Analysis of the relationship between 18F-FDG PET/CT and ultrasound BI-RADS classification and their combined application in the diagnosis of breast diseases.

Abstract

Objective: To analyze the relationship between fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) and ultrasound breast imaging reporting and data system (BI-RADS) classification, and to evaluate the diagnostic value of their combined application in breast diseases.

Subjects and methods: A retrospective analysis was conducted on the ¹⁸F-FDG PET/CT images and ultrasound BI-RADS classification data of 110 patients with suspected breast cancer treated at our hospital from July 2020 to May 2022. Pearson correlation analysis was used to assess the relationship between the maximum standardized uptake value (SUVmax) and BI-RADS classification. Using pathology or long-term follow-up results as the "gold standard," the diagnostic value of ¹⁸F-FDG PET/CT, ultrasound BI-RADS classification, and their combined application in breast diseases was analyzed.

Results: Based on the "gold standard" of pathology or long-term follow-up, of the 110 patients with suspected breast cancer, 49 were benign, and 61 were malignant. The SUVmax levels of malignant lesions were significantly higher than those of benign lesions (P<0.05). Pearson correlation analysis indicated a low correlation between SUVmax and ultrasound BI-RADS classification (r=0.458, P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of the combined application of SUVmax and ultrasound BI-RADS classification was higher than that of either method alone, both for breast tumors and for patients classified as BI-RADS category 3 to 4.

Conclusion: The correlation between SUVmax and ultrasound BI-RADS classification is low (r=0.458), indicating that these two methods assess different biological aspects of breast tumors. However, the combined use of SUVmax and BI-RADS classification significantly enhances diagnostic accuracy, particularly for patients with BI-RADS 3 to 4 lesions. Although this combination improves diagnostic efficacy, ¹⁸F-FDG PET/CT should not be used as a primary screening tool but rather as a complementary method in specific clinical scenarios where imaging findings are inconclusive or suspicion of malignancy is high.