CAJ | 학술논문

目的探讨18F-FDG 符合线路 SPECT/CT 显像半定量分析法预测乳腺癌腋窝淋巴结转移的最佳阈值.资料与方法以58例行腋窝淋巴结清扫术的乳腺癌患者为研究对象,18F-FDG 符合线路 SPECT/CT 测量腋窝淋巴结(L)与对侧相应部位腋窝本底(B)最大放射性计数比值(L/B 值).以病理为“金标准”,通过 ROC曲线建立预测乳腺癌腋窝淋巴结转移的最佳阈值,将最佳阈值下的判定结果与病理结果行一致性检验.结果58例患者共检测到119枚与手术区匹配的淋巴结(直径≥8 mm).L/B 值的 ROC 曲线下面积为0.938,最佳阈值为2.22.采用 L/B 值≥2.22预测腋窝淋巴结转移的灵敏度、特异度、阳性预测值、阴性预测值分别为88.9%、97.9%、98.5%、85.2%,与病理诊断的一致性较好(Kappa=0.862, P<0.05).结论采用 L/B 值≥2.22作为预测直径≥8 mm 的腋窝淋巴结转移的标准具有较高的准确性,可用于腋窝淋巴结转移的评估.
목적탐토18F-FDG 부합선로 SPECT/CT 현상반정량분석법예측유선암액와림파결전이적최가역치.자료여방법이58례행액와림파결청소술적유선암환자위연구대상,18F-FDG 부합선로 SPECT/CT 측량액와림파결(L)여대측상응부위액와본저(B)최대방사성계수비치(L/B 치).이병리위“금표준”,통과 ROC곡선건립예측유선암액와림파결전이적최가역치,장최가역치하적판정결과여병리결과행일치성검험.결과58례환자공검측도119매여수술구필배적림파결(직경≥8 mm).L/B 치적 ROC 곡선하면적위0.938,최가역치위2.22.채용 L/B 치≥2.22예측액와림파결전이적령민도、특이도、양성예측치、음성예측치분별위88.9%、97.9%、98.5%、85.2%,여병리진단적일치성교호(Kappa=0.862, P<0.05).결론채용 L/B 치≥2.22작위예측직경≥8 mm 적액와림파결전이적표준구유교고적준학성,가용우액와림파결전이적평고.
Purpose To investigate the optimal threshold of 18F-FDG coincidence SPECT/CT imaging using semiquantitative analysis method in the prediction of axillary lymph node metastasis in breast cancer. Materials and Methods Fifty-eight patients with breast cancer confirmed by axillary lymph node dissection were enrolled. Maximum radioactive count ratio (L/B value) of axillary lymph node (L) and the corresponding areas of contralateral axillary background (B) were measured by the 18F-FDG coincidence SPECT/CT. ROC curve was established to predict the optimal threshold of axillary lymph node metastasis in breast cancer, and Kappa analysis was used to do consistency test of judgment results under optimal threshold and pathologic findings (gold standard). Results 119 lymph nodes in 58 patients matched with operation area ( ≥ 8 mm diameter) were detected. The area under the ROC curve of L/B value was 0.938, the optimum threshold value was 2.22. Sensitivity, specificity, positive predictive value, and negative predictive value, using L/B ≥ 2.22 to predict axillary lymph node metastases as judge of malignant and pathological diagnosis criteria (Kappa=0.862, P<0.05), were 88.9%, 97.9%, 98.5%and 85.2%, respectively. Conclusion It has higher accuracy for the threshold of the L/B ≥ 2.22 as a predictor of axillary lymph node metastasis ( ≥ 8 mm diameter), and it can be used for the assessment of axillary lymph node metastasis.