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目的 比较~(99)Tc~m-MIBI SPECT/CT断层融合显像与SPECT平面显像在评价乳腺癌新辅助化疗(NAC)疗效中的效能,并探讨SPECT/CT断层融合显像的临床增益价值。资料与方法 回顾性分析2011年1月—2016年3月宁夏医科大学总医院穿刺活检病理确诊的乳腺癌患者47例,分别于NAC前和4～6疗程化疗后行~(99)Tc~mMIBI SPECT/CT显像。以NAC后手术切除的病理反应为标准,将纳入的研究对象分为有效组(n=30)和无效组(n=17),比较两组肿瘤对MIBI的摄取率及SPECT、CT和SPECT/CT融合显像评价NAC疗效的效能。结果 早期相有效组和无效组的平均放射性计数比值分别为1.46±0.58和1.10±0.48,差异有统计学意义(t=2.185,P<0.05)。SPECT、CT和SPECT/CT评价NAC疗效与病理反应结果比较,差异均无统计学意义(P>0.05);3种方法评价NAC疗效的敏感度、特异度和准确度分别为80.0%、52.9%和70.2%,86.7%、70.6%和80.9%及92.3%、88.2%和89.4%。SPECT/CT与SPECT平面显像评价NAC疗效的特异度和准确度差异有统计学意义(χ~2=5.10、8.16,P<0.05)。结论 肿瘤摄取率可预测NAC疗效的敏感性。~(99)Tc~m-MIBI SPECT/CT乳腺断层显像评价NAC疗效的效能高于SPECT平面显像。
Objective To compare the efficacy of ~(99)Tc~m-MIBI SPECT/CT tomography and SPECT planar imaging in evaluating the efficacy of neoadjuvant chemotherapy (NAC) in breast cancer, and to discuss the clinical gain of SPECT/CT tomographic fusion imaging. value. Materials and Methods Retrospective analysis of 47 cases of breast cancer patients diagnosed by needle biopsy from January 2011 to March 2016 at the General Hospital of Ningxia Medical University took ~99 Tc~mMIBI before NAC and after 4 to 6 cycles of chemotherapy. SPECT/CT imaging. Using the pathological response after surgical resection of NAC as the standard, the included subjects were divided into effective group (n=30) and ineffective group (n=17). The uptake rates of MIBI and SPECT, CT, and SPECT were compared between the two groups of tumors. CT fusion imaging evaluates the efficacy of NAC efficacy. Results The average radioactivity counts of the early phase effective group and the ineffective group were 1.46±0.58 and 1.10±0.48, respectively. The difference was statistically significant (t=2.185, P<0.05). There was no significant difference in the efficacy and pathological response of NAC between SPECT, CT and SPECT/CT (P>0.05). The sensitivity, specificity and accuracy of the three methods in evaluating NAC were 80.0% and 52.9%, respectively. And 70.2%, 86.7%, 70.6% and 80.9% and 92.3%, 88.2% and 89.4%. The specificity and accuracy of SPECT/CT and SPECT plane imaging evaluation of NAC were statistically significant (χ~2=5.10, 8.16, P<0.05). Conclusion Tumor uptake rate can predict the sensitivity of NAC efficacy. The efficacy of ~(99)Tc~m-MIBI SPECT/CT mammography in evaluating the efficacy of NAC was higher than that of SPECT.