| Objective:To systematically observe the 18F-FDG uptake and its laws of four human breast cancer cells and corresponding xenograft nude models, and analyse the 18F-FDG PET-CT imaging in patients with breast cancer, to evaluate the value of 18F FDG PET-CT imaging in clinical application of breast cancer. In a word, to provide a scientific basis for eraly diagnosis and correct staging, and make contribution for the improvement of diagnosis, decision of treatment regimen, prolonging the survival time and. the improvement of life quality,and so on.Methods:(1)Human breast carcinoma cells, MCF-7, MDA-MB-231, T-47D, ZR-75-1, were grown in six pore plate, respectively, for the following day use. 18F-FDG was added into every pore and then incubated for 30min,60 min and 120min, and at the end of incubation, the radioactivity was measured byγ-counter, and the radioactivity of every 104 cells at different time was caculated. (2) Established the breast carcinoma xenograft nude model, and when the tumor length-diameter growing at 8 mm-10mm, routine dose 18F-FDG PET-CT Imaging was applying, via tail intravenous injection. Regions of interest (ROI) were placed over the tumor (T) and contralateral normal muscle (NT), and then T/NT value was caculated. (3) According to pathological diagnostic results,34 breast cancer patients were recruited for the study. Their 18F-FDG PET-CT imaging data were analyzed qualitatively by visual assessment and semi-quantitatively by using ROI technology measuring maximum standardized uptake values (SUVmax) of breast lesions and the contralateral one. According to Berg standeard they would be divided into three levels:I, II and III, then obtained diagnosis, In CT image the diagnostic criteria were the different sizes of the lymph nodes, and in PET-CT imaging relyed on visual and semi-quantitatively assessment. All of the results were compared with histopathology results, and the diagnostic parameters of different diagnostic criterions were compared with each other differences in axillary lymph nodes. (4) statistical methods: using SPSS statistical software packages 15.0 for data analysis.Results:①At incubation 30min, there was no statistical difference in the uptake of F-FDG among the human breast carcinoma cells; and at 60min the uptake was significant different between MCF-7 and MDA-MB-231, MCF-7 and ZR-75-1, MDA-MB-231 and ZR-75-1; as for 120min, except for no obvious difference between the uptake of MDA-MB-231 and ZR-75-1, there were significant differences between each other.②At 60 and 120min the uptake of 18F-FDG was higher in MCF-7 and T-47D than in MDA-MB-231 and ZR-75-1 cells; For MCF-7, T-47D and ZR-75-1, the uptake was highest at 60min, and with time going on, the uptake decreased, As for MDA-MB-231 the uptake of 18F-FDG was increased with the time, and reached the peak at 120min.③18F-FDG PET-CT imaging of four breast carcinoma xenografts showed that T/NT value was 1.33～1.67 (1.53±0.03), and there was no difference among various groups.④or breast lesions:18F-FDG PET-CT qualitative and semi-quantitative analysis both missed 1 case, carcinoma in situ, and the sensitivity, specificity and accuracy of qualitative analysis diagnostics was 97.7%, 100% and 97.9%, respectively, while for semi-semi-quantitative analysis when SUVmax set at 2.0, the sensitivity, specificity and diagnostic accuracy was 93.2% and 100.0% and 93.6%, respectively. Qualitative analysis was superior to SUVmax2.0 semi-semi- quantitative analysis.⑤or axillary lymph nodes:Comparing with pathological results, imaging checked out 96 lymph nodes (96/393), the true positive rate was 64.4% (38/59), true negative rate was 17.4% (58/334), and there were statistical differences between the two groups in SUVmax value, the longest and shortest diameter of lymph nodes, respectively. Qualitative and semi-quantitative analysis of 18F-FDG PET-CT imaging in the diagnosis of axillary lymph node were equivalent. In the diagnosis of axillary lymph node metastasis, there was significant difference between 18F-FDG PET-CT and simple CT, and in diagnostic accuracy, negative predictive value and consistent with pathological diagnosis 18F-FDG PET-CT were superior to simple CT, what's more,18F-FDG PET-CT was also better in sensitivity, specificity and positive predictive value,Conclusions:(1) At 30min the uptake of F-FDG is equivalent among different human breast carcinoma cells, at 60 and 120min the uptake of F-FDG is higher in MCF-7 and T-47D than in MDA-MB-231 and ZR-75-1 cells, and the optimum occasion for in vivo imaging is 60min; (2) 18F-FDG PET-CT imaging of breast carcinoma xenografts show that there is no different between the T/TN ratios, and it can be extensively used in detecting breast cancer and its metastases. (3) 18F-FDG PET-CT has high sensitivity, specificity and accuracy in detecting breast cancer and its metastases, and it is superior to simple CT scan in detecting axillary lymph node. (4) PET-CT could provide a scientific and effective model to evaluate the early stage breast cancer at molecular level and in vivo conditiont. |
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