Clinical Significance of Incidental Finding of Focal Activity in the Breast at 18F-FDG PET/CT
Clinical Significance of Incidental Finding of Focal Activity in the Breast at 18F-FDG PET/CT
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DOI：
10.2214/ajr.10.6126
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发表时间：
2011-08-01
影响因子：
5
通讯作者：
Yim, Hyeon Woo
中科院分区：
文献类型：
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作者：
Kang, Bong Joo;Lee, Ji Hye;Yim, Hyeon Woo
OBJECTIVE.本研究的目的是确定在乳腺癌以外的恶性疾病患者或在筛查检查期间，在F-18-FDG PET/CT中偶然发现乳腺高代谢病灶的临床意义。回顾性分析了2004年11月至2009年10月期间接受FDG PET/CT检查的13，897名妇女的档案。48例偶发性乳腺摄取患者接受了组织确认或临床随访，并进行了额外的超声成像。评价了以下四个变量：年龄、FDG PET乳腺摄取的最大标准摄取值（SUVmax）、PET/CT的CT部分结果和超声检查结果。计算每个变量的平均发病率。18例（37.5%）患者被诊断为乳腺癌，30例（62.5%）患者被诊断为良性疾病。SUVmax小于2组（24.2%）和SUVmax大于等于2组（66.7%）之间以及BI-RADS超声分类小于4组（10.7%）和分类大于等于4组（75.0%）之间的恶性肿瘤发生率存在统计学显著差异（p < 0.05）。在PET/CT的CT部分上，小于45岁组（11.1%）和45岁及以上组（53.3%）之间，或BI-RADS分类低于4的病变组（30.2%）和分类4或更高的病变组（100%）之间的恶性肿瘤发生率无显著差异。乳腺偶发性高代谢病灶可能代表恶性肿瘤，占37.5%。SUVmax和超声表现可用于鉴别良恶性病变。
OBJECTIVE. The purpose of this study was to determine the clinical significance of the incidental finding of hypermetabolic foci in the breast at F-18-FDG PET/CT in patients with malignant disease other than breast cancer or during a screening examination.MATERIALS AND METHODS. The files of 13,897 women who underwent FDG PET/CT from November 2004 to October 2009 were retrospectively reviewed. Forty-eight patients with incidental breast uptake had undergone either tissue confirmation or clinical follow-up with additional sonographic imaging. The following four variables were evaluated: age, maximum standard uptake value (SUVmax) of breast uptake at FDG PET, findings in the CT portion of PET/CT, and sonographic findings. Malignancy rates were calculated for each variable.RESULTS. Malignancy was diagnosed in 18 (37.5%) patients and a benign condition in 30 (62.5%) patients. Statistically significant differences in malignancy rate were found between the groups with SUVmax less than 2 (24.2%) and the group with SUVmax of 2 or greater (66.7%) and between the group with lesions in a BI-RADS ultrasound category lower than 4 (10.7%) and the group with lesions in category 4 or higher (75.0%) (p < 0.05). There was no significant difference in malignancy rates between the groups younger than 45 years (11.1%) and 45 years and older (53.3%) or between the group with lesions in a BI-RADS category lower than 4 (30.2%) and that with lesions in category 4 or higher (100%) on the CT portion of PET/CT.CONCLUSION. Incidental hypermetabolic foci in the breast may represent malignancy in as many as 37.5% of cases. The SUVmax and sonographic findings can be useful for differentiating benign from malignant lesions.