Apparent diffusion coefficient values of diffusion-weighted imaging for distinguishing focal pulmonary lesions and characterizing the subtype of lung cancer: a meta-analysis.

OBJECTIVES: The potential performance of apparent diffusion coefficient (ADC) values for distinguishing malignant and benign pulmonary lesions, further characterizing the subtype of lung cancer was assessed. METHODS: PubMed, EMBASE, Cochrane Library, EBSCO, and three Chinese databases were searched to identify eligible studies on diffusion-weighted imaging (DWI) of focal pulmonary lesions. ADC values of malignant and benign lesions were extracted by lesion type and statistically pooled based on a linear mixed model. Further analysis for subtype of lung cancer was also performed. The methodological quality was assessed using the quality assessment of diagnostic accuracy studies tool. RESULTS: Thirty-four articles involving 2086 patients were included. Malignant pulmonary lesions have significantly lower ADC values than benign lesions [1.21 (95% CI, 1.19-1.22) mm(2)/s vs. 1.76 (95% CI, 1.72-1.80) mm(2)/s; P < 0.05]. There is a significant difference between ADC values of small cell lung cancer and non-small cell lung cancer (P < 0.05), while the differences were not significant among histological subtypes of lung cancer. The methodological quality was relatively high, and the data points from Begg's test indicated that there was probably no obvious publication bias. CONCLUSIONS: The ADC value is helpful for distinguishing malignant and benign pulmonary lesions and provides a promising method for differentiation of SCLC from NSCLC. KEY POINTS: • This meta-analysis assesses the role of DWI in pulmonary lesions. • Differentiation and classification subtype of lung cancer is essential for treatment decision-making. • ADC values can help distinguish between malignant and benign lesions. • ADC values might help characterize the subtype of lung cancer.

Performance of DWI in the Nodal Characterization and Assessment of Lung Cancer: A Meta-Analysis.

OBJECTIVE: The purpose of this study is to assess the diagnostic performance of DWI in the N stage assessment of patients with lung cancer. MATERIALS AND METHODS: The PubMed, EMBASE, Cochrane Library, Web of Science, and EBSCO English-language databases and two Chinese-language databases were searched for eligible studies. On the basis of the data extracted from included studies, we determined the pooled sensitivity and specificity, calculated the positive and negative likelihood ratios, and constructed summary ROC curves. In addition, we also performed threshold effect analysis, metaregression analysis, subgroup analysis, and publication bias analysis to explain the source of heterogeneity. RESULTS: A total of 18 articles involving 1116 patients met the inclusion criteria. On a per-patient basis, the pooled sensitivity and specificity estimates of DWI were 0.68 (95% CI, 0.63-0.73) and 0.92 (95% CI, 0.90-0.94), respectively. On a per-lesion basis, the corresponding estimates were 0.72 (95% CI, 0.69-0.75) for sensitivity and 0.96 (95% CI, 0.95-0.96) for specificity. Only the analysis method (quantitative vs qualitative) affected the diagnostic accuracy on the basis of subgroup and metaregression analysis. CONCLUSION: Current evidence suggests that DWI is beneficial in the nodal assessment of patients with lung cancer, and it is necessary to conduct high-quality prospective studies regarding the use of DWI in detecting metastatic lymph nodes of lung cancer to determine its true value.

[Meta-analysis of PET/CT for diagnosis of residual/recurrent nasopharyngeal carcinoma].

OBJECTIVE: To assess the diagnostic value of 18-fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in detecting residual/recurrent nasopharyngeal carcinoma. METHOD: The literatures published between January 1990 and September 2013 were searched in PubMed, EM-BASE, EBSCO, Web of Science, CBM, CNKI, VIP and Wanfang databases. Two researchers independently selected studies, extracted data and assessed the quality of included studies according to the QUADAS tool. Summary sensitivity, specificity, diagnostic odds ratios (DOR), and receiver-operating characteristic (SROC) curves were obtained using Meta-Disc software. Subgroup analysis was also conducted. RESULT: Twenty-six studies were included in this meta-analysis, involving 1203 patients. The pooled sensitivity, specificity and DOR were 0. 92 (95% CI:0.89-0.94), 0. 87 (95% CI:0.84-0.90) and 51. 10 (95% CI:34.29-76.15), respectively. The area under the curve (AUC) and Q index estimate for PET/CT were 0. 9494 and 0. 8897, respectively. The results of subgroup analysis showed no significant differences between subgroups(P>0.05). CONCLUSION: In a word, 18F-FDG PET/CT performed well for diagnosis of residual/recurrent nasopharyngeal carcinoma, with relatively high sensitivity and specificity.

