Application Of Computed Tomographic Laser Mammography In Breast Tumor Diagnosis

Purposes:In this study,computed tomographic laser mammography(CTLM)was used to examine breast tumor patients in Shaanxi Provincial Cancer Hospital to observe the abnormal hemoglobin production of breast tumors,compared with the ultrasound examination of ultrasound,mammography,MRI,etc.And the postoperative pathological diagnosis was the"gold standard"to explore the application value of CTLM in the clinical diagnosis of breast tumors.At the same time,we combined multiple clinical and pathological indicators to explore the image features of abnormal hemoglobin generation in different types of breast tumors.Materials and Methods:1.We included 322 patients with breast lesions treated from January 2018 to February2020,and all of them were examined by CTLM,and collected relevant mammography,B-ultrasound,MRI and other examination results,to analyze the diagnostic effectiveness of CTLM imaging of breast tumors.According to the enrollment and exclusion criteria,310 patients were enrolled for surgery.The pathological results were regarded as the"gold standard",and patients were divided into benign and malignant groups according to their pathological results,including 110 cases of malignant and 200 cases of benign.According to whether neoadjuvant chemotherapy was performed,patients who undergo neoadjuvant chemotherapy will be grouped separately.2.Statistical methods:The SPSS 25 software was used to analyze CTLM and ultrasound,MRI,Mammography and other imaging examination of breast tumor diagnosis specificity,sensitivity,negative predictive value,positive prediction,diagnostic compliance rate,positive ratio,negative ratio and so on.The results were compared using the?~2 test,corrected?~2 test,and Fisher's exact probability method for statistical analysis(P<0.05 was considered statistically significant).Results:1.Pathological results and CTLM image features:1)The total detection rate of CTLM for breast tumors was 83.23%(258/310),and the detection rate for breast malignant tumors was higher than that of benign breast tumors.The diagnostic sensitivity,specificity,negative predictive value,and positive predictive value of CTLM for breast malignant tumors were 88.18%(97/110),80%(114/200),92.49%(160/173),and 70.80%(97/137),respectively.The positive likelihood ratio and negative likelihood ratio were 4.409 and 0.148.The coincidence rates of fibroadenoma,adenopathy,invasive lobular carcinoma,and invasive ductal carcinoma were 57.8%(74/128),59.1%(26/44),90.57%(48/53),and 92.68%(38/41),respectively.2)In the pathological malignant group,the CTLM examination lesion area was a bright area(bright white);the edge was irregular;the abnormal blood vessel laser attenuation signal was strong.The incidence of the 3D structure was a plate-like structure or diverticulum structure or ring structure was significantly higher than that of benign lesions Group;the difference was statistically significant(P<0.05).In the pathological benign group,the lesion area was a high-intensity signal area(yellow-green);the edges were regular,and the laser attenuation signal of abnormal blood vessels was moderate.The incidence of the 3D structure was an inverted cone structure or a spherical structure or a cylindrical structure was significantly higher than that of the malignant lesion group.The difference was statistically significant(P<0.05)3)The expression of ER in breast cancer was related to the detection rate of CTLM,that is,the detection rate of CTLM in the ER(+)group was higher than that in the ER(-)group,and the difference was statistically significant(P<0.05).2.Mammographys and CTLM diagnostic efficacy researchThe total detection rate of mammographys for breast tumors was 75.5%(170/225),and the detection rate for breast malignant tumors was higher than that of benign breast tumors,the difference was statistically significant(P<0.05).CTLM diagnostic coincidence rate and specificity of breast malignant tumors were higher than those of mammographys,the difference was statistically significant(P<0.05),and there was no statistically significant difference in sensitivity,negative predictive value,positive predictive value,etc.3.Breast ultrasound and CTLM diagnostic efficacy researchThe total detection rate of breast ultrasound to breast tumors was 97.74%(303/310),and there was no statistically significant difference in the detection rates of benign and malignant breast tumors(P>0.05).The diagnostic specificity,positive predictive value,and diagnostic coincidence rate of breast ultrasound for breast malignant tumors were higher than CTLM,the difference was statistically significant(P<0.05),and there was no statistically significant difference in sensitivity and negative predictive value(P>0.05).4.The diagnostic sensitivity,specificity,diagnostic coincidence rate,negative predictive value,positive predictive value,etc.of CTLM and MRI were not statistically significant(P>0.05).5.CTLM had a certain value in evaluating the efficacy of neoadjuvant therapy for breast cancer.Conclusion:1.CTLM could show the hemoglobin production area of breast tumors,and the imaging features were different between benign and malignant tumors.The detection rate of CTLM in breast malignant tumors of the ER(+)group was higher than that of the ER(-)group.CTLM had auxiliary value in the diagnosis of breast cancer.2.The diagnosis rate and specificity of CTLM for breast tumors were higher than those of mammographys;the diagnosis specificity,positive predictive value and diagnosis coincidence rate of breast ultrasound for breast malignant tumors were higher than CTLM;the diagnostic accuracy rate of breast ultrasound for breast fibroadenoma and adenopathy was higher than CTLM.3.CTLM belongs to functional imaging,which could not directly provide morphological manifestations,and there was no uniform standard for image features.The evaluation criteria still need to be further optimized to improve diagnostic efficiency.