Diagnostic efficacy of 18F-FDG-PET or PET/CT in breast cancer with suspected recurrence

Xiao, Yunfeng; Ling, Wang; Jiang, Xingyu; She, Wei; He, Lin; Hu, Gang

doi:10.1097/mnm.0000000000000573

Cited by 31 publications

(22 citation statements)

References 45 publications

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“…Positron emission tomography/computed tomography (PET/CT) with [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) would only be used in situations where standard staging studies are equivocal or suspicious [5,6]. Although clinical studies have indicated high diagnostic accuracy with sensitivities ranging from 81% to 100% and specificities ranging from 52% to 91%, and have suggested the superiority of [ 18 F]FDG PET/CT over standard imaging studies [7][8][9][10][11], these studies are largely retrospective with heterogeneous cohorts, and there are also methodological issues of concern [7,10,11]. The diagnostic accuracy was not separately determined in patients who presented with equivocal or suspicious imaging studies [8,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…The diagnostic accuracy was not separately determined in patients who presented with equivocal or suspicious imaging studies [8,[12][13][14]. In addition, both false-negative and false-positive [ 18 F]FDG PET/CT results [7,10] are inherent in [ 18 F]FDG PET/CT [15,16]. The consensus is that biopsy is more likely to provide useful information [6].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of diagnostic sensitivity of 18F-fluoroestradiol and 18F-fluorodeoxyglucose positron emission tomography/computed tomography for breast cancer recurrence in patients with a history of estrogen receptor-positive primary breast cancer

Chae

Son

Lee

et al. 2020

Preprint

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Background To compare the diagnostic sensitivity of [ 18 F]fluoroestradiol ([ 18 F]FES) and [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT) for breast cancer recurrence in patients with estrogen receptor (ER)-positive primary breast cancer. Methods Our database of consecutive patients enrolled in a previous prospective cohort study to assess [ 18 F]FES PET/CT was reviewed to identify eligible patients who had ER-positive primary breast cancer with suspected first recurrence at presentation and who underwent [ 18 F]FDG PET/CT. The sensitivity of qualitative [ 18 F]FES and [ 18 F]FDG PET/CT interpretations was assessed, comparing them with histological diagnoses. Results Of the 46 enrolled patients, 45 were confirmed as having recurrent breast cancer, while one was diagnosed with chronic granulomatous inflammation. Forty (89%) patients were ER-positive, four (9%) were ER-negative, and one (2%) patient did not undergo an ER assay. The sensitivity of [ 18 F]FES PET/CT was 71.1% (32/45, 95% CI: 55.7–83.6), while that of [ 18 F]FDG PET/CT was 80.0% (36/45, 95% CI: 65.4–90.4) with a threshold of positive interpretation, and 93.3% (42/45, 95% CI: 81.7–98.6) when a threshold of equivocal was used. There was no significant difference in sensitivity between [ 18 F]FES and [ 18 F]FDG PET/CT ( P =0.48) with a threshold of positive [ 18 F]FDG uptake, but the sensitivity of [ 18 F]FDG was significantly higher than [ 18 F]FES ( P =0.013) with a threshold of equivocal [ 18 F]FDG uptake. One patient with a benign lesion showed negative [ 18 F]FES but positive [ 18 F]FDG uptake. Conclusions The restaging of patients who had ER-positive primary breast cancer and present with recurrent disease may include [ 18 F]FES PET/CT as an initial test when standard imaging studies are equivocal or suspicious.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of diagnostic sensitivity of 18F-fluoroestradiol and 18F-fluorodeoxyglucose positron emission tomography/computed tomography for breast cancer recurrence in patients with a history of estrogen receptor-positive primary breast cancer

Chae

Son

Lee

et al. 2020

Preprint

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“…In clinical practice, during the follow-up of breast cancer, it is difficult to manage treatment when serum tumor marker levels increase without any morphological imaging finding or when suspicious morphological imaging findings are found in terms of breast cancer recurrence but histopathological confirmation is not convenient. In such circumstances, PET/CT scan can be used for evaluating recurrence ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

The Role of 18F-FDG PET/CT in Evaluating Elevated Levels of Tumor Markers in Breast Cancer

Göktaş

Cayvarlı

2018

Mirt

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Objective:Our aim was to assess the diagnostic performance of integrated positron emission tomography/computed tomography (PET/CT) in the follow-up of breast cancer patients, who underwent a PET/CT scan due to a suspicion of recurrence based on elevated levels of serum tumor markers.Methods:Seventy-seven consecutive patients were included in this study. PET/CT scan results were compared with the final diagnoses that were obtained from histopathological sampling or a minimum 6 months of radiological follow-up. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the diagnostic accuracy of PET/CT for detecting recurrence were calculated.Results:All 77 patients had increased serum cancer antigen 15-3 levels while 37 had increased serum carcinoembryonic antigen levels. According to PET/CT scan results, 59 of 77 patients (PET/CT positive) had local recurrence and/or distant metastasis while there was no pathological finding in 18 patients (PET/CT negative). In a follow-up of minimum 6 months, tumor recurrence was confirmed in 58 of “PET/CT positive” patients while no tumor recurrence was detected in 16 of “PET/CT negative” patients. According to these results the sensitivity, specificity, PPV, NPV and the diagnostic accuracy of PET/CT for detecting recurrence on a per-person basis were calculated as 98%, 88%, 96%, 94% and 96%, respectively.Conclusion:In case of elevated levels of serum tumor markers, PET/CT has a high diagnostic accuracy in detecting tumor recurrence in patients with breast cancer, and it is an effective modality that can be used in addition to conventional imaging techniques.

