글로벌 연구동향
핵의학
- 2022년 02월호
[Nucl Med Commun.] The new perspective of PET/CT for axillary nodal staging in early breast cancer patients according to ACOSOG Z0011 trial PET/CT axillary staging according to Z0011영남의대 / 공은정*, 최정은
- 출처
- Nucl Med Commun.
- 등재일
- 2021 Dec 1
- 저널이슈번호
- 42(12):1369-1374. doi: 10.1097/MNM.0000000000001466.
- 내용
Abstract
Objective: Post Z0011 trial, axillary lymph node dissections (ALNDs) can be performed in patients with ≥3 positive axillary lymph nodes (ALNs). We investigated the diagnostic performance of 18F-fluorodeoxyglucose PET/computed tomography (FDG PET/CT) to predict ≥3 metastasis [high nodal burden (HNB)].Methods: We retrospectively analyzed preoperative FDG PET/CT from January 2010 to June 2012. Patients had clinical T1-2N0 primary invasive breast cancer and underwent breast-conserving surgery with sentinel lymph node biopsy ± ALND. All suspicious ALNs were counted considering FDG-avidity with morphologic changes. Images were considered positive if the axillary basin took up more FDG than the surrounding tissue. On CT, abnormal ALNs were round/ovoid or had cortical thickening with contrast enhancement. PET/CT results were compared with the histology and follow-up findings.
Results: In total, 221 females with 224 axillae were enrolled; 161 had negative, 53 had 1-2 metastasis [low nodal burden (LNB)] and 10 had HNB. The sensitivity, specificity, negative predictive value and positive predictive value of PET/CT for HNB were 70, 100, 98.6 and 100%, respectively. There was a correlation between the number of suspicious ALNs on PET/CT and the metastatic nodes on final histology. There were no significant differences in age, tumor size and FDG-avidity between patients with negative or LNB and HNB. During follow-up, 25 patients had a recurrence. The three false-negative patients did not show recurrence.
Conclusion: Preoperative PET/CT predicts HNB with high accuracy and is useful for evaluating clinical T1-2N0 invasive breast cancer.
Affiliations
Eunjung Kong 1 , Jungeun Choi 2
1 Department of Nuclear Medicine.
2 Department of Surgery, Yeungnam University College of Medicine, Daegu, Republic of Korea.
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