Diagnostic value of full-dose FDG PET/CT for axillary lymph node staging in breast cancer patients

Heusner, Till A.; Küemmel, Sherko; Hahn, Steffen; Koeninger, Angela; Otterbach, Friedrich; Hamami, M; Kimmig, Klaus R.; Forsting, Michael; Bockisch, Andreas; Antoch, Gerald; Stahl, Alexander

doi:10.1007/s00259-009-1145-6

Cited by 140 publications

(139 citation statements)

References 38 publications

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“…Garami et al [10] found that 18 IQR interquartile range, ALN axillary lymph node, NS not significant, DCIS ductal carcinoma in situ, ER