[1]董佳佳,章斌.多种影像学方法评价乳腺癌新辅助化疗疗效的价值比较[J].国际放射医学核医学杂志,2014,38(6):427-432.[doi:10.3760/cma.j.issn.1673-4114.2014.06.018]
 Dong Jia-jia,Zhang Bin.Comparision on the values of different image modalities in monitoring the response to neoadjuvant chemotherapy in breast cancer patients[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(6):427-432.[doi:10.3760/cma.j.issn.1673-4114.2014.06.018]
点击复制

多种影像学方法评价乳腺癌新辅助化疗疗效的价值比较(/HTML)
分享到:

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
38
期数:
2014年第6期
页码:
427-432
栏目:
出版日期:
2014-11-25

文章信息/Info

Title:
Comparision on the values of different image modalities in monitoring the response to neoadjuvant chemotherapy in breast cancer patients
作者:
董佳佳 章斌
苏州大学附属第一医院核医学科, 215006
Author(s):
Dong Jia-jia Zhang Bin
Department of Nuclear Medicine, the First Affiliated Hospitd of Soochow University, Suzhou 215006, China
关键词:
乳腺肿瘤正电子发射断层显像术体层摄影术X线计算机磁共振成像超声检查乳房X线摄影术肿瘤辅助疗法
Keywords:
Breast neoplasmsPositron-emission tomographyTomographyX-ray computedMagnetic resonance imagingUltrasonographyMammographyNeoadjuvant therapy
DOI:
10.3760/cma.j.issn.1673-4114.2014.06.018
摘要:
影像学方法在乳腺癌新辅助化疗(NAC)疗效评价中具有重要地位。钼靶X线操作简单,曾是早期发现乳腺癌的简便、有效的方法,可显示微小钙化灶,但不常用于疗效评价;CT适应人群广、扫描时间短、密度分辨率高,后处理时可以三维重建以更好显示癌灶,可用于诊断及疗效评价;MRI具有多种参数和良好的软组织分辨率,可显示癌灶周围的微小浸润及炎症反应;超声无放射性、检查角度灵活、可重复性强,可以显示病灶和转移淋巴结的形态、结构及血流,并引导介入操作。PET/CT显像可以反映肿瘤细胞的代谢水平,其将分子代谢变化与解剖结构的准确定位相结合,在评估NAC疗效方面拥有更高的灵敏度及特异度,比单纯测量肿瘤大小的改变更准确。
Abstract:
Imaging examinations are important in monitoring the response to neoadjuvant chemotherapy (NAC)in breast cancer patients.Mammography is easy to operate,which used to be the predominant imaging procedure used for breast cancer screening.It has great advantage in the detection of calcification,but it is not commonly used in therapeutic evaluation.CT provides high-spatial resolution,clear anatomical structures and powerful reconstruction ability,and the post-processing 3D reconstruction can show cancer more clearly,which could be used for diagnosis and therapeutic evaluation.MRI gives various sequence parameters to choose and provides the best soft tissue resolution which can show the small infiltration and inflammatory reaction around the tumor.Ultrasonic examination,as a technique without radioactivity,can show the shapes,structures and blood supplies of tumor sites and lymph node metastasis,and also can used as guidance for intervention procedures.PET/CT has unique advantage in monitoring the response to NAC by observing the changes of tumor metabolism.The image fusion of molecular metabolic changes and anatomical location can offer higher sensibility and specificity in curative effect of NAC,which is more accurate than measuring the tumor size.

参考文献/References:

