18F-FDG PET/CT in Differential Diagnosis of Breast Cancer with Solitary Pulmonary Lesions
10.3969/j.issn.1005-5185.2025.10.008
- VernacularTitle:18F-FDG PET/CT对乳腺癌合并孤立性肺病变的鉴别诊断价值
- Author:
Yiting ZHAO
1
;
Qin PENG
;
Mei MA
;
Mengying YANG
;
Jing LI
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院核医学科(PET-CT 中心),北京 100021
- Publication Type:Journal Article
- Keywords:
Lung neoplasms;
Breast neoplasms;
Neoplasms metastasis;
Positron-emission tomography;
Tomography,X-ray computed;
Fluorodeoxyglucose F18;
Diagnosis,differential
- From:
Chinese Journal of Medical Imaging
2025;33(10):1072-1078
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To evaluate the diagnostic value of 18F-fluorodeoxyglucose(18F-FDG)PET/CT in differentiating primary lung cancer(PLC)from metastatic pulmonary breast cancer in breast cancer patients with solitary pulmonary lesion(SPL).Materials and Methods This retrospective analysis included 58 breast cancer patients with SPL in the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2015 to August 2024.All patients had pathologically confirmed breast cancer with SPL and underwent PET/CT scans,including 36 cases of PLC and 22 cases of metastatic pulmonary breast cancer.Differences in clinical pathological features,high resolution CT morphological,and PET metabolic characteristics were analyzed.Multivariate Logistic regression was utilized to investigate independent predictive factors for SPL diagnosis.Results Statistically significant differences were observed between lesion density,nodule-lung interface,bubble sign,vascular convergence sign and pleural indentation sign(χ2=9.420,7.000,8.487,all P<0.05).PET/CT metabolic analysis revealed a significant difference in maximum standardized uptake value(SUVmax)between the two groups(Z=4.613,P<0.001).Multivariate analysis showed that bubble sign,pleural indentation sign and lower SUVmax were independent predictors for PLC.With an SUVmax threshold of 2.5,the area under the receiver operating curve(AUC)was 0.862,with a sensitivity of 90.9%,specificity of 77.8%and an accuracy of 82.8%.Combined analysis of high resolution CT and SUVmax demonstrated the highest diagnostic efficacy,with an area under the curve of 0.937,sensitivity of 90.9%,specificity of 94.4%and accuracy of 93.1%.Conclusion The presence of bubble sign,pleural indentation and SUVmax<2.5 suggests a high likelihood of PLC.Combined high resolution CT imaging features and PET metabolic characteristics significantly improve diagnostic accuracy for SPLs in breast cancer patients.
