CN113398287A - Reagent for detecting breast cancer axillary lymph node metastasis and application thereof - Google Patents

Abstract

The invention discloses a reagent for detecting breast cancer axillary lymph node metastasis and application thereof.¹⁸F-Alfatide II, or¹⁸F-Alfatide II and¹⁸the application of the combination of F-FDG in detecting axillary lymph node metastasis of breast cancer by PET/CT. Intravenous injection of PET/CT tracer to patient¹⁸F-Alfatide II or¹⁸The PET/CT examination is carried out after F-FDG,¹⁸F-Alfatide II T/NT has the highest Youden index (76.5%), specificity (100%), accuracy (89.2%), positive predictive value (100%). These data show that it is possible to identify,¹⁸F-Alfatide II T/NT may be the most valuable semi-quantitative parameter for evaluating axillary lymph nodes.

Description

Reagent for detecting breast cancer axillary lymph node metastasis and application thereof

Technical Field

The invention belongs to the field of biomedicine, and relates to a reagent for detecting breast cancer axillary lymph node metastasis and application thereof.

Background

Axillary lymph nodes are the most common metastatic sites of breast cancer, and the status of axillary lymph nodes determines the stage, treatment strategy and prognosis of breast cancer patients. Involvement of axillary lymph nodes by breast cancer usually means later staging, expansion of the surgical field, systemic treatment and lower survival rates, and axillary lymph node metastasis is also the most important predictor of recurrence and survival in breast cancer patients, and therefore, identification of axillary lymph node metastasis is critical to breast cancer patients. The gold standard for diagnosing axillary lymph node metastasis is lymph node surgical resection, however this approach can lead to complications such as arm edema, pain, neuropathy, etc. Although minimally invasive methods (e.g., sentinel lymph node biopsy, coarse needle biopsy, fine needle aspiration cytology) have significantly reduced complications than lymph node surgery, there is a risk of implant metastasis. For this reason, noninvasive evaluation of axillary lymph nodes is essential.

X-ray molybdenum targets, ultrasound, CT, and MRI are traditional methods for non-invasive assessment of axillary lymph node metastasis, which are based on anatomical abnormalities and morphological changes, and often do not accurately reflect the status of the lymph nodes. As a molecular imaging method, PET has clinical superiority compared with the traditional imaging method, and PET is widely applied to diagnosis, staging, curative effect evaluation and recurrence monitoring of tumors.¹⁸F-FDG is the most commonly used tracer for PET and provides information on glucose metabolism in tissues. A plurality of¹⁸The F-FDG PET or PET/CT studies have shown good promise in evaluating axillary lymph nodes, but relatively low sensitivity (50-80%),¹⁸F-FDG PET or PET/CT may underestimate the number of metastatic axillary lymph nodes. Therefore, there is a need to develop new PET tracers to more accurately assess axillary lymph nodes.

¹⁸F-Alfatide II is based on RGD peptidesThe PET tracer agent can target integrin alpha highly expressed on tumor new vessel activated endothelial cells_vβ₃Some are about¹⁸Studies with F-Alfatide II have shown the usefulness of this tracer in detecting tumors, predicting treatment response, and evaluating prognosis. However, as to¹⁸There are no reports of F-Alfatide II detecting metastasis in axillary lymph nodes of breast cancer.

Disclosure of Invention

The object of the present invention is to provide a solution to the above-mentioned disadvantages of the prior art¹⁸F-Alfatide II, or¹⁸F-Alfatide II and¹⁸use of a combination of F-FDG in the preparation of a PET/CT tracer for detecting metastasis to axillary lymph nodes of breast cancer.

Another object of the present invention is to provide an agent for detecting metastasis of axillary lymph nodes of breast cancer.

It is yet another object of the present invention to provide a method for detecting metastasis to axillary lymph nodes of breast cancer.

The purpose of the invention can be realized by the following technical scheme:

¹⁸F-Alfatide II, or¹⁸F-Alfatide II and¹⁸use of a combination of F-FDG in the preparation of a PET/CT tracer for detecting metastasis to axillary lymph nodes of breast cancer.

An agent for detecting metastasis of axillary lymph nodes of breast cancer, comprising¹⁸F-Alfatide II or¹⁸F-Alfatide II and¹⁸combinations of F-FDG in combination¹⁸F-Alfatide II and¹⁸F-FDG is independently packaged.