[1] 周纯武,李二妮.乳腺影像学发展历程及展望[J].中华放射学杂志,2013,47增刊:27-29.
[2] 田荣华,王艳,汪娇,等.钼靶X线对乳腺癌的诊断(附174例分析)[J].实用放射学杂志,2011,27(11):1670-1672.
[3] 张洪涛,赵一冰,宋培记,等.钼靶乳腺摄像在乳腺癌新辅助化疗疗效评价中的应用[J].军事医学,2012,36(8):616-618.
[4] Sperber F,Weinstein Y,Sarid D,et al.Preoperative clinical,mammographic and sonographic assessment of neoadjuvant chemotherapy response in breast cancer[J].Isr Med Assoc J,2006,8(5):342-346.
[5] 夏晓天,张永学.影像学检查在乳腺癌的诊断及疗效评估中的应用价值[J].国际放射医学核医学杂志,2010,34(4):242-246,249.
[6] Belli P,Costantini M,Malaspina C,et al.MRI accuracy in residual disease evaluation in breast cancer patients treated with neoadjuvant chemotherapy[J].Clin Radiol,2006,61(11):946-953.
[7] Choi JH,Lim HJ,Lee SK,et al.The role of PET CT to evaluate the response to neoadjuvant chemotherapy in advanced,breast cancer:comparison with ultrasonography and magnetic resonance imaging[J].J Sur Oncol,2010,102(5):392-397.
[8] Wu LM,Hu JN,Gu HY,et al.Can diffusion-weighted MR imaging and contrast-enhanced MR imaging precisely evaluate and predict pathological response to neoadjuvant chemotherapy in patients with breast cancer?[J].Breast Cancer Res Treat,2012,135(1):17-28.
[9] 袁建伟,杨劼,贺小红,等.乳腺癌18F-FDG PET/CT和3.0T MRI联合显像评分与Ki-67表达水平的相关性分析[J].国际放射医学核医学杂志,2013,37(2):84-87.
[10] 郁骐襄,陈小松,沈坤炜.MRI在乳腺癌新辅助化疗中的地位[J].中华外科学杂志,2011,49(9):845-847.
[11] 李蔚萍,苗华栋,唐健雄,等.多排螺旋CT在乳腺癌诊断和术前中的价值[J].中华普通外科杂志,2011,26(1):29-32.
[12] 徐民,纪建松,卢陈英,等.多层螺旋CT对进展期乳腺癌新辅助化疗的疗效评估[J].医学影像学杂志,2012,22(10):1677-1680.
[13] Tozaki M,Kobayashi T,Uno S,et al.Breast-conserving surgery after chemotherapy:value of MDCT for determining tumor distribution and shrinkage pattern[J].AJR Am J Roentgenol,2006,186(2):431-439.
[14] 黄朝光,辛付莹,鲁毅.彩超、钼靶评价新辅助化疗疗效的应用研究[J].中外医疗,2011(17):181.
[15] Chen M,Zhan WW,Han BS,et al.Accuracy of physical examination,ultrasonography,and magnetic resonance imaging in predicting response to neo-adjuvant chemotherapy for breast cancer[J].Chin Med J(Engl),2012,120:1862-1866.
[16] Cao X,Xue J,Zhao B,et al.Potential application value of contrast-enhanced ultrasound in neoadjuvant chemotherapy of breast cancer[J].Ultrasound Med Biol,2012,38(12):2065-2071.
[17] 陈谦谦,薛恩生.超声、钼靶X线联合MRI在乳腺癌术前评价中的应用[J].中国医学影像学杂志,2012,20(2):148-152.
[18] Dietl B,Marienhagen J.The therapeutic impact of 18F-FDG whole body PET A radiooncologist’s view[J].Nuklearmedizin,2005,44(1):8-14.
[19] 席云,张敏,郭睿,等.18F-FDG PET或PET/CT评估乳腺癌新辅助化疗疗效价值的meta分析[J].中华核医学与分子影像杂志,2012,32(3):192-197.
[20] 贾丽,于金明,王仁本,等.18F-FDG PET/CT对乳腺癌新辅助化疗疗效预测的价值[J].中国肿瘤临床与康复,2006,13(3):215-218.
