The clinical value of the qualitative and semi-quantitative 18F-FDG PET/CT in the detection of primary breast cancer and lymph node metastasis

Objective The purpose of this study was to assess the diagnostic efficiency of the qualitative and semi-quantitative analyses of 18F-fluorodeoxyglucose(FDG)PET/CT for staging primary breast cancer.Methods This prospective study included 39 patients.Of the 39 cases,24 were primary breast cancer,15 were benign breast lesions.Patients underwent regional FDG PET/CT scanning covering bilateral breasts and axilla.All primary breast cancer lesions were confirmed by pathologic results of surgery.Twenty-four cases with benign lesions were established according to the results of surgery or clinical follow up for at least 12 months.The qualitative and semi-quantitative 18F-FDG uptake results were used fbr T staging and N staging of breast cancer.SPSS 11.5 was used for data analysis.Results When using SUVmax＞4.5 as the cutoff value or SUVmax＞x+2s of contra-lateral normal breast SUVmax as the cutoff value combined CT malignant signs for initial diagnosis,the sensitivity,specificity of diagnosing breast malignant lesion were 96.0%(24/25),63.2%(12/19),respectively.By using threshold of SUVmax＞2.5,the sensitivity,specificity were 60%(6/10),92.3%(12/13)respectively for staging regional lymphadenopathy.Conclusion For staging primary breast carcinoma with FDG PET/CT,higher sensitivity could be acquired when using SUVmax＞4.5 or SUVmax＞-x+2s of contra-lateral normal breast SUVmax as the cutoff value combined with CT malignant signs. Key words: Breast neoplasms; Lymphatic metastasis; Tomography,emission-computed; Tomography,X-ray computed; Deoxyglucose