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Objective To explore the value of ~(18)F 2-deoxy-2-fluoro-d-glucose(~(18)F-FDG)positron e-mission tomography (PET)/computed tomographic (CT) imaging and CT perfusion in evaluating metabolic and blood flow characteristics in breast cancer.Methods 32 women with untreated breast masses were both ex-amined with ~(18)F-FDG PET/CT and CT perfusion at the same day.All the lesions were confirmed histopothologi-cally by surgery or biopsy.The PET/CT images were analyzed semi-quantitatively.CT perfusion images were analyzed using the GE perfusion 3 soft package.The findings of two modalities above were commed with patho-logical diagnosis.Results There were significant differences between standardized uptake values (SUVs) of ~(18)F-FDG of benign tumors and breast cancer (Wilcoxon test:P=0.000 3,T=15.000,u=3.433,C=1).Differ-ences of SUVs between the center and periphery of breast Inasses were also significant.In addition.the SUVs were related to the pathological type and the grading of tumors.In the CT perfnsion,the differences of perfusion including bloodflow (BF),blood volume(BV)and permeability surface area product (PS) values between tumor and normal breast tissue were statistically significant(t=8.065,P<0.000 1;t=2.769 1,P=0.011 5;T~+=253.000 0,T~- =0.000 0,P<0.000 1)respectively.The differences of BF,BV and PS values between pe-ripheral zone and central portions of tumor were also statistically significant (t=8.015 8,P<0.000 1;t=2.243 4,P=O.017 9;t=3.485 7,P=0.002 2),respectively.Conclusion ~(18)F-FDG PET/CT imaging and CT peffusion reveal the metabolic and blood flow characteristics,and reflect biological behavior of breast tumor indirectly and have important value for the diagnosis and prognosis of breast cancer.
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Objective To assess the value of coronal MPR of 64-slice spiral CT in investigation of the cause of bowel obstruction. Methods Thirty-eight patients with different kinds of bowel obstruction underwent 64-slice spiral CT examination, and the data of axial and coronal image were reconstructed. Then the images were analyzed respectively by 4 readers in group A and B. Doctors in one group viewed the axial images first, then the coronal images, while in the other group viewed the coronal images first and then the axial images. The CT findings were compared with the surgical and pathologic results. Results The accuracy of coronal MPR of 64-slice spiral CT for investigating the cause of bowel obstruction was similar to that of axial MPR (86.84% vs 89.47%), and both had high accuracy. Diagnostic accuracy and confidence of doctors were improved obviously with the combination of axial images and coronal images (both 94.73%). Conclusion Coronal MPR of 64-slice spiral CT has very high clinical application value for diagnosing bowel obstruction. Diagnostic accuracy and doctors' confidence are improved with the help of axial images.
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Objective To evaluate the significance of MRI before surgery to remove polyaeryl-amide hydrogel (PAMHG) which has been used for augmentation mammaplasty. MethodsTwenty female patients with 40 breasts, having been injected PAMHG as augmentation mammaplasty, under-went bilateral breast axial T1WI, T2WI-fat saturation (FS) and sagittal T2WI-FS by 4-channal phased-assay breast coil at 3.0T (Philips) before removal surgery, in which 8 patients underwent axial multiphase contrast-enhanced MRI with THRIVE after Gd-DTPA (2.0 ml/s, 0.1 mmol/kg) adminis- tration. The results of MRI were compared with that of operation and pathology. ResultsPAMHG showed iso-intensity compared with breast gland on T1WI and hyperintensity on T2WI-FS. Low signal septa were noted within PAMHG in 40 breasts (20 patients), 90% (36/40) PAMHG without capsule, 10 % (4/40) with smooth capsule which showing homogenous low signal on T1WI and T2WI-FS. Subcutaneous lump of PAMHG was 70 % (28/40), lump of that in breast gland was 20% (8/40). Diffuse gel along spatium intermusculare of pectoralis major was 100 % (40/40), that along spatium intermusculare of intercostal muscle was 10 % (4/40). All PAMHG in breast of the 8 patients showed no enhancement, an irregular enhanced mass was found in gland of 1 patient. All distributions of PAMHG and appearances of its complications on T2WI-FS were consistent with the results of operation. ConclusionsT2WI-FS can accurately display the distribution of PAMHG and its complication before removal surgery. MRI plane scan combined with muhiphase contrast-enhanced MRI can differentiate PAMHG from the lesions in the gland and find the breast carcinoma, so that it can guide clinicians before surgery to remove PAMHG used for augmentation mammaplasty.
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Objective To evaluate and compare spiral CT and positron emission tomography-CT (PET-CT) in characterization of of axillary lymph nodes in breast cancer patients.Methods Forty patients with pathologically proven breast Cancer underwent contrast-enhanced spiral CT of tbe breast and axilla,13 of them also underwent PET-CT examination.One hundred and fifty-eight axillary lymph nodes were found in the 40 patients through contrast enhanced spiral CT,while 57 lymph nodes were found in the 13 patients through PET-CT.Three radiologists rated the lymph nodes found in CT images on a five-point scale.If the score was equal to or greater than 3,it was defined as positive (metastatic),otherwise negative.Visual observation and semiquantitative analysis were used to classify lymph nodes in PET-CT images.The results of spiral CT observation and PET-CT observation of lymph nodes were compared with pathological results.The relative value of CT and PET-CT was analyzed.Exact probability statistics were employed.Results One hundred and fifty eight lymph nodes of 40 patients were detected by spiral CT,91 of them were diagnosed as positive and 67 as negative Among the lymph nodes found in spiral CT,99 were positive and 59 were negative pathologicall.A total of 57 lymph nodes were found by PET-CT.Thirty-nine of them were defined as positive and 18 as negative.Among the lymph nodes found in PET-CT,39 were positive and 18 were negative pathologically.The sensitivity,specificity,accuracy,positive and negative predictive values in CT prediction in axillary lymph nodes metastases were 88.89%,94.91%,91.14%,96.70%,and 83.58%,respectively.The sensitivity,specificity,accuracy,positive and negative predictive values in PET-CT prediction in axillary lymph nodes metastases were 97.44%,94.44%,96.49%,97.44%,and 94.44%,respectively.PET-CT had no significant difference with spiral CT in sensitivity,accuracy,positive and negative predictive values for detection of axillary lymph nodes in breast cancer.But there was significant difierence between PET-CT and CT in negative predictive value(P＜0.05).Conclusions Both helical CT and PET-CT were the efficient methods in predicting the axillary lymph node status in breast cancer patiens.The negative predictive value of PET-CT was higher than that of helical CT.PET-CT has a better predictive ability than CT for the presurgical evaluation for breast cancer patients.