[21] Humbert O,Berriolo-Riedinger A,Riedinger JM,et al.Changes in 18F-FDG tumor metabolism after a first course of neoadjuvant chemotherapy in breast cancer:influence of tumor subtypes[J],Ann Oncol,2012,23(10):2572-2577.
[22] Kumar A,Kumar R,Seenu V,et al.The role of 18F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer[J].Eur Radiol,2009,19(6):1347-1357.
[23] Andrade WP,Lima EN,Osório CA,et al.Can FDG-PET/CT predict early response to neoadjuvant chemotherapy in breast cancer?[J].EurJ Sur Onco,2013,39(12):1358-1363.
[24] Koolen BB,Valdés Olmos RA,Elkhuizen PH,et al.Locoregional lymph node involvement on 18F-FDG PET/CT in breast cancer patients scheduled for neoadjuvant chemotherapy[J].Breast Cancer ResTreat.2012,135(1):231-240.
[25] Koolen BB,Vranckhen Peeters MJ,Aukema TS,et al.18F-FDG PET/CT as a staging procedure in primary stage D and M breast cancer:comparison with conventional imaging techniques[J].Breast Cancer Res Treat,2012,131(1):117-126.
[26] 吴建伟,高红,艾书跃,等.PET/CT对乳腺癌术后转移的诊断意义[J].医学研究生学报,2013,26(1):41-44.
[27] Smyezek-Gargya B,Fersis N,Dittmann H,et al.PET with[18F] fluorothymidine for imaging of primary breast cancer:a pilot study[J],Eur J Nucl Med Mol Imaging,2004,31(5):720-724.
[28] van Waarde A,Cobben DC,Suurmeijer AJ,et al.Selectivity of 18F-FLT and 18F-FDG for differentiating tumor from inflammation in a rodent model[J].J Nucl Med,2004,45(4):695-700.
[29] Yamamoto Y,Nishiyama Y,Ishikawa S,et al.3’-Deoxy-3’-18F-fluorothymidine as a proliteration imaging tracer for diagnosis of lung tumors:comparison with 2-deoxy-2-18f-fluoro-D-glucose[J].J Compute Assist Tomogr,2008,32(3):432-437.
[30] 陈雷,柳曦.18F-FDG和18F-FLT的正电子发射断层显像对肿瘤放化疗疗效评价的实验研究[J].中国医药导报,2013,10(18):41-43.
[31] Peterson LM,Mankoff DA,Lawton T,et al.Quantitative imagine of estrogen receptor expression in breast cancer with PET and 18F-fluoroestradiol[J].J Nucl Med,2008,49(3):367-374.
[32] Dehdashti F,Flanagan FL,Mortimer JE,et al.Positron emission tomographic assessment of "metabolic flare" to predict response of metastatic breast cancer to antiestrogen therapy[J].Eur J Nucl Med,1999,26(1):51-56.
[33] Mortimer JE,Dehdashti F,Siegel BA,et al.Metabolic flare:indicator of hormone responsiveness in advanced breast cancer[J].J Clin Oncol,2001,19(11):2797-2803.
[34] Brepoels L,Stroobants S,Verhoef G,et al.18F-FDG and 18F-FLT uptake early after cyclophosphamide and mTOR inhibition in an experimental lymphoma model[J].J Nucl Med,2009,50(7):1102-1109.
[35] Song SL,Liu JJ,Huang G,et al.Changes in 18F-FDG uptake within minutes after chemotherapy in a rabbit VX2 tumor model[J].J Nucl Med,2008,49(2):303-309.

