| Objective:To assess the diagnostic value of Color Doppler ultrasound combined withdouble-phase99mTC-MIBI tomographic imaging for early breast cancer.Methods:109female patients who were suspected of early breast cancer were examinedby the color Doppler ultrasound as well as double-phase99mTC-MIBI tomographicimaging. All the nodules had the pathological diagnosis.Operator should scan breast and auxiliary using a clockwise, sequential,overlapping radial approach. If detect lesion, then record the lesion’s size, shape,boundary, calcification, and intensity of internal echoes, CDFI was used to observethe blood flow of the tumor.Let the patient prone and placed the breast in the self-made breast imagingdevice.The99m TC-MIBI was injected into an elbow vein contra lateral to thepalpable breast lesion. The early and delay images were acquired at5min and180minafter injection of the tracer with SPECT. The imaging was performed use specialdesigned imaging device made by ourselves. The imaging was handled by computerto form emission tomography of coronal, sagittal horizontal position. All theinformation was analyzed through visual inspection and semi-quantitative analysis tomake comprehensive judgments.The diagnostic criteria of the two methods combined examination is as follows:The lesion being innocent if the two methods all discover innocent sign. The lesion being malignant if both examinations all discover malignant sign. If diagnostic resultdifferent with each other, the lesion being malignant to fit one of them:⑴USdiscovered typical malignant appearance.⑵The result of the double-phase99mTC-MIBI tomographic imaging is positive or weak positive.Statistical analysis:Analysis the difference of the accuracy, sensitivity, specificity for thedouble-phase99m TC-MIBI tomographic imaging, ultrasound and the combined twomethods.Chi-square Test is applied for categorical variables.T-test is applied for continuous variables.The above statistical analysis were conducted with the statistical softwarepackage SPSS for window, version13.0.Results:①.Results of pathology: of all nodules:66lesions were benign lesions andother43lesions were malignant nodules. There were15small breast cancers less than1cm in diameter. The benign nodules include32lesions of hyperplasia,31fibroadenoma and3intraductal papilloma. The malignant nodules include lesion of5atypical hyperplasia and38breast cancer.②.Results of ultrasonography: All of109nodules were detected clearly by colorDoppler ultrasound. There were difference between benign and malignant nodules,such as the shape border, internal echoes, and the malignant nodules have much richerblood flow signals than the benign ones. The accuracy, sensitivity, specificity for USdiagnosis was82.57%,76.74%and86.36%. The positive rate of Color Dopplerultrasonography for very small breast cancer less than1cm in diameter was53.32%.Kappa test displayed that the Coincidence degree of color Doppler ultrasound andpathologic findings was secondary (k=0.61).③. Results of radionuclide imaging: The accuracy, sensitivity, specificity for thedouble-phase99m TC-MIBI tomographic imaging were83.49%,88.37%and80.30%.The positive rate of radionuclide imaging for very small breast cancer less than1cm in diameter was66.67%.Kappa test displayed that the Coincidence degree ofradionuclide imaging and pathologic findings was secondary (k=0.67).④. The accuracy, sensitivity, specificity of the combined two methods couldreach86.24%,97.67%, and78.79%, the positive rate of combined diagnosis for verysmall breast cancer less than1cm in diameter was93.33%. Kappa test displayed thatthe Coincidence degree of Combined diagnosis and pathologic findings wassecondary (k=0.73). There was no significant difference between Color Dopplerultrasonography and radionuclide imaging for the diagnosis of early breast cancer (P＞0.05).The accuracy, sensitivity of the combined two methods was significantly higherthan that of the only one method. Compare to US and radionuclide imaging, there wassignificant difference (P<0.05).Conclusion:①. There was a good clinical value for both Color Doppler ultrasound andradionuclide imaging examination in the diagnosis of early breast cancer.②. A higher sensitivity could be achieved by using combination of US andradionuclide imaging. And there were obvious advantages for combined with ColorDoppler ultrasound and radionuclide imaging in the diagnosis of small breast cancerless than1cm in diameter... |
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