›› 2012, Vol. 32 ›› Issue (6): 761-.doi: 10.3969/j.issn.1674-8115.2012.06.015

• Original article (Clinical research) • Previous Articles     Next Articles

18F-FDG PET/CT in diagnosis of invasive breast cancer and lymph node metastasis

TANG Li-min1, MA Chao2   

  1. 1.Department of Nuclear Medicine, Affiliated Hospital of Qingdao University School of Medicine, Qingdao 266003, China;2.Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Online:2012-06-28 Published:2012-07-02
  • Supported by:

    National Natural Science Foundation of China, 30700185

Abstract:

Objective To evaluate the value of fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET/CT) in the diagnosis of primary breast cancer and axillary lymph node (ALN) metastasis. Methods The clinical data of 88 patients with invasive breast cancer were retrospectively analysed. All patients underwent 18F-FDG PET/CT scanning, mammography and ultrasonography examinations, and 40 patients received magnetic resonance imaging (MRI). The diagnostic results of 18F-FDG PET/CT were compared with postoperative pathological findings. Results In 88 patients with pathologically confirmed breast cancer, 18F-FDG PET/CT was positive in 75 (85%) patients and negative in 13 (15%) patients. The values of sensitivity of 18F-FDG PET/CT, mammography, ultrasonography, mammography combined with ultrasonography, and MRI were 85%(75/88), 85%(75/88), 92%(81/88), 97%(85/88) and 95%(38/40) respectively. The sensitivity of mammography combined with ultrasonography was significantly higher than that of 18F-FDG PET/CT (P<0.05), while there was no significant difference between 18F-FDG PET/CT and mammography, ultrasonography and MRI (P>0.05). The sensitivity of 18F-FDG PET/CT in diagnosis of primary breast cancer was significantly related to tumor staging and size (P<0.05). With maximum standard uptake value (SUVmax) cutoff at 1.5, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 18F-FDG PET/CT in diagnosis of ALN metastasis were 34.1%(8/21),84%(56/67),72%(64/88),42%(8/19) and 81%(56/69) respectively, and the false negative rate and false positive rate were 19%(13/69) and 57%(11/19) respectively. Conclusion 18F-FDG PET/CT is not superior to mammography, ultrasonography and MRI in diagnosis of breast cancer, which has limited value in determination of ALN metastasis. Mammography combined with ultrasonography has higher sensitivity and is the first choice for diagnosis of breast cancer.

Key words: breast cancer, 18F-FDG PET/CT, mammography, ultrasonography, axillary lymph node