相似文献/References:

[1]何燕,苏晋,郑晓霞,等.P-糖蛋白抑制剂在PET显像中的应用研究[J].国际放射医学核医学杂志,2016,40(1):1.[doi:10.3760/cma.j.issn.1673-4114.2016.01.001]
 He Yan,Su Jin,ZhengXiaoxia,et al.Developing P-glycoprotein inhibitor marked by PET[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):1.[doi:10.3760/cma.j.issn.1673-4114.2016.01.001]
[2]许飞,刘建军,黄钢,等.PET乏氧显像在预测肿瘤乏氧及指导临床治疗中的应用进展[J].国际放射医学核医学杂志,2016,40(1):35.[doi:10.3760/cma.j.issn.1673-4114.2016.01.008]
 Xu Fei,Liu Jianjun,Huang Gang,et al.The application of hypoxia imaging with PET in predicting tumor hypoxia and guiding clinical therapy[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):35.[doi:10.3760/cma.j.issn.1673-4114.2016.01.008]
[3]胡伟,赵军.小胶质细胞在AD炎性机制中的作用及其常见PET显像剂的应用进展[J].国际放射医学核医学杂志,2016,40(1):44.[doi:10.3760/cma.j.issn.1673-4114.2016.01.009]
 Hu Wei,Zhao Jun.Microglia’s Alzheimer disease inflammatory mechanisms and progress of its common application in PET imaging agents[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):44.[doi:10.3760/cma.j.issn.1673-4114.2016.01.009]
[4]张莹莹,王振光,孔艳.PET/CT显像在肺间质纤维化中的应用进展[J].国际放射医学核医学杂志,2016,40(1):55.[doi:10.3760/cma.j.issn.1673-4114.2016.01.011]
 Zhang Yingying,Wang Zhenguang,Kong Yan.Application advancement on PET/CT in pulmonary interstitial fibrosis[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):55.[doi:10.3760/cma.j.issn.1673-4114.2016.01.011]
[5]李海峰,张晓军,李云钢,等.国产模块LOOP环改良法合成11C-蛋氨酸[J].国际放射医学核医学杂志,2016,40(2):106.[doi:10.3760/cma.j.issn.1673-4114.2016.02.004]
 Li Haifeng,Zhang Xiaojun,Li Yungang,et al.Synthesis of 11C-methionine on home-made module by the improved LOOP method[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):106.[doi:10.3760/cma.j.issn.1673-4114.2016.02.004]
[6]杨雷,袁卫红,王家平,等.99Tcm-MIBI显像与钼靶X线对乳腺癌诊断的比较研究[J].国际放射医学核医学杂志,2016,40(2):111.[doi:10.3760/cma.j.issn.1673-4114.2016.02.005]
 Yang Lei,Yuan Weihong,Wang Jiaping,et al.Diagnostic value of technetium 99Tcm sestamibi and X-ray mammography in breast cancer: a comparison study[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):111.[doi:10.3760/cma.j.issn.1673-4114.2016.02.005]
[7]史文杰,孟召伟,谭建.基于Deauville标准探讨18F-FDG PET/CT在霍奇金淋巴瘤复发诊断中的应用价值[J].国际放射医学核医学杂志,2016,40(2):120.[doi:10.3760/cma.j.issn.1673-4114.2016.02.007]
 Shi Wenjie,Meng Zhaowei,Tan Jian.Value of 18F-FDG PET/CT on diagnosis of Hodgkin lymphoma recurrence using Deauville criterion[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):120.[doi:10.3760/cma.j.issn.1673-4114.2016.02.007]
[8]马乐,张万春,李晓敏.乳腺癌前哨淋巴结核素显像新进展[J].国际放射医学核医学杂志,2016,40(2):145.[doi:10.3760/cma.j.issn.1673-4114.2016.02.012]
 Ma Le,Zhang Wanchun,Li Xiaomin.Evolution of radionuclide imaging of sentinel node lymphscintigraphy in breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):145.[doi:10.3760/cma.j.issn.1673-4114.2016.02.012]
[9]李海峰,张晓军,张锦明.多巴胺转运蛋白显像剂11C-β-CFT在帕金森病中的应用研究[J].国际放射医学核医学杂志,2016,40(3):218.[doi:10.3760/cma.j.issn.1673-4114.2016.03.011]
 Li Haifeng,Zhang Xiaojun,Zhang Jinming.Review of the use of dopamine transporter imaging agent 11C-β-CFT for diagnosing Parkinson disease[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):218.[doi:10.3760/cma.j.issn.1673-4114.2016.03.011]
[10]尤阳,轩昂,张杰,等.淋巴瘤患者大脑静息葡萄糖代谢改变[J].国际放射医学核医学杂志,2016,40(4):255.[doi:10.3760/cma.j.issn.1673-4114.2016.04.003]
 You Yang,Xuan Ang,Zhang Jie,et al.Changes in resting-state brain glucose metabolism in patients with lymphoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):255.[doi:10.3760/cma.j.issn.1673-4114.2016.04.003]
