유방암의 술 후 추적 관찰 시 양전자 방출 단층촬영의 적용
Application of Positron Emission Tomography (PET) in Postoperative Follow-Up of the Breast Cancer
김희정, 김정한, 김상욱, 남석진, 김병태, 양정현,
소속 상세정보
김희정 ( Kim Hee-Jung )
성균관대학교 의과대학 삼성서울병원 외과학교실
김정한 ( Kim Jung-Han )
성균관대학교 의과대학 삼성서울병원 외과학교실
김상욱 ( Kim Sang-Wook )
성균관대학교 의과대학 삼성서울병원 외과학교실
남석진 ( Nam Seok-Jin )
성균관대학교 의과대학 삼성서울병원 외과학교실
김병태 ( Kim Byung-Tae )
성균관대학교 의과대학 삼성서울병원 핵의학과
양정현 ( Yang Jung-Hyun )
성균관대학교 의과대학 삼성서울병원 외과학교실
KMID : 0371320020630020112
Abstract
Purpose: Positron Emission Tomography (PET) is an imaging method that can diagnose diseases by detecting physiologic and biochemical changes of the body. In this study, we attempted to evaluate the value of PET in the postoperative follow-up
of
breast cancer.
Methods: From September, 1994 to December, 2001, postoperative PET was performed 67 times at Samsung Medical Center on 66 patients who underwent curative operation for breast cancer. Clinical outcomes were confirmed by clinicoradiologic
courses,
fine needle aspiration cytology, biopsy and operation. We reviewed the medical records and PET reports of these patients.
Results: The time interval between operation and PET ranged from 1 to 88 months with a median of 26.5 months. The PET results were abnormal physical examination (23 cases, 34.3%), equivocal result of bone scan (22 cases, 2.8%), other
radiologic
abnormalities (9 cases, 13.4%), abnormal laboratory findings (4 cases, 6.0%), and symptoms of patients (4 cases, 6.0%). Among the 67 PET studies, 48 were confirmed as having metastasis or recurrence, while 19 did not have metastasis or
recurrence.
Forty-five of the studies produced true positive results, 16 true negative, 3 false positive and 3 false negative. Therefore, in the detection of postoperative metastasis or recurrence of breast cancer the parameters for the use of PET were 93.8%
sensitivity, 84.3% specificity, 93.8% positive predictive value, 84.3% negative predictive value and 91.0% accuracy. On the basis of the lesion site, the accuracy of PET in the detection of bone (98.5%), lung (100%) and liver (98.5%) metastases
was
superior to that of local recurrence (85.1%) or lymph node metastasis (86.6%).
Conclusion: PET may be diagnostically helpful in a select subgroup of patients for whom findings remain inconclusive after performning conventional postoperative follow-up methods for breast cancer, especially in the detection of bone, lung
and
liver metastases.
키워드
유방암; 양전자 방출 단층촬영; 술 후 추적 관찰; 전이; 재발; Breast cancer; PET; Postoperative follow-up; Metastasis; Recurrence;
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