Breast Imaging With Positron Emission Tomography and Fluorine-18 Fluorodeoxyglucose: Use and Limitations

Avril, Norbert; Rose, Christian; Schelling, M.; Dose, J.; Kuhn, Walther; Bense, Sandra; Weber, Wolfgang; Ziegler, S.I.; Graeff, H.; Schwaiger, Markus

doi:10.1200/jco.2000.18.20.3495

Cited by 491 publications

(341 citation statements)

References 39 publications

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“…Therefore, clinical examinations, as well as mammography, ultrasound, and magnetic resonance imaging (MRI), are often used to evaluate the presence and the extent of residual tumour. It has been suggested that positron emission tomography (PET) using the radiolabelled glucose analogue 2-(fluorine-18)-fluoro-2-deoxy-D-glucose (FDG) can be used to assess the extent and localisation of tumour deposits for a large variety of tumours, including breast cancer (Avril et al, 2000;Fletcher et al, 2008;Mahner et al, 2008). In lymphoma patients, FDG-PET has been recommended for routine post-treatment assessment, particularly for the differentiation between viable tumour and fibrosis and scarring in residual masses (Juweid et al, 2007).…”

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confidence: 99%

Assessment of residual tumour by FDG-PET: conventional imaging and clinical examination following primary chemotherapy of large and locally advanced breast cancer

et al. 2009

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BACKGROUND: The aim of this was to evaluate FDG-PET (2-(fluorine-18)-fluoro-2-deoxy-D-glucose positron emission tomography) for assessment of residual tumour after primary chemotherapy of large and locally advanced breast cancer in comparison with conventional imaging modalities. METHODS: In a prospective multicentre trial, 99 patients underwent one or more breast imaging modalities before surgery in addition to clinical examination, namely, FDG-PET (n ¼ 89), mammography (n ¼ 47), ultrasound (n ¼ 46), and magnetic resonance imaging (MRI) (n ¼ 46). The presence of residual tumour by conventional imaging, dichotomised as positive or negative, and the level of FDG uptake (standardised uptake values, SUV) were compared with histopathology, which served as the reference standard. Patients with no residual tumour or only small microscopic foci of residual tumour were classified as having minimal residual disease and those with extensive microscopic and macroscopic residual tumour tissue were classified as having gross residual disease. RESULTS: By applying a threshold SUV of 2.0, the sensitivity of FDG-PET for residual tumour was 32.9% (specificity, 87.5%) and increased to 57.5% (specificity, 62.5%) at a threshold SUV of 1.5. Conventional imaging modalities were more sensitive in identifying residual tumour, but had a low corresponding specificity; sensitivity and specificity were as follows: MRI 97.6 and 40.0%, mammography 92.5 and 57.1%, ultrasound 92.0 and 37.5%, respectively. Breast MRI provided the highest accuracy (91.3%), whereas FDG-PET had the lowest accuracy (42.7%). CONCLUSIONS: FDG-PET does not provide an accurate assessment of residual tumour after primary chemotherapy of breast cancer. Magnetic resonance imaging offers the highest sensitivity, but all imaging modalities have distinct limitations in the assessment of residual tumour tissue when compared with histopathology.

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Assessment of residual tumour by FDG-PET: conventional imaging and clinical examination following primary chemotherapy of large and locally advanced breast cancer

et al. 2009

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“…18 F FDG PET is particularly well adapted for women with axillary lymph nodes, which could be secondary to a breast cancer, because it allows detection of breast cancer when mammography fails, for example, as a result of dense breasts or architectural distortion after surgery. Small breast cancer lesions or low-FDG-avid malignant cell types such as invasive lobular carcinoma can be missed on 18 F FDG PET [11]. But, there are a few reports that 18 F FDG PET can be helpful in localizing occult carcinoma of the breast that presents with metastatic lymph nodes and in excluding other potential primaries [12,13].…”

Section: Discussionmentioning

confidence: 99%

Hypermetabolic Axillary Mass on 18F FDG PET/CT: Breast Cancer Arising from Accessory Breast Tissue

Park

Lee

Bae

et al. 2010

Nucl Med Mol Imaging

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Differential diagnosis among several causes of axillary malignant mass is important. The most common cause of palpable malignant axillary mass is metastatic lymphadenopathy. Although carcinoma arising from ectopic breast tissue is rare, the diagnosis should be kept in mind when evaluating malignant axillary mass. In this report we present a case with carcinoma arising from ectopic breast tissue. 18 F FDG PET/CT was performed for the purpose of localizing primary breast cancer lesion and systemic evaluation. PET/CT showed hypermetabolic lesions only in the right axilla. There is no evidence of malignancy in both breasts. When nuclear physicians encounter a hypermetabolic axillary mass indicating malignant lesion without evidence of primary breast malignant lesion, carcinoma arising from ectopic breast tissue should be included in the differential diagnosis.

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“…18 F-FDG PET/CT has no role in the diagnosis of primary breast cancer as its ability to detect small and/ or noninvasive carcinomas is poor, with an overall sensitivity of only 68% for tumors of size <2 cm 12. For axillary nodal staging, 18 F-FDG PET/CT has variable sensitivity (79%-94%) and specificity (86%-92%),34 and therefore the predictive accuracy is insufficient to recommend this modality for routine use 5…”

Section: Methodsmentioning

confidence: 99%

¹⁸F-FDG PET/CT Imaging In Oncology

Almuhaideb

Παπαθανασίου

Bomanji

2011

Annals of Saudi Medicine

258

123

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Accurate diagnosis and staging are essential for the optimal management of cancer patients. Positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) has emerged as a powerful imaging tool for the detection of various cancers. The combined acquisition of PET and CT has synergistic advantages over PET or CT alone and minimizes their individual limitations. It is a valuable tool for staging and restaging of some tumors and has an important role in the detection of recurrence in asymptomatic patients with rising tumor marker levels and patients with negative or equivocal findings on conventional imaging techniques. It also allows for monitoring response to therapy and permitting timely modification of therapeutic regimens. In about 27% of the patients, the course of managment is changed. This review provides guidance for oncologists/ radiotherapists and clinical and surgical specialists on the use of 18F-FDG PET/CT in oncology.

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Breast Imaging With Positron Emission Tomography and Fluorine-18 Fluorodeoxyglucose: Use and Limitations

Cited by 491 publications

References 39 publications

Assessment of residual tumour by FDG-PET: conventional imaging and clinical examination following primary chemotherapy of large and locally advanced breast cancer

Assessment of residual tumour by FDG-PET: conventional imaging and clinical examination following primary chemotherapy of large and locally advanced breast cancer

Hypermetabolic Axillary Mass on 18F FDG PET/CT: Breast Cancer Arising from Accessory Breast Tissue

¹⁸F-FDG PET/CT Imaging In Oncology

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Breast Imaging With Positron Emission Tomography and Fluorine-18 Fluorodeoxyglucose: Use and Limitations

Cited by 491 publications

References 39 publications

Assessment of residual tumour by FDG-PET: conventional imaging and clinical examination following primary chemotherapy of large and locally advanced breast cancer

Assessment of residual tumour by FDG-PET: conventional imaging and clinical examination following primary chemotherapy of large and locally advanced breast cancer

Hypermetabolic Axillary Mass on 18F FDG PET/CT: Breast Cancer Arising from Accessory Breast Tissue

18F-FDG PET/CT Imaging In Oncology

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¹⁸F-FDG PET/CT Imaging In Oncology