[11]胡鸿,唐刚华,聂大红.乳腺癌分子显像研究进展[J].国际放射医学核医学杂志,2015,39(1):91.[doi:10.3760/cma.j.issn.1673-4114.2015.01.019]
 Hu Hong,Tang Ganghua,Nie Dahong.Progress on molecular imaging of breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):91.[doi:10.3760/cma.j.issn.1673-4114.2015.01.019]
[12]李雯,冯彦林.18F-FDG PET/CT评估三阴性乳腺癌新辅助化疗疗效的研究进展[J].国际放射医学核医学杂志,2014,38(3):197.[doi:10.3760/cma.j.issn.1673-4114.2014.03.013]
 Li Wen,Feng Yanlin.Advances of assessment with 18F-FDG PET/CT in triple-negative breast cancer during neoadjuvant chemotherapy[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(6):197.[doi:10.3760/cma.j.issn.1673-4114.2014.03.013]
[13]胡梦裳,章斌.PET/CT显像在乳腺癌疗效评价及预后中的作用[J].国际放射医学核医学杂志,2014,38(5):332.[doi:10.3760/cma.j.issn.1673-4114.2014.05.013]
 Hu Meng-shang,Zhang Bin.The role of PET/CT imaging in the evaluation of the efficacy and prognosis of breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(6):332.[doi:10.3760/cma.j.issn.1673-4114.2014.05.013]
[14]袁建伟,杨劼,贺小红,等.乳腺癌18F-FDG PET/CT和3.0T MRI联合显像评分与Ki-67表达水平的相关性分析[J].国际放射医学核医学杂志,2013,37(2):84.[doi:10.3760/cma.j.issn.1673-4114.2013.02.006]
 YUAN Jian-wei,YANG Jie,HE Xiao-hong,et al.Correlation between combined imaging modalities of 18F-FDG PET/CT and 3.0T MRI and expression of Ki-67 in breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(6):84.[doi:10.3760/cma.j.issn.1673-4114.2013.02.006]
[15]袁建伟,杨劼,贺小红,等.18F-FDG PET/CT与3.0T MRI联合显像在乳腺癌原发病灶诊断中的价值[J].国际放射医学核医学杂志,2013,37(4):199.[doi:10.3760/cma.j.issn.1673-4114.2013.04.003]
 YUAN Jian-wei,YANG Jie,HE Xiao-hong,et al.Diagnosis value of 18F-FDG PET/CT and 3.0T MRI combined imaging in detecting the primary focus of breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(6):199.[doi:10.3760/cma.j.issn.1673-4114.2013.04.003]
[16]林美福,陈文新,周硕,等.18F-FES PET/CT显像在雌激素受体阳性乳腺癌诊疗中的初步应用[J].国际放射医学核医学杂志,2013,37(4):216.[doi:10.3760/cma.j.issn.1673-4114.2013.04.007]
 LIN Mei-fu,CHEN Wen-xin,ZHOU Shuo,et al.Application of 18F-FES PET/CT in diagnosis and endocrine therapy of patients with estrogen receptorpositive breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(6):216.[doi:10.3760/cma.j.issn.1673-4114.2013.04.007]
[17]夏晓天,张永学.影像学检查在乳腺癌的诊断及疗效评估中的应用价值[J].国际放射医学核医学杂志,2010,34(4):242.[doi:10.3760/cma.j.issn.1673-4114.2010.04.014]
 XIA Xiao-tian,ZHANG Yong-xue.The value of imaging examinations in diagnosis and curative effect evaluation of breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(6):242.[doi:10.3760/cma.j.issn.1673-4114.2010.04.014]
[18]鲁胜男,冯彦林.乳腺癌新辅助化疗过程中18F-FDG PET-CT与化疗前Ki-67、COX-2表达的相关性研究[J].国际放射医学核医学杂志,2011,35(4):238.[doi:10.3760/cma.j.issn.1673-4114.2011.04.011]
 LU Sheng-nan,FENG Yan-lin.The correlation analysis between 18F-FDG PET-CT in breast cancer with neoadjuvant chemotherapy and the expression of Ki-67 and COX-2 before neoadjuvant chemotherapy[J].International Journal of Radiation Medicine and Nuclear Medicine,2011,35(6):238.[doi:10.3760/cma.j.issn.1673-4114.2011.04.011]
[19]张亶,章斌,邓胜明,等.18F-FDG PET/CT在乳腺癌术后随访中的价值[J].国际放射医学核医学杂志,2017,41(3):159.[doi:10.3760/cma.j.issn.1673-4114.2017.03.001]
 Zhang Dan,Zhang Bin,Deng Shengming,et al.Clinical value of 18F-FDG PET/CT in follow-up of postoperative breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2017,41(6):159.[doi:10.3760/cma.j.issn.1673-4114.2017.03.001]

备注/Memo

备注/Memo:
收稿日期:2014-05-22。
基金项目:苏州市应用基础研究计划(SYS201224);苏州市科技发展计划项目(SYSD2013076)
通讯作者:章斌(Email:zbnuclmd@126.com)
更新日期/Last Update: 1900-01-01