Analysis On The Application And Influence Factors Of ¹⁸F-FDG PET-CT Imaging In Diagnosing Breast Cancer

Objective Evaluate the clinical value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography(18F-FDG PET-CT)imaging in diagnosis of primary breast cancer and the lymph node metastasis.Probe the correlation between the maximum of standardized uptake value(SUVmax)and the clinicopathological features of breast cancer patients by 18F-FDG PET-CT imaging.To explore the clinical value of 18F-FDG PET-CT combined with the breast color Doppler ultrasound and mammography examination in the diagnosis of breast cancer and axillary lymph node metastasis.To analyze the causes of different results of the 18F-FDG PET-CT examination and the pathologic diagnosis to improve the diagnostic efficacy of 18 FFDG PET-CT examination.Methods The data of 295 cases of patients with breast mass examined by the 18F-FDG PETCT imaging in our hospital from December 2016 to August 2018 was collected.295 patients did the ultrasonography examination and 286 of them did the mammography examination.All the patients did the core-needle biopsy of breast mass or the postoperative pathological diagnosis.All the patients did comprehensive 18F-FDG PETCT examinations on primary breast cancer lesions,regional lymph node and the internal organs of the whole body.The SUVmax of breast mass and ALN was measured by semi-quantitative analysis and the visual analysis was compared with healthy breast intake.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the two methods were calculated by using pathological diagnosis as the standard.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic efficacy of 18F-FDG PET-CT examination for breast cancer and ALN metastasis,and to determine the SUVmax diagnostic threshold.Probe the correlation between SUVmax of primary breast cancer lesions and the clinicopathological features.Analyze the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 18F-FDG PET-CT examination for breast cancer on different classes of mammography,breast color Doppler ultrasound imaging breast imaging and reporting data system(BI-RADS).286 cases of breast masses were examined by breast color doppler ultrasound,mammography and 18F-FDG PET-CT examination.Combined with the pathological results,the accuracy of diagnosis of ALN metastasis of breast cancer and breast cancer was compared by using the three methods alone or in combination.The results of 18F-FDG PET-CT were compared with the pathological results.The false positive and false negative results were compared with the results of breast color ultrasound and mammography.Results In the collected 295 cases,diagnosing breast cancer on per patient,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the primary breast cancer lesions by 18F-FDG PET-CT visual analysis is 96.67%,85.22%,91.10%,94.23%,92.20%.With the semi-quantitative analysis,the best SUVmax diagnostic threshold is 3.20,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of diagnosis is 91.11%,79.13%,87.23%,88.05%,86.44%.The discrepancy in breast cancer diagnosis by visual analysis and semi-quantitative analysis is not statistically significant(p>0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of breast cancer ALN metastasis diagnosis is 86.84%,93.27%,90.41%,90.65%,90.56%.With the semi-quantitative analysis,the best SUVmax diagnostic threshold is 2.18,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of diagnosis is 82.90%,94.23%,91.30,88.29%,89.44%.The discrepancy in breast cancer ALN diagnosis by Mc Nemar test visual analysis and semi-quantitative analysis are not statistically significant(p>0.05).There is clear correlation between primary breast cancer lesions SUVmax and clinical stages(p<0.05),the SUVmax is positive correlated with T,N and M stage(p<0.05).SUVmax is positive correlated with Ki67(p<0.05),and the 18F-FDG of Ki67 high expression(Ki67>20%)is higher than the tumor of low expression(Ki67?20%),the discrepancy is statistically significant(p<0.05).The discrepancy between the positive SUVmax and the negative SUVmax of epithelial growth factor receptor and P35 gene is statistically significant(p<0.05).The discrepancy between the SUVmax of primary lesions and the expressions of estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(HER-2)is not statistically significant(p>0.05).The accuracy of breast cancer diagnosis of BI-RADS 4A and 4B patients on the results of PET-CT examination and breast color Doppler ultrasound examination is worse than the accuracy of breast cancer diagnosis of BI-RADS 4C and 5 class patients.The combined application of breast color Doppler ultrasound,mammography and the PET-CT examination can increase the accuracy of breast cancer diagnosis,the combined application of PET-CT and breast color Doppler ultrasound examination can increase the accuracy of breast cancer ALN metastasis diagnosis,without any help of mammography examination.Conclusion(1)18F-FDG PET-CT has important clinical value in the diagnosis of primary breast cancer,ALN metastasis of breast cancer,staging of breast cancer and evaluation of general condition.(2)Metabolic parameters SUVmax of 18F-FDG PET-CT is positive correlated with part of cancer,s clinicopathological features.(3)There are merits and demerits in diagnosing pathological changes of breast cancer by suing breast color Doppler ultrasound,mammography and the 18F-FDG PET-CT examination.When difficulties come to part of pathological changes diagnosis,the features of changes in these three methods should be carefully analyzed and combined with the clinical history to increase the accuracy of diagnosis.