| 朱虹,吴江,孙传金,王新刚,王婧洁,王少华,陈小元.18F-Alfatide Ⅱ PET/CT诊断乳腺癌腋窝淋巴结转移[J].中国医学影像技术,2021,37(11):1670~1673 |
| 18F-Alfatide Ⅱ PET/CT诊断乳腺癌腋窝淋巴结转移 |
| 18F-Alfatide Ⅱ PET/CT for diagnosis of axillary lymph node metastasis of breast cancer |
| 投稿时间：2020-08-23 修订日期：2020-12-27 |
| DOI：10.13929/j.issn.1003-3289.2021.11.019 |
| 中文关键词: 乳腺肿瘤 淋巴结转移 正电子发射断层显像 |
| 英文关键词:breast neoplasms lymphatic metastasis positron-emission tomography |
| 基金项目:江苏省自然科学基金（BK20211131、BK20160610、BK2011665）、江苏省博士后科研基金计划项目（1601090C）。 |
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| 中文摘要: |
| 目的 探讨18F-Alfatide Ⅱ PET/CT诊断乳腺癌腋窝淋巴结转移的价值。方法 对44例疑诊乳腺癌女性患者于1周内行18F-Alfatide Ⅱ和18F-FDG PET/CT显像，分别以视觉法、半定量法（SUVmax和SUVmean）分析图像，以病理结果作为金标准，计算视觉分析法的诊断效能；绘制受试者工作特征（ROC）曲线，分析半定量法指标的曲线下面积（AUC）、约登指数和最佳截断值。结果 44例中，39例经病理学确诊为乳腺癌；其中37例接受活检或手术，17例存在腋窝淋巴结转移。视觉分析法用于18F-Alfatide Ⅱ PET/CT诊断乳腺癌腋窝淋巴结转移的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为70.59%（12/17）、90.00%（18/20）、81.08%（30/37）、85.71%（12/14）和78.26%（18/23），用于18F-FDG PET/CT分别为64.71%（11/17）、90.00%（18/20）、78.38%（29/37）、84.62%（11/13）和75.00%（18/24），二者联合分别为82.35%（14/17）、85.00%（17/20）、83.78%（31/37）、82.35%（14/17）和85.00%（17/20）；其对18F-Alfatide Ⅱ与18F-FDG的诊断效能相当（P均>0.05）。以半定量分析法获得的18F-Alfatide Ⅱ的SUVmax和SUVmean及18F-FDG的SUVmax和SUVmean的AUC分别为0.81、0.80、0.92及0.92，约登指数分别为0.67、0.66、0.72及0.72，最佳截断值分别为1.10、0.81、1.27及0.79；其用于18F-Alfatide Ⅱ的诊断效能低于18F-FDG，而SUVmax和SUVmean的AUC差异均无统计学意义（P=0.13、0.12）。结论 18F-Alfatide Ⅱ PET/CT可用于诊断乳腺癌腋窝淋巴结转移，并能在一定程度上弥补18F-FDG的不足。 |
| 英文摘要: |
| Objective To explore the diagnostic value of 18F-Alfatide Ⅱ PET/CT for diagnosis of axillary lymph node metastasis of breast cancer. Methods A total of 44 female patients with suspected breast cancer who underwent 18F-Alfatide Ⅱ and 18F-FDG PET/CT within 1 week were enrolled. PET/CT images were interpreted with visual analysis and semi-quantitative analysis (SUVmax and SUVmean), respectively. The diagnostic efficacy of visual analysis were calculated according to pathological results. Receiver operating characteristic (ROC) curve was drawn to find out the area under the curve (AUC), the Youden index and the cutoff value of semi-quantitative parameters. Results Among 44 patients, breast cancer was proved in 39 patients, 37 underwent biopsy or surgical operation, and 17 of them were found with axillary lymph node metastasis. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of visual analysis of 18F-Alfatide Ⅱ was 70.59% (12/17), 90.00% (18/20), 81.08% (30/37), 85.71% (12/14) and 78.26% (18/23), respectively, while of 18F-FDG was 64.71% (11/17), 90.00% (18/20), 78.38% (29/37), 84.62% (11/13) and 75.00% (18/24), respectively, of the combination of 18F-Alfatide Ⅱ and 18F-FDG was 82.35% (14/17), 85.00% (17/20), 83.78% (31/37), 82.35% (14/17) and 85.00% (17/20), respectively. Visual analysis showed that the diagnostic efficacy of 18F-Alfatide Ⅱ was equivalent to that of 18F-FDG. The AUC of semi-quantitative analysis of SUVmax and SUVmean of 18F-Alfatide Ⅱ and 18F-FDG was 0.81, 0.80, 0.92 and 0.92, the Youden index was 0.67, 0.66, 0.72 and 0.72, and the cutoff value was 1.10, 0.81, 1.27 and 0.79, respectively. Semi-quantitative analysis showed that the diagnostic efficacy of 18F-Alfatide Ⅱ was lower than that of 18F-FDG, but no significant difference of AUC of SUVmax nor SUVmean was found (P=0.13, 0.12). Conclusion 18F-Alfatide Ⅱ could be used in diagnosis of axillary lymph node metastasis of breast cancer, which might compensate 18F-FDG to a certain extent. |
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