Interesting Layering of Excreted 18F-FDG in the Urinary Bladder in Patients with Urinary Tract Infection and Distended Bladder.

Settling of (18)F-FDG in the bladder is often noted on whole-body PET/CT images, but this phenomenon has never received any careful attention and the mechanism has been unclear. The 2 patients described in this report, one with a T1 pathologic fracture and another with widespread bone and lymph node metastases from an unknown primary tumor, underwent PET/CT. Both had urinary tract infection and a distended bladder during scanning. The interesting layering of (18)F-FDG in the urinary bladder was observed in both patients. The presence of this phenomenon demands careful evaluation of the urine by the clinician, and the mechanism is hypothesized to be slow (18)F-FDG excretion in patients with a distended urinary bladder, resulting in delayed mixing with urine. In addition, urinary tract infection may be a potential cause. Images showing this interesting layering should be interpreted with care.

Diagnostic value of dual time-point 18 F-FDG PET/CT versus single time-point imaging for detection of mediastinal nodal metastasis in non-small cell lung cancer patients: a meta-analysis.

BACKGROUND: Lymph node staging in non-small cell lung cancer (NSCLC) is challenging and important for determining treatment policy. Conflicting results have been presented to date. PURPOSE: To evaluate the diagnostic performance of dual time-point (DTP) 18 F-FDG PET/CT compared with single time-point (STP) imaging for detecting mediastinal nodal metastases in patients with NSCLC. MATERIAL AND METHODS: The PubMed, EMBASE, EBSCO, and Web of Knowledge databases were searched for relevant articles. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were calculated using Meta-Disc software. Summary receiver-operating characteristic (SROC) curves were also constructed. The potential for between-study heterogeneity was explored using subgroup analyses. RESULTS: A total of eight studies involving 654 patients fulfilled the inclusion criteria. On a per-patient analysis, the pooled sensitivity and specificity with a 95% confidence interval (CI) for DTP PET/CT were 0.85 (0.78-0.91), 0.75 (0.68-0.82), and for STP imaging, they were 0.79 (0.70-0.85), 0.73 (0.65-0.79), respectively. On a per-lesion basis, the corresponding values for DTP imaging were 0.84 (0.81-0.86), 0.89 (0.87-0.91), and for STP imaging, they were 0.84 (0.80-0.86), 0.83 (0.81-0.85), respectively. CONCLUSION: DTP PET/CT performed better than STP imaging in evaluating the lymph node status of NSCLC patients and had the potential to be broadly applied in clinical practice. However, due to the small sample size and large heterogeneity, current evidence does not justify the implementation of DTP imaging in routine PET protocols for mediastinal lymph node staging of NSCLC.

[Diagnostic value of MRI versus 99Tcm-MDP bone scan in osseous metastasis of prostate cancer: a meta-analysis].

This paper is aimed to assess the diagnostic value of MRI versus 99 Tcm-methylene diphosphonate (99 Tcm- MDP) bone scan (BS) for osseous metastases in patients with prostate cancer. The computer-based retrieval was conducted on PubMed, EMBASE, EBSCO, Web of Knowledge, the Cochrane Library and Ovid data bases to search for trials about diagnosing osseous metastases of prostate cancer with MRI and 99Tc"m-MDP BS. Selected with time acceptance and time exclusion criteria, the data quality were evaluated with QUADAS quality assessment tool and collected. We used the Meta-Disc software to conduct meta-analysis, and then calculated the pooled sensitivity, specificity and diagnostic odds ratio (DOR), drew the summary receiving operating characteristic (SROC) curve, and measured the area under curve (AUC) and Q value. Then five studies were included, involving 353 patients. The pooled sensitivity of MRI and BS was 0. 95 (95% CI 0. 90~0. 98) and 0. 67 (95% CI 0. 58~0. 75), respectively. The pooled specificity was 0. 97 (95% CI 0. 94~0. 99) and 0. 88 (95% CI 0. 83~0. 91), respectively. The pooled DOR was 402.99 (95% CI 119. 05 ~1364. 15) and 23. 85 (95% CI 1. 32~431. 48), respectively. The AUC was 0. 990 1 and 0. 624 1, respectively. The Q was 0. 958 7 and 0. 593 8. It can well be concluded that MRI is more effective than 99 Tcm-MDP BS in the diagnosis of osseous metastases in patients with prostate cancer.

