The Value Of ¹⁸F-FDG PET/CT In Follow-up Of Postoperative Breast Cancer

PART ONE:Recurrence and metastases,therapeutic strategy and prognosis of postoperative breast cancer:The value of ¹⁸F-FDG PET/CTObjective:To evaluate the value of ¹⁸F-FDG PET/CT imaging in detecting recurrence and metastasis,therapeutic strategy,prognosis in postoperative breast cancer patients.Methods:From July 2007 to September 2016,fifty-nine patients with postoperative breast cancer were retrospectively studied.Thirty-five patients in the participants were true positive and the influence of ¹⁸F-FDG PET/CT in therapeutic strategy was analyzed,Kaplan-Meier survival analysis was conducted based on the two groups of patients which were true positive and true negative.In the ¹⁸F-FDG PET/CT imaging true-positive group,according to the age,ER,PR,HER2 and subtypes of patients,the comparion of SUV_max in the group was examined by T test.Results:The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ¹⁸F-FDG ¹⁸F-FDG PET/CT were 97.22%,86.96%,93.22%,92.11%,95.24%.The true positive group and the true negative group patients were followed for a median period of 58.16 and 49.70 months,and the median survival time were 3.58 years and 4.16 years respectively.Overall survival and progression free survival time had a significant difference between two groups?c²=10.274,p<0.01;c²=17.187,p<0.01?.In thirty-five true-positive patients clinical restaging was raised in twenty-five patients after¹⁸F-FDG PET/CT imaging,therapeutic strategy were changed in thirty patients.There was no statistically significant difference between the two groups of SUVmax of breast cancer recurrence and metastases in age,ER,PR,HER2 and subtypes of breast cancer?p>0.05?.Conclusions:¹⁸F-FDG PET/CT imaging has highly sensitive and accuracy in the diagnosis of recurrence and metastasis of postoperative breast cancer,and torevise the clinical restaging timely.It helps to choose an appropriate clinical therapeutic strategy.This is important for patients to improve the prognosis.True-negative patients with PET/CT imaging had a better prognosis than true-positive patients.There is a high clinical value in the follow-up of breast cancer.PART TWO:Correlation study of ¹⁸F-FDG PET/CT and CA153,CA125, CEA in recurrence and metastases of postoperative breast cancerObjective To study the correlation of ¹⁸F-FDG PET/CT and CA153,CA125,CEA in recurrence and metastases of postoperative breast cancer.Methods From July 2007 to September 2016,forty-eight patients of postoperative breast cancer were examined by ¹⁸F-FDG PET/CT.The interval between the detection of tumor markers and PET/CT scan in within one month.The pathologic type of the patients was invasive ductal carcinoma.Diagnostic criteria of recurrence and metastases was depended on the pathological diagnosis,multiple imaging examinations,clinical long-term follow-up??6months?.The diagnostic efficiency of ¹⁸F-FDG PET/CT and CA153,CA125,CEA in detecting recurrence and metastases postoperative breast cancer were calculated and analyzed respectively.According to the CA153,CA125,CEA level,patients were divided into elevated and normal group.The aim was to analyze the difference between the two groups in the diagnosis of recurrence and metastases with PET/CT,and the correlation between SUVmax and CA153,CA125,CEA level.Results In forty-eight postoperative breast cancer patients,there were twenty-nine patients were confirmed that recurrence and metastases by pathology or clinical follow-up.Another nineteen were normal.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ¹⁸F-FDG PET/CT and tumor markers were 100%,80%,93.75%,87.5%,100%and 62.07%,94.74%,75%,94.74%,94.74%respectively.The detection rate of ¹⁸F-FDG PET/CT for recurrence and metastases were 94.73%in CA153,CA125,CEA elevated group and 90.91%in CA153,CA125,CEA normal group.The tumor markers were associated with ¹⁸F-FDG PET/CT examination?Kappa=0.459,p<0.05?.There was no correlation between CA153 level and SUVmax?r_s=0.371,P=0.173?.Conclusion ¹⁸F-FDG PET/CT had highly sensitive and accuracy in the diagnosis of recurrence and metastases of postoperative breast cancer,and the detection rate of recurrence and metastases in CA153?CA125?CEA elevated group was higher than that in normal group.There was some correlation between tumor markers and ¹⁸F-FDG PET/CT examination.CA153?CA125?CEA raised level had nothing to do with SUV_max.In addition,the risk of recurrence and metastases of breast cancer cannot be excepted that tumor markers ranged in the normal level.The combination of ¹⁸F-FDG PET/CT examination and tumor markers test were of great significance to improve the accuracy of diagnosis.