A method of detecting metastasis to axillary lymph nodes of breast cancer, comprising the steps of:

(1) intravenous PET/CT tracer¹⁸Carrying out PET/CT examination after F-Alfatide II;

(2) PET, CT and fused images are displayed on the post-processing workstation MSViewer, and if the radioactive uptake of the axillary lymph nodes is higher than the surrounding normal tissue, the visual analysis is determined to be positive; obtaining semi-quantitative parameters SUV for axillary lymph node delineation of region of interest_max(maximum standard uptake value) and SUV_mean(average standard uptake value); SUV is measured if axillary lymph nodes ipsilateral to the breast lesion have increased uptake of tracer_maxAnd measuring SUV of normal-sized axillary lymph node on the contralateral side of the breast lesion_maxThe axillary lymph nodes on the same side are SUV_maxAnd the contralateral axillary lymph node SUV_maxIn contrast, target/non-target SUV was calculated_maxThe uptake ratio is recorded as T/NT;

(3) comparing the T/NT value with the Cutoff value, and judging that the T/NT value is larger than the Cutoff value to be breast cancer axillary lymph node metastasis; to be provided with¹⁸When F-Alfatide II is a tracer, the Cutoff value is 2.5.

A method of detecting metastasis to axillary lymph nodes of breast cancer, comprising the steps of:

(1) respective intravenous PET/CT tracer¹⁸F-Alfatide II or¹⁸Performing PET/CT examination after F-FDG; the two examinations are separated by one day;

(2) PET, CT and fused images are displayed at a post-processing workstation, and if the radioactive uptake of the axillary lymph nodes is higher than that of the surrounding normal tissues, the visual analysis is determined to be positive; obtaining semi-quantitative parameters SUV for axillary lymph node delineation of region of interest_maxAnd SUV_mean(ii) a SUV is measured if axillary lymph nodes ipsilateral to the breast lesion have increased uptake of tracer_maxAnd measuring the normal size of axillary lymph node SUV contralateral to the breast lesion_maxThe axillary lymph nodes on the same side are SUV_maxAnd the contralateral axillary lymph node SUV_maxIn contrast, target/non-target SUV was calculated_maxThe uptake ratio is recorded as T/NT;

(3) comparing the T/NT value with the Cutoff value, and judging that the T/NT value is larger than the Cutoff value to be breast cancer axillary lymph node metastasis; to be provided with¹⁸When F-Alfatide II is used as tracer, the Cutoff value is 2.5, so that¹⁸When F-FDG is a tracer, the Cutoff value is 2.745.

Has the advantages that:

the invention finds combined application¹⁸F-Alfatide II and¹⁸F-FDG can obviously improve the sensitivity and the negative predictive value of detecting the metastasis of axillary lymph nodes of breast cancer, and shows the mutual complementary action of the two tracers.¹⁸F-Alfatide II evaluation of axillary lymph nodes of luminal B breast cancer¹⁸F-FDG exerts a complementary effect; while¹⁸F-FDG can compensate¹⁸F-Alfatide II was deficient in assessing triple negative breast cancer axillary lymph nodes. According to the semi-quantitative evaluation results of the present invention,¹⁸three parameters (SUV) of F-Alfatide II_max、SUV_meanT/NT) are greater than 0.8, indicating that they have great potential for detecting axillary lymph node metastases. As shown in Table 3, the best cutoff value for diagnosing axillary lymph node metastasis,¹⁸F-Alfatide II SUV_maxthe content of the organic acid is 1.1,¹⁸F-Alfatide II SUV_meanthe content of the organic acid is 0.8,¹⁸F-Alfatide II T/NT is 2.5. Although it is not limited to¹⁸Area under the curve of F-Alfatide II: (<0.9) are all less than¹⁸F-FDG(>0.9), but¹⁸F-Alfatide II T/NT has the highest Youden index (76.5%), specificity (100%), accuracy (89.2%), positive predictive value (100%). These data show that it is possible to identify,¹⁸F-Alfatide II T/NT may be the most valuable semi-quantitative parameter for evaluating axillary lymph nodes. Therefore, the temperature of the molten metal is controlled,¹⁸F-Alfatide II, or¹⁸F-Alfatide II and¹⁸the combination of F-FDG can be applied to PET/CT detection of breast cancer axillary lymph node metastasis.