Potential performance of dual-time-point 18F-FDG PET/CT compared with single-time-point imaging for differential diagnosis of metastatic lymph nodes: a meta-analysis.

In recent years, dual-time-point (DTP) fluorine-18 fluorodeoxyglucose PET/computed tomography (CT) has emerged as a new method for evaluating metastatic lymph nodes in cancer patients. We performed this meta-analysis to evaluate the performance of DTP PET/CT compared with single-time-point (STP) imaging for differential diagnosis of lymph nodes metastases. On the basis of data from included studies, pooled sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio were calculated. Summary receiver-operating characteristic curves were also constructed to assess the diagnostic value of DTP PET/CT and STP imaging in detecting metastatic lymph nodes. Totally, 17 articles were included in the analysis. On a per-patient basis, the pooled sensitivity and specificity were 0.74 [95% confidence interval (CI): 0.68-0.79] and 0.77 (95% CI: 0.72-0.81) for DTP PET/CT and 0.68 (95% CI: 0.61-0.73) and 0.81 (95% CI: 0.78-0.85) for STP PET/CT, respectively. On a per-lesion basis, the pooled sensitivity of DTP and STP PET/CT was 0.82 (95% CI: 0.79-0.84) and 0.80 (95% CI: 0.78-0.83), respectively. The pooled specificity was 0.88 (95% CI: 0.86-0.89) for DTP PET/CT and 0.82 (95% CI: 0.80-0.84) for STP PET/CT. Compared with STP imaging, DTP PET/CT has higher sensitivity but lower specificity in detecting lymph nodes metastases on a per-patient analysis, and DTP PET/CT performs only a little better than STP PET/CT on a per-lesion basis. The current results of our meta-analysis do not support the routine use of DTP imaging for the diagnosis of metastatic lymph nodes. Further prospective research with large samples is required to better define the potential benefits of DTP PET/CT imaging.

Comparison of choline-PET/CT, MRI, SPECT, and bone scintigraphy in the diagnosis of bone metastases in patients with prostate cancer: a meta-analysis.

Published data on the diagnosis of bone metastases of prostate cancer are conflicting and heterogeneous. We performed a comprehensive meta-analysis to compare the diagnostic performance of choline-PET/CT, MRI, bone SPECT, and bone scintigraphy (BS) in detecting bone metastases in parents with prostate cancer. Pooled sensitivity, specificity, and diagnostic odds ratios (DOR) were calculated both on a per-patient basis and on a per-lesion basis. Summary receiver operating characteristic (SROC) curves were also drawn to obtain the area under curve (AUC) and Q* value. Sixteen articles consisting of 27 studies were included in the analysis. On a per-patient basis, the pooled sensitivities by using choline PET/CT, MRI, and BS were 0.91 [95% confidence interval (CI): 0.83-0.96], 0.97 (95% CI: 0.91-0.99), 0.79 (95% CI: 0.73-0.83), respectively. The pooled specificities for detection of bone metastases using choline PET/CT, MRI, and BS, were 0.99 (95% CI: 0.93-1.00), 0.95 (95% CI: 0.90-0.97), and 0.82 (95% CI: 0.78-0.85), respectively. On a per-lesion basis, the pooled sensitivities of choline PET/CT, bone SPECT, and BS were 0.84 (95% CI: 0.81-0.87), 0.90 (95% CI: 0.86-0.93), 0.59 (95% CI: 0.55-0.63), respectively. The pooled specificities were 0.93 (95% CI: 0.89-0.96) for choline PET/CT, 0.85 (95% CI: 0.80-0.90) for bone SPECT, and 0.75 (95% CI: 0.71-0.79) for BS. This meta-analysis indicated that MRI was better than choline PET/CT and BS on a per-patient basis. On a per-lesion analysis, choline PET/CT with the highest DOR and Q* was better than bone SPECT and BS for detecting bone metastases from prostate cancer.

[Positron emission tomography for molecular imaging of prostate cancer].

