The Role Of Metabolic Parameters Of ¹⁸F-FDG PET/CT In The Diagnosis Of Primary Breast Cancer,Monitoring Metastasis And Evaluating Prognosis Of Postsurgical Breast Cancer

Object:1.To assess the role of ¹⁸F-FDG PET/CT in the diagnosis of primary breastcancer and its correlation with the pathological features of the primary tumor.2.To assess the role of ¹⁸F-FDG PET/CT in monitoring metastasis of postsurgicalbreast cancer and to determine the value ofPET in the evaluation of their prognosis.Method:We included 46 preoperative cancer patients in the first study.The clinical data of the patients included in the study was retrospectivelycollected.Classification was based on patient age,pathological type of primary tumor,tumor size,lymph node metastasis,pathophysiological indicators?ER,PR,Her-2,Ki-67 expression?and molecular pathology type.Two experimental doctor specialized in nuclear medicine made thediagnosis by visual analysis or semi-quantiative analysis separately.And the semi-quantitative parameter including SUVmax,MTV and TLG were given by MeDex workstation.And it wascompared with the final pathological results and clinical follow-up information.92 patients of postsurgical breast cancer were included in the second part.Andall the patients had underwent pathological examination or had been observed byimaging madalities or clinical follow-up process.SUVmax,MTV and TLG weremeasured,which were further employed to determine whether or not did SUVmax,MTV andTLG correlate with their clinical and pathological characteristics and the patientssurvival outcomes.ResultsIn correlation analysis of the factors of SUVmax and MTV of the first part,analysisshowed that the SUVmax and MTV significantly correlated with themaximum diameter of breast mass and the lymph nodules numbers.In clinical stages I,II,and III&IV,the higher the clinical stage was,the higher the mean SUVmax and MTV level was.In the M₀ and M₁ groups,the SUVmax and MTV of the primary lesion in the M₁ group was significantly higher than those of the M₀ group.At the same time,the mean SUVmax level has no significant differencebetween ER,PR,Her-2,and Ki-67 groups.The MTV value of ER-negative group was higher than that of ER-positive group;the MTV value of Her-2 positive group was higher than that of Her-2-negative group,the difference was statistically significant.In the diagnose of postsurgical breast cancer patients,the sensitivity and specificity were 92.0%and 97.6%.For the ¹⁸F-FDG avid patients,by ROC curve analysis,SUVmax cut-off value of 6.45,and MTV of 29.09 cm³ had the highest diagnostic value in the prediction of survival status in patients.Conclusion ¹⁸F-FDG PET/CT had important role in monitoring metastasis and restaging postsurgical breast petients.The degree of ¹⁸F-FDG uptake of primary breast cancer correlated with themaximum diameter of breast mass and metastasis lymph nodules,but it was not significantly relevant with ER,PR,Her-2 or Ki-67 expression.Postsurgical PET/CT findings can provide strong prognostic value for the overall survival after PET examination.