Drawings

FIG. 1. female, age 49, HER-2 overexpressing breast cancer (blue arrow) with axillary lymph node metastasis (red arrow),¹⁸F-Alfatide II、¹⁸F-FDG uptake was increased.

FIG. 2 female, 47 years old, luminal B breast cancer (blue arrow)¹⁸F-Alfatide II、¹⁸F-FDG uptake was increased, but axillary lymph node metastases were not seen¹⁸F-Alfatide II、¹⁸F-FDG uptake was increased (red arrow).

FIG. 3. female, age 46, triple negative breast cancer (blue arrow) with axillary lymph node metastasis (red arrow), not seen¹⁸Increased uptake of F-Alfatide II, however¹⁸F-FDG uptake is increased.

FIG. 4. female, age 60, luminal B breast cancer (blue arrow) with axillary lymph node metastasis (red arrow),¹⁸F-Alfatide II uptakeIncrease the height but not seen¹⁸F-FDG uptake is increased.

FIG. 5. female, age 57, carcinoma in situ in the mammary duct (blue arrow),¹⁸F-Alfatide II、¹⁸increased uptake of F-FDG and non-metastatic lymph nodes¹⁸F-Alfatide II、¹⁸F-FDG uptake was slightly increased.

Fig. 6.⁸F-Alfatide II、¹⁸F-FDG diagnoses axillary lymph node metastasis ROC curve of breast cancer.

Detailed Description

Example 1

1. Patient data

The study was approved by the eastern war zone general hospital ethics committee (approval No.: 2015NZYW-007), and was registered at the clinical trial website (accession No.: NCT 02582801). Patient enrollment criteria: traditional imaging examinations for suspicious breast cancer; no treatment was given to the breast lesions; age 18 < age < 70. Exclusion criteria included: pregnancy or lactation; with severe disease (such as liver and kidney function damage, active tuberculosis, and other malignant tumors). 44 female patients (age range: 28-66 years; mean age: 50.73. + -. 8.01 years) were included in the study, each patient signed an informed consent.

PET/CT acquisition

¹⁸Synthetic preparation of F-Alfatide II reference (Guo J, Lang L, Hu S, et al. Comparison of three dimer)¹⁸F-ALF-NOTA-RGD tracers.Mol Imaging Biol,2014,16:274-83.)。¹⁸F-Alfatide II、 ¹⁸The two scans of F-FDG PET/CT are separated by at least one day and completed within one week.¹⁸No special preparation is needed before F-Alfatide II injection,¹⁸fasting is required for at least 6 hours prior to F-FDG injection.¹⁸The F-Alfatide II injection dose is 306 +/-80 MBq (range: 155-503MBq),¹⁸the F-FDG injection dose was 3.7MBq per kg body weight. In addition to this, the present invention is,¹⁸before F-FDG injection, blood sugar needs to be confirmed to be below 140 mg/dL. After intravenous tracer injection, the patient was rested for 60 minutes and examined by PET/CT using a Biographic 16PET/CT scanner from Siemens Germany. Firstly, CT acquisition is started, the tube voltage is 120kV, the tube current is 140mA,the layer thickness was 5 mm. PET acquisition was then started for 3 minutes per bed, and the PET data was reconstructed iteratively and corrected for attenuation using CT data.

3. Imaging analysis

The PET, CT, and fused images are displayed at a post-processing workstation and interpreted by two experienced nuclear medicine physicians and agreed upon, neither physician being aware of the histological diagnosis and other imaging results. Visual analysis is judged positive if the axillary lymph nodes have higher radioactive uptake than surrounding normal tissue. Obtaining semi-quantitative parameters SUV for axillary lymph node delineation of region of interest_maxAnd SUV_mean. SUV is measured if axillary lymph nodes ipsilateral to the breast lesion have increased uptake of tracer_maxAnd measuring SUV of normal-sized axillary lymph node on the contralateral side of the breast lesion_maxThe axillary lymph nodes on the same side are SUV_maxAnd the contralateral axillary lymph node SUV_maxIn contrast, target/non-target (T/NT) SUV was calculated_maxUptake ratio.

