T. F. D. Vrancken
DOI：
10.2967/jnumed.109.063016
发表时间：
2009-08
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
--
作者：
Kadrmas DJ;Casey ME;Conti M;Jakoby BW;Lois C;Townsend DW
通讯作者：
Townsend DW
DOI：
10.1007/s00259-013-2515-7
发表时间：
2014-01-01
影响因子：
9.1
作者：
Koolen, Bas B.;Pengel, Kenneth E.;Olmos, Renato A. Valdes
通讯作者：
Olmos, Renato A. Valdes