Prostate cancer is the most common malignancy in the urinary system of males. The remarkable biological and clinical heterogeneity of prostate cancer poses challenges to the initial diagnosis, differential diagnosis, treatment, and prognosis of the disease. Positron emission tomography/computed tomography (PET/CT) is an ideal imaging tool for noninvasive interrogation of underlying tumor biology. Recently, there are a variety of molecular imaging paths and radiopharmaceuticals for the diagnosis and treatment of prostate cancer. This article reviews the current state and prospects of the application of PET in the diagnosis of prostate cancer.

[Influence of endogenous TgAb upon serum Tg measurement results and Tg positive rate in patients with differentiated thyroid carcinoma].

The first aim of this study was to compare the serum thyroglobulin (Tg) positive rate between differentiated thyroid carcinoma (DTC) patients with positive thyroglobulin antibody (TgAb) and patients with negative TgAb. The second aim of this study was to investigate the correlation between serum Tg value and antithyroglobulin (TgAb) concentration of patients with DTC. We collected the serum Tg value and TgAb concentration of patients with DTC after thyroid ablation by operation and radioiodine therapy retrospectively. Then we investigated the Tg positive rate of DTC patients with positive TgAb and patients with negative TgAb separately. The scatter diagram between serum Tg value and TgAb concentration of DTC patients was performed to analyze their potential relationship. As a result, among 252 patients with DTC after thyroid ablation, 7 of 47 patients (14.89%) with positive TgAb (>115 IU/mL) had positive serum Tg (>10 microg/L), and 61 of 205 (29.76%) patients with negative TgAb (<115 IU/mL) had positive serum Tg. Eighty three of the 252 patients with DTC had accurate serum Tg and TgAb concentration. No correlation between serum Tg value and TgAb concentration was found among these Eighty three patients. Thus, it may be concluded that positive TgAb could cause much more TgAb interference in serum Tg value than negative TgAb could because of a different quality of TgAb. Serum Tg value is not correlated with serum TgAb concentration in patients with DTC after thyroid ablation.

Hepatic and splenic uptake on bone scintigraphy in patients with intravenous administration of 99mTc methylene diphosphonate prior to gadolinium-containing contrast.

Earlier studies indicate that abnormal liver and spleen uptake on bone scan has been observed in association with intravenous injection of Gd-DTPA contrast for MRI. All of these patients, however, received Gd-DTPA injection prior to (99m)Tc MDP administration. We report herein 3 patients with hepatic and splenic uptake on bone scan; all were administered (99m)Tc MDP before Gd-DTPA. Thus, we can conclude that Gd-DTPA after (99m)Tc MDP administration may also induce increased hepatic and splenic radioactivity on bone scan.

Strontium-89 therapy for the treatment of huge osseous metastases in prostate carcinoma: A case report.

Prostate cancer is a growing public health problem. The palliation of pain in patients with painful bone metastases is of primary importance in the clinical management of advanced cancer. Internal therapy with radionuclides, which concentrate at sites of increased bone turnover, is used to control pain and improve quality of life as an alternative to conventional therapies. In the present study, we report the case of a 52-year-old male who had been diagnosed with prostate cancer. The patient presented with severe pain in multiple areas, but particularly in the right hip. A whole-body bone scan revealed that the right hip, ilium and ischium were covered with huge metastatic lesions. Treatment with radionuclide strontium-89 chloride ((89)Sr) resulted in a partial response which was confirmed by the successful relief of pain and other imaging modalities. No significant change in the leukocyte or thrombocyte levels was observed. The results of the present study indicate that systemic radionuclide therapy using (89)Sr is an effective, well-tolerated and safe palliative treatment in patients with huge osseous metastases in prostate carcinoma.

[A new radiopharmaceutical for bone imaging: experimental study of 99mTc-HEDTMP].

The purpose of this study is to prepare 99mTc-HEDTMP [N-(2-hydroxyethyl) ethlenediamine-1,1,2-tri (methylene phosphonic acid), a new kind of bone seeking compound; to investigate its biological properties; and to explore the possibility of using it as a potential radiopharmaceutical for skeleton scintigraphy. HEDTMP was labeled with 99mTc by "pretinning" method, the radiochemical purity was 97.00% +/- 0.34%. 99mTc-HEDTMP was found to be stable in 5 hours in vitro with the radiochemical purity over 95% even after being diluted by physiological saline with the factor of dilution 100. The plane bone scanning of rabbits showed that 99mTc-HEDTMP was principally absorbed by skeletal system. Skull, spine and legs could be observed clearly, and were more legible than the images of 99mTc-MDP. Mice trial also indicated the high bone seeking of 99mTc-HEDTMP. The skeletal uptake was 11.92% ID/g, 13.19% ID/g, 10.14% ID/g, 10.04% ID/g, 7.71% ID/g separately at 30 minutes, 1 hour, 3 hours, 6 hours and 24 hours after the injection. Kidney seemed to be the major excretory organ. The clearance of blood was quick and the retaining amount in non-target organs was small. These results indicate that 99mTc-HEDTMP can be prepared easily, and its biological properties can be compared favorably with the commonly used bone imaging agent, and it is well worth further researching as a promising potential radiopharmaceutical in nuclide diagnosis for skeleton diseases.