4. Histological analysis

After two PET/CT examinations, the breast lesion of the patient is subjected to biopsy or surgery, and the axillary lymph node of some patients is subjected to biopsy or surgery. Tissue specimens from these patients are routinely subjected to HE staining, and if HE staining confirms diagnosis of breast cancer, immunohistochemistry involving ER, PR, HER-2, Ki-67 is performed to further molecularly classify the breast cancer. If the results of HER-2 immunohistochemistry are ambiguous, FISH is additionally performed to further confirm HER-2 status. Based on immunohistochemistry and FISH results, breast cancer is further divided into four subtypes, namely luminal a, luminal B, HER-2 overexpression, and tripartite.

5. Statistical analysis

Statistical analysis used SPSS software (version 17.0), all semi-quantitative data were expressed as mean ± standard deviation, comparison of two independent samples used t-test, calculation of sensitivity, specificity, accuracy, positive predictive value, negative predictive value for each diagnostic parameter, ROC curve analysis to assess diagnostic performance, determination of area under the curve and cutoff value from the maximum Youden index, P value less than 0.05 considered statistically significant.

Results

1. Pathological results

Of the 44 patients, 39 patients were pathologically diagnosed as breast cancer and 5 patients were diagnosed as benign lesions of the breast. Of the 39 breast cancer patients, 2 patients had no biopsy or surgery on the axillary lymph node, and thus the axillary lymph nodes of these two patients were unable to determine whether metastasis was present. Unambiguous pathological results were obtained for the axillary lymph nodes of 37 breast cancer patients, of which 17 confirmed axillary lymph node metastasis and 20 did not. Of 37 breast cancer patients, 4 ductal carcinoma patients were excluded, 33 invasive breast cancer patients were further divided into four subtypes, and axillary lymph node metastasis occurred in 2 cases of luminal a (2/5), 8 cases of luminal B (8/14), 3 cases of HER-2 overexpression (3/4), and 4 cases of triple negative (4/10).

2. Visual evaluation results

Of 17 patients with axillary lymph node metastasis, 12 patients were used¹⁸F-Alfatide II was correctly diagnosed (FIG. 1), 5 cases of false negativity (FIG. 2). As a comparison, 11 cases used¹⁸F-FDG was diagnosed correctly (FIG. 1), 6 false negatives (FIG. 2). By means of a combination¹⁸F-Alfatide II and¹⁸F-FDG, false negative was reduced to 3 cases. In 20 patients without axillary lymph node metastasis, the drug is administered¹⁸F-Alfatide II has 18 true negatives and 2 false positives. Use of¹⁸The number of true negatives was 18 in F-FDG, and the number of false positives was 2. 1 patient¹⁸F-Alfatide II and¹⁸F-FDG was false positive. By means of a combination¹⁸F-Alfatide II and¹⁸F-FDG, the number of false positives is 3. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the two tracers are shown in a table 1.¹⁸F-Alfatide II and¹⁸F-FDG has the same high specificity (90%), relatively low sensitivity (70.6% vs. 64.7%), and similar accuracy (81.1% vs. 78.4%), positive predictive value (85.7% vs. 84.6%), and negative predictive value (78.3% vs. 75%). When two tracers are used in combination, sensitivity and negative predictive value are shownThe accuracy is improved to 82.4 percent and 85 percent, and the accuracy is improved to 83.8 percent.

3 patients¹⁸F-Alfatide II and¹⁸F-FDG was false negative, and all 3 patients were of luminal B (FIG. 2). Other two examples¹⁸The F-Alfatide II false negative patients were of the triple negative type (FIG. 3), and 3 other cases¹⁸Patients that were false negative for F-FDG were also luminal B (FIG. 4). Axillary lymph nodes of 1 ductal carcinoma in situ¹⁸F-Alfatide II and¹⁸F-FDG was false positive (FIG. 5),¹⁸another false positive for F-Alfatide II is luminal B, whereas¹⁸Another false positive for F-FDG is the HER-2 overexpression type.

