Presence of a focal colonic FDG uptake incidental finding on a PET/CT scan justifies a colonoscopy to detect (pre-)malignant lesions. The fusion of PET and CT images allows an accurate localization of the lesions. PET/CT is a useful tool to differentiate pathologic from physiologic FDG uptake.

In a multidisciplinary team approach, (18)F-FDG PET helps to manage suspicious CT scan lesions. An adrenal to liver maxSUV ratio less than 1.45 is highly predictive of a benign lesion.

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Many studies have pointed out the role of 18 F-FDG PET/CT (or 18 F-FDG PET) in patients with clinical stage III or II breast cancer. 18 F-FDG PET/CT might advantageously replace other staging procedures, such as bone scanning and possibly contrast-enhanced CT of the thorax or abdomen-pelvis. We discuss the findings, locoregional or distant, that can be expected in different categories of breast cancer and their impact on prognosis and management. We also discuss the role of 18 F-FDG PET/CT in restaging and how 18 F-FDG PET/CT compares with conventional techniques in restaging for patients with suspected disease recurrence. We conclude with some recommendations for clinical practice and future research. Accur ate staging is important for management decisions in patients with newly diagnosed breast cancer. Several studies have pointed out the lack of utility of PET/CT with 18 F-FDG in staging for patients with cancer detected early, that is, tumors of less than or equal to 2-3 cm and no palpable nodes-findings that represent most breast cancer cases (1-5). The lower sensitivity of 18 F-FDG imaging than of the sentinel node technique in assessing axillary lymph node involvement is well known (1-3), and the risk of distant metastases in early-stage cases is low (4,5). These factors, combined with the good but finite specificity of 18 F-FDG PET/CT, result in a relative abundance of false-positive findings and a paucity of truepositive findings; such findings lead to unwarranted patient anxiety and delay of care with the routine use of 18 F-FDG PET/CT for breast cancer detected early.In contrast, in such high-risk patients as those with inflammatory (T4d) or locally advanced breast cancer (LABC) (6,7), the role of 18 F-FDG imaging in detecting distant lesions has been highlighted (8-12). Recently, several studies pointed out that staging with 18 F-FDG PET/CT might be of value not only in patients with locally advanced disease but also in "intermediate-risk" patients (13-21)-that is, patients with clinical stage IIB disease (T2N1/T3N0) or higher-with significant diagnostic yield and prognostic information (18,19). PET/CT has also shown good performance in restaging for breast cancer patients (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).This review assesses the advantages and limits of 18 F-FDG PET/CT in initial staging and restaging for breast cancer patients. REGIONAL AND DISTANT STAGING IN LOCALLY ADVANCED AND INFLAMMATORY BREAST CANCERLABC is variably defined but usually refers to clinical N2, N3, or T4 disease and typically includes American Joint Committee on Cancer (AJCC) clinical stage IIIA (excluding T3N1), IIIB, and IIIC breast cancer (Table 1) (6,7). Within this entity, distinction is made between inflammatory carcinoma (T4d) and noninflammatory LABC. Patients without identified distant metastases usually receive neoadjuvant chemotherapy followed by surgery and radiation therapy as standard treatment. Detection of Regional Node Involvement Outside Axillary Levels I and IIAxillary node clearance by...

This study emphasizes that metformin significantly increases (18)F-FDG uptake in colon and, to a lesser extent, in small intestine. It raises the question of stopping metformin treatment before an (18)F-FDG PET/CT scan is performed for intra-abdominal neoplasic lesion assessment.

BACKGROUND:To prospectively assess fluorodeoxyglucose positron emission tomography/computed

IBC (inflammatory breast cancer) is a rare but very aggressive form of breast cancer with a particular phenotype. The molecular mechanisms responsible for IBC remain largely unknown. In particular, genetic and epigenetic alterations specific to IBC remain to be identified. MicroRNAs, a class of small noncoding RNAs able to regulate gene expression, are deregulated in breast cancer and may therefore serve as tools for diagnosis and prediction. This study was designed to determine miRNA expression profiling (microRNAome) in IBC. Quantitative RT-PCR was used to determine expression levels of 804 miRNAs in a screening series of 12 IBC compared to 31 non-stage-matched non-IBC and 8 normal breast samples. The differentially expressed miRNAs were then validated in a series of 65 IBC and 95 non-IBC. From a set of 18 miRNAs of interest selected from the screening series, 13 were differentially expressed with statistical significance in the validation series of IBC compared to non-IBC. Among these, a 5-miRNA signature comprising miR-421, miR-486, miR-503, miR-720 and miR-1303 was shown to be predictive for IBC phenotype with an overall accuracy of 89%. Moreover, multivariate analysis showed that this signature was an independent predictor of poor Metastasis-Free Survival in non-IBC patients.IBC (inflammatory breast cancer) is a rare but very aggressive form of breast cancer with a unique phenotype.

guides-etrecommandations/355-recommandations-de-bonne-pratique-clinique-pour-l-utilisation-de-la-tepen-cancerologie. *** These good clinical practice recommendations have been awarded joint French National Heath Authority (HAS) and French Cancer Institute (INCa) label status, in recognition that they were developed in line with HAS and INCa-recommended rules, methods and procedures.