[Strontium-89 for bone metastases from prostate cancer: an update].

Strontium-89 (Sr-89) is a pure emitter with maximum beta energy of 1.46 MeV, average beta energy of 0.58 MeV, and a physical half-life of 50.5 days. It is rapidly taken up by bone and preferentially retained at the sites of osseous metastases. Its biological half-life is >50 days at the metastatic sites, but about 14 days only in the normal bone. The dose of its absorption in the tumor-bearing bone ranges from 21 +/- 4 to 231 +/- 56 cGy/MBq, 2-25 times higher than in the normal bone. Strontium-89 therapy is an effective palliative treatment of bone metastases from prostate cancer, with analgesic effectiveness in 80%.

[Preliminary application of strontium-89 for the treatment of bone metastases from prostate cancer].

Bone metastases are a major problem in the clinical management of patients with prostate cancer. Despite the use of analgesic for the relief of such pain, the outcomes are not often satisfactory. Strontium-89 (89Sr) is a pure beta-emitting radioisotope to be avidly concentrated in the areas of high osteoblastic activity. The aim of this study was to evaluate the efficacy of 89Sr in the therapy for bone metastases of prostate carcinoma. 116 patients received intravenous injection of 89Sr at the dose of 3mCi (111MBq). All patients underwent physical examination and Karnofsky's Performance Score (KPS) evaluation before and after administration; the analgesic effects were evaluated by scores of pain. The complete response (CR) was defined as scores of pain > 75%; no response (NR) was defined as scores of pain < 25% the remaining was partial response (PR). The changes of bone metastases were screened by CT, MRI and 99mTc-MDP bone scintigraphy according to the standards of WHO. After the treatment with 89Sr, the total response rate was 80.2%. In the 116 cases, 21 cases (18.1%) displayed complete response and 72 cases (62.1%) displayed partial response, but 23 cases (19.2%) showed no response. The mean score on Karnfsky's performance status (KPS) was 20.0% higher. About 1/3 cases exhibited an obvious decrease in the number of metastases, and some foci disappeared. Thirteen cases (12%) showed a greater decrease in prostate-specific antigen (PSA) value. 89Sr chloride is an effective and safe therapy of the bone metastases from prostate cancer.

[A new radiopharmaceutical for osteoarthral cartilage imaging: preparation and animals experiment of 99mTc-CS].

The objective of this research work is to prepare a new and reliable radiopharmaceutical for osteoarthral cartilage imaging. Chondroitin sulfate (CS) was labeled directly with 99mTc by "pretinning" method, the labeling efficiency was 79.30% +/- 1.72% and radiochemical purity was 90.12% +/- 1l.23% after filtration by use of asepsis filter membrane. The biodistribution of 99Tc-CS was studied at 10, 30 min and 1, 2, 3, 4, 5, 6, 7, 8, 9 h respectively after caudal vein injection in normal mice,which showed that the radiolabeled product was washed out from blood quickly, and it was mainly excreted through kidney, but 99mTc-CS had distinctive characteristic of philo- cartilage. Scintigraphy of 99mTc-CS was performed on the rabbit with ostarthritis at 5 h after intravenous injection; the scintigram was clear,and the focus showed increased radiopharmaceutical uptake. The radioactivity ratio of the injured/uninjured side (T/NT) calculated over the region of interest (ROI) was 3.0 +/- 0.6 (P < 0.05). These results indicate that 99mTc-CS is an easily prepared compound with the characteristic of high philo-cartilage and it may be a new ideal cartilage imaging agent.

[A clinical study on the diagnosis of early rheumatoid arthritis using bone imaging with 99mTc-MDP].

This study aimed to explore the usefulness of 99mTechnetium methylenediphosphonate (99mTc-MDP) bone imaging in diagnosticating rheumatoid arthritis (RA). In 66 patients with RA, 99mTc-MDP whole body bone imaging, feet and hands regional bone imaging and ROI were performed. And from each patient, X-ray film, rheumatoid factor (RF), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were taken for examination. By the use of 99mTc-MDP, abnormal bone images were observed in 55 cases of RA; the total positive rate of incidence (83.3%) was significantly higher than those by use of X-ray (45.5%), RF (51.5%), CRP (63.6%) and ESR (69.7%); the positive rates of imaging with 99mTc-MDP in the 55 cases of RA (divided into 4 groups according to the course of disease; namely, < 1,1-, 5- and >10-year groups) were 75.0%, 88.9%, 92.3% and 100.0% respectively, whereas the positive rates of those year-groups by use of X-ray were 10.7%, 33.3%, 84.6%, 100.0% respectively; comparison of the two methods, showed statistically significant difference: P<0.01 (< 5-year group); P >0.05 (> 5-year group). In 177 joint lesions detected by bone images, 144 lesions (81.4%) were symmetric, and 33 lesions (18.6%) were single. The most frequently detected lesions were at metacarpophalangeal joints or interphalangeal and wrist joints, metatarsophalangeal or ankle joints, and knee joints. We have noticed that 99mTc-MDP bone imaging can elevate the detectability at the early stage of RA, so it is of value for the treatment of RA.

[Construction and expression of replication-deficient recombinant adenovirus vector with hNET gene by adeasy-1 system].

OBJECTIVE: To construct and identify the recombinant replication deficient adenovirus vector which codes for human Norepinephrine Transporter (hNET) gene by using the method of homogenous recombination in bacteria. METHODS: hNET gene was obtained from the recombinant plasmid pCMV5 via Kpn I + Xba I digestion, and subcloned into E1 deleted expression plasmid pAdtrack-CMV shuttle vector, forming transfer vector pAdtrack-CMV-hNET. Then it was linearized with Pme I followed by homologous recombination with bone plasmid pAdEasy-1 in BJ5183 cells to generate recombinant plasmid Ad-hNET. The DNA of identified Ad-hNET was digested with Pac I and transfected to HEK293 cells by liposome-mediated method to package recombinant adenovirus. The PCR technique was applied to detect the target gene and Western Blotting to verify the expression of hNET. The titre of the Ad-hNET was measured with the aid of green fluorescence protein (GFP) expression after multiplication and purification. RESULTS: By sequencing, it was confirmed that the product was the gene of hNET. PCR test, restriction endonuclease digestion and Western Blotting confirmed the successful construction of the recombinants Ad-hNET. The titre of purified recombinant adenovirus Ad-hNET was 1.2 X 10(10) pfu/mL. CONCLUSION: The recombinant adenovirus with the hNET gene was constructed successfully. It will be helpful for the further investigation of its potentiality to be applied in the tumors targeted therapeutic strategy.

[Standard uptake value of 18F-fluorine-2-deoxyglucose is correlated with the expression of estrogen receptor in duct carcinoma of breast].

OBJECTIVE: To explore the relationship between the standard uptake value (SUV) of 18F-fluorine-2-deoxyglucose (18F-FDG) and the expression of estrogen receptor (ER) in duct carcinoma of breast, as well as their correlation. METHODS: From March 2004 to November 2006, PET/CT scans were performed to 41 patients (female, mean age (55.2 +/- 9.55) years) with duct carcinoma of breast. All of the diagnoses were proved by pathology and immunohistochemical ER assays. The SUVs were calculated. RESULTS: ER positive patients comprised 43.9% of the 41 patients. The mean age of ER positive patients was (60.20 +/- 9.34) years, older than the ER negative patients ((50.32 +/- 9.33) years, P = 0.012). The SUV in the ER positive patients (2.76 +/- 1.34) was significantly less than in the ER negative patients (5.84 +/- 2.90, P = 0 004). The receiver operating characteristic (ROC) by FDG SUV for ER demonstrated that the area under curves reached 0.801 +/- 0.075, with significant implications on the expression of estrogen receptor (P = 0.002); The cut point of FDG SUV for ER was 3.135, with sensitivity of 72.2% and specificity of 73.9%. CONCLUSION: 18F-FDG SUV is significantly correlated with the expression of ER. We propose 3.135 as a threshold of SUV for the indication of expression of ER in duct carcinoma of breast.