3. Semi-quantitative evaluation results

ROC curves for various semi-quantitative parameters are shown in figure 6,¹⁸F-Alfatide II and¹⁸the ROC curves for F-FDG are all located above and to the left of the chance line, indicating that they have strong potential to identify axillary lymph node metastases of breast cancer, however,¹⁸the area under the curve of F-Alfatide II is slightly lower than that of¹⁸F-FDG. The corresponding statistical indices of the ROC curves are presented in table 2,¹⁸the area under the curve of F-Alfatide II is between 0.8 and 0.9, and¹⁸the area under the curve of F-FDG exceeds 0.9. Of these semi-quantitative parameters, the maximum Youden indices are very close,¹⁸the F-Alfatide II T/NT has the highest Youden index (76.5%), which indicates that the parameter has the highest diagnosis accuracy. Corresponding to the maximum Youden index, each semi-quantitative parameter has a respective cutoff value, and based on the respective cutoff value, the respective sensitivity, specificity, accuracy, positive predictive value, and negative predictive value are calculated (Table 1). Although it is not limited to¹⁸The sensitivity of each parameter of F-Alfatide II is lower than that of F-Alfatide II¹⁸F-FDG, however¹⁸The specificity of the F-Alfatide II parameter is better than or equal to that of the F-Alfatide II parameter¹⁸F-FDG parameter, in particular¹⁸F-Alfatide II T/NT has the highest specificity (100%), accuracy (89.2%) and positive predictive value (100%).¹⁸F-FDG T/NT showed the highest sensitivity (88.2%) and negative predictive value (89.5%).

4. Comparison of axillary lymph nodes of different groups

¹⁸SUV was used for F-Alfatide II_max、SUV_meanThe results of the comparison of T/NT in the metastatic axillary lymph node group and the non-metastatic axillary lymph node group are shown in Table 3,¹⁸the results of the comparison of F-FDG between the two groups are also given in Table 3. Using SUV_max、SUV_meanT/NT, metastatic axillary lymph node¹⁸F-Alfatide II、¹⁸The uptake of F-FDG was higher than that of non-metastatic lymph nodes. Primary focus of mammary gland, SUV, for metastatic axillary lymph node group and non-metastatic axillary lymph node group_max、SUV_meanThe results of comparison of the three parameters T/NT are shown in Table 4, and the differences between the primary foci of the two groups of mammary glands are not statistically significant (all P values are greater than 0.05).

Table 1.¹⁸F-Alfatide II、¹⁸Visual and semi-quantitative analysis of F-FDG diagnosis of axillary lymph node metastasis of breast cancer

Table 2.¹⁸F-Alfatide II、¹⁸ROC analysis of F-FDG diagnosis of axillary lymph node metastasis of Breast cancer

TABLE 3 between metastatic axillary lymph nodes and non-metastatic axillary lymph nodes¹⁸F-Alfatide II、¹⁸Comparison of F-FDG uptake

TABLE 4. between primary foci of mammary gland of metastatic axillary lymph nodes and primary foci of mammary gland of non-metastatic axillary lymph nodes¹⁸F-Alfatide II、¹⁸Comparison of F-FDG uptake

The results of the visual evaluation of this study show that,¹⁸F-Alfatide II for detecting false negative rate and false negative rate of axillary lymph node metastasis¹⁸F-FDG is similar (5/17vs.6/17), but¹⁸False positive rate of F-Alfatide II and¹⁸same as F-FDG (2/20). And¹⁸compared with the F-FDG, the method has the advantages that,¹⁸F-Alfatide II has the same high specificity (90%) and relatively higher sensitivity (70.6%), and,¹⁸the accuracy, positive predictive value and negative predictive value of the F-Alfatide II are slightly higher than those of the F-Alfatide II¹⁸F-FDG。¹⁸F-Alfatide II diagnosis of mammary cancer axillary lymph node metastasis¹⁸F-FDG has further advantages. To pair¹⁸F-Alfatide II and¹⁸the relatively large number of false negatives is responsible for the lower sensitivity in the case of F-FDG, but the combined use¹⁸F-Alfatide II and¹⁸F-FDG can significantly improve sensitivity and negative predictive value, indicating the mutual complementary action of the two tracers.

To pair¹⁸For F-FDG, all 6 cases of false negatives were of the luminal B type. With respect to hormone receptor status, whether HER-2 overexpression is equal¹⁸F-FDG uptake is still controversial, in the case of luminal B breast cancer patients, even though the axillary lymph nodes are absent¹⁸F-FDG uptake, which still needs to be kept alert. To pair¹⁸In the case of F-Alfatide II, 3 of the 5 false negatives were also of luminal B, probably due to the fact that the axillary lymph nodes in these 3 cases were too small. Other 2 examples of the¹⁸The F-Alfatide II false negative is of the tripartite negative type. Our previous section of research also demonstrated that the primary focus of triple negative breast cancer was the lowest compared to the other triple types¹⁸F-Alfatide II uptake, thus¹⁸F-Alfatide II also showed similar results to the primary focus, i.e., high false negative rate, when evaluating the triple negative type breast cancer axillary lymph nodes. Based on the results of these tests, it was found that,¹⁸F-Alfatide II in evaluating axillary lymph nodes of luminal B breast cancer¹⁸F-FDG exerts a complementary effect; while¹⁸F-FDG can compensate¹⁸F-Alfatide II was deficient in the evaluation of the triple negative breast cancer axillary lymph nodes.