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“…Positron emission tomography/computed tomography (PET/CT) with 18 F-fluorodeoxyglucose ( 18 F-FDG) would only be used in situations where standard staging studies are equivocal or suspicious [5,6]. Although clinical studies have indicated high diagnostic accuracy with sensitivities ranging from 81-100% and specificities ranging from 52-91%, and have suggested the superiority of 18 F-FDG PET/CT over standard imaging studies [7][8][9][10][11], these studies are largely retrospective with heterogeneous cohorts, and there are also methodological issues of concern [7,10,11]. The diagnostic accuracy was not separately determined in patients who presented with equivocal or suspicious imaging studies [8,[12][13][14].…”

mentioning

confidence: 99%

“…The diagnostic accuracy was not separately determined in patients who presented with equivocal or suspicious imaging studies [8,[12][13][14]. In addition, both false-negative and false-positive 18 F-FDG PET/CT results [7,10] are inherent in 18 F-FDG PET/CT [15,16]. The consensus is that biopsy is more likely to provide useful information [6].…”

mentioning

confidence: 99%

Comparison of diagnostic accuracy of 18F-fluoroestradiol and 18F-fluorodeoxyglucose positron emission tomography/computed tomography for breast cancer recurrence in patients with a history of estrogen receptor-positive primary breast cancer

Young

Son

Lee

et al. 2020

Preprint

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Background To compare the diagnostic accuracy of 18F-fluoroestradiol (18F-FES) and 18F-fluorodoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for breast cancer recurrence in patients with estrogen receptor (ER)-positive primary breast cancer.Methods Our database of consecutive patients enrolled in a previous prospective cohort study to assess 18F-FES PET/CT was reviewed to identify eligible patients who had ER-positive primary breast cancer with suspected first recurrence at presentation and who underwent 18F-FDG PET/CT. The diagnostic accuracy of qualitative 18F-FES and 18F-FDG PET/CT interpretations was assessed, comparing them with histological diagnoses.Results Of the 46 enrolled patients, 45 were confirmed as having recurrent breast cancer, while one was diagnosed with chronic granulomatous inflammation. Forty (89%) patients were ER-positive, four (9%) were ER-negative, and one (2%) patient did not undergo an ER assay. The sensitivity of 18F-FES PET/CT was 71.1% (32/45, 95% CI: 55.7–83.6), while that of 18F-FDG PET/CT was 80.0% (36/45, 95% CI: 65.4–90.4) when malignant interpretation was defined as positive, and 93.3% (42/45, 95% CI: 81.7–98.6) when an equivocal or malignant interpretation was considered positive. There was no significant difference in sensitivity between 18F-FES and 18F-FDG PET/CT (P=0.48) when malignant 18F-FDG interpretation was considered positive, but the sensitivity of 18F-FDG was significantly higher than 18F-FES (P=0.013) when equivocal or malignant interpretation was considered positive. One patient with a benign lesion showed negative 18F-FES but malignant 18F-FDG uptake.Conclusions The restaging of patients who had ER-positive primary breast cancer and present with recurrent disease may include 18F-FES PET/CT.

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Diagnostic efficacy of 18F-FDG-PET or PET/CT in breast cancer with suspected recurrence

Abstract: F-FDG-PET, and in particular F-FDG-PET/CT, seemed to be a more valuable supplement to current surveillance techniques to detect relapse in suspected recurrent breast cancer patients.

Cited by 31 publications

References 45 publications

Comparison of diagnostic sensitivity of 18F-fluoroestradiol and 18F-fluorodeoxyglucose positron emission tomography/computed tomography for breast cancer recurrence in patients with a history of estrogen receptor-positive primary breast cancer

Comparison of diagnostic sensitivity of 18F-fluoroestradiol and 18F-fluorodeoxyglucose positron emission tomography/computed tomography for breast cancer recurrence in patients with a history of estrogen receptor-positive primary breast cancer

The Role of 18F-FDG PET/CT in Evaluating Elevated Levels of Tumor Markers in Breast Cancer

Comparison of diagnostic accuracy of 18F-fluoroestradiol and 18F-fluorodeoxyglucose positron emission tomography/computed tomography for breast cancer recurrence in patients with a history of estrogen receptor-positive primary breast cancer

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