The Value Of PEM In The Early Diagnosis For Breast Cancer

Objective:Through analyzing of 128 cases of women with early clinical findings of breast neoplasm,do the PEM,mammography or ultrasonography examination and compare the effectiveness of qualitative analysis and quantitative analysis of breast cancer diagnosis with pathological results as the gold standard,comparing PEM with mammography,ultrasound,discusses PEM value in early diagnosis of breast cancer.Methods:?1?Screening of 128 cases of breast neoplasm by mammography or ultrasonography in women patients in tianjin cancer hospital,then do the PEM examination,then do surgery or biopsy in two weeks;?2?Draw the ROC curve,analysis the SUV_max,calculated the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and compare the qualitative diagnosis and quantitative analysis in diagnosis of breast cancer;?3?According to BI-RADS grading,123 patients whose breast neoplasm are not close to the chest wall were reclassified according to mammography,ultrasound and PEM results;?4?With the pathological results as the gold standard,PEM were compared with mammography,ultrasonography in breast benign and malignant lesions diagnostic coincidence rate and accuracy of diagnosis of breast cancer,and compare the efficiency of three examination in diagnosis of different pathological type of breast cancer;?5?PEM with mammography,ultrasound is applied to diagnosis of breast cancer,and discuss the method of improving the diagnostic accuracy of breast cancer;?6?Using SPSS 16.0 statistical software for data processing and analysis accordingly.Results:?1?According to the results of the pathological,breast malignant lesions with infiltrating ductal carcinoma and intraductal carcinoma in the highest proportion,breast benign lesions with adenofibroma accounted for the highest;?2?PEM image breast lesions are often characterized by 18F-FDG uptake increased,give priority to 2 levels of uptake,benign lesions are characterized by 18 F-FDG uptake has no obvious abnormal uptake,give priority to 0 levels of uptake.SUV_max showed that malignant group is significantly higher than benign group?P<0.001?.?3?Draw the ROC curve,and selected SUV_max range 2.0?6.0,and 0.2 for the class,for different SUV_max critical value in the diagnosis of performance evaluation,through the comparison,when SUV_max4.2 various diagnostic indexes is higher,the diagnostic sensitivity,specificity,positive predictive value,negative predictive value,accuracy was 78.9%,78.8%,91.4%,56.5%,78.9%.Qualitative analysis is better than semi-quantitative analysis,qualitative analysis and pathological diagnosis has good consistency,kappa value was 0.78;?4?The diagnostic accuracy of PEM for infiltrating ductal carcinoma and invasive lobular carcinoma and invasive papillary carcinoma,leaf tumors,and other special types is 96.4%?83.3%?100.0%?100.0%?100%,higher than mammography and ultrasound;PEM for intraductal carcinoma of the diagnostic accuracy?86.6%?,is lower than mammography?100.0%?,and the same with ultrasonography,because the lower the metabolic activity of carcinoma in situ;?5?The diagnostic accuracy comparing PEM with mammography and ultrasound in breast cancer,X2=1.872,P=0.392,it is proved that there are no significant differences about the diagnosis accuracy of breast cancer comparing PEM with mammography and ultrasound;?6?Using PEM,mammography and ultrasound to diagnosis of breast cancer can improve the diagnostic accuracy significantly?98.8%?.Conclusion:?1?The PEM images of Breast cancer usually expresse as intaking FDG abnormally uptake,benign lesions usually expresse as no obvious abnormally uptake,but the PEM images have some false positive and false negative cases,so combined with other imaging examinations analysis is needed;?2?Through drawing ROC curve SUV_max4.2 is the best diagnostic cut-off point;?3?The qualitative analysis is superior to the quantitative analysis;?4?PEM's diagnostic accuracy is higher than mammography and ultrasound about invasive ductal carcinoma,invasive lobular carcinoma,invasive papillary carcinoma,phyllodes tumor or other special types of cancer;?5?PEM hava high resolution and high sensitivity,it has a very high clinical value for the diagnosis of small breast cancer;?6?Diagnosis of breast cancer using PEM,mammography and ultrasound can improve the diagnostic accuracy significantly,it supports an effective method for the early diagnosis and treatment.