According to the semi-quantitative evaluation results of the present invention,¹⁸three parameters (SUV) of F-Alfatide II_max、SUV_meanT/NT) are greater than 0.8, indicating that they have great potential for detecting axillary lymph node metastases. As shown in Table 2, the best cutoff value for diagnosing axillary lymph node metastasis,¹⁸F-Alfatide II SUV_maxthe content of the organic acid is 1.1,¹⁸F-Alfatide II SUV_meanthe content of the organic acid is 0.8,¹⁸F-Alfatide II T/NT is 2.5. Although it is not limited to¹⁸Area under the curve of F-Alfatide II: (<0.9) are all less than¹⁸F-FDG(>0.9), but¹⁸F-Alfatide II T/NT has the highest Youden index (76.5%), specificity (100%), accuracy (89.2%), positive predictive value (100%). These data show that it is possible to identify,¹⁸F-Alfatide II T/NT is probably the most valuable semi-quantitative parameter for evaluating axillary lymph nodes.

Claims (4)

1.¹⁸F-Alfatide II, or¹⁸F-Alfatide II and¹⁸use of a combination of F-FDG in the preparation of a PET/CT tracer for detecting metastasis to axillary lymph nodes of breast cancer.

2. An agent for detecting metastasis of axillary lymph nodes of breast cancer, comprising¹⁸F-Alfatide II or¹⁸F-Alfatide II and¹⁸combinations of F-FDG in combination¹⁸F-Alfatide II and¹⁸F-FDG is independently packaged.

3. A method for detecting metastasis to axillary lymph nodes of breast cancer, comprising the steps of:

(1) injecting positive electron tracer to vein of patient¹⁸Carrying out PET/CT examination after F-Alfatide II;

(2) PET, CT and fused images are shown at the post-processing workstation if the axillary lymph nodes have higher radioactivity uptake than the surrounding normal tissueJudging the test result to be positive in visual analysis; obtaining semi-quantitative parameters SUV for axillary lymph node delineation of region of interest_maxSUV is measured if axillary lymph nodes ipsilateral to the breast lesion have increased uptake of tracer_maxAnd measuring SUV of normal-sized axillary lymph node on the contralateral side of the breast lesion_maxThe axillary lymph nodes on the same side are SUV_maxAnd the contralateral axillary lymph node SUV_maxIn contrast, target/non-target SUV was calculated_maxThe uptake ratio is recorded as T/NT;

(3) comparing the T/NT value with the Cutoff value, and judging that the T/NT value is larger than the Cutoff value to be breast cancer axillary lymph node metastasis; to be provided with¹⁸When F-Alfatide II is a tracer, the Cutoff value is 2.5.

4. A method for detecting metastasis to axillary lymph nodes of breast cancer, comprising the steps of:

(1) respectively injecting positron tracer to patients intravenously¹⁸F-Alfatide II or¹⁸Performing PET/CT examination after F-FDG;

(2) PET, CT and fused images are displayed at a post-processing workstation, and if the radioactive uptake of the axillary lymph nodes is higher than that of the surrounding normal tissues, the visual analysis is determined to be positive; obtaining semi-quantitative parameters SUV for axillary lymph node delineation of region of interest_maxAnd SUV_mean(ii) a SUV is measured if axillary lymph nodes ipsilateral to the breast lesion have increased uptake of tracer_maxAnd measuring SUV of normal-sized axillary lymph node on the contralateral side of the breast lesion_maxThe axillary lymph nodes on the same side are SUV_maxAnd the contralateral axillary lymph node SUV_maxIn contrast, target/non-target SUV was calculated_maxThe uptake ratio is recorded as T/NT;

(3) comparing the T/NT value with the Cutoff value, and judging that the T/NT value is larger than the Cutoff value to be breast cancer axillary lymph node metastasis; to be provided with¹⁸When F-Alfatide II is used as tracer, the Cutoff value is 2.5, so that¹⁸When F-FDG is a tracer, the Cutoff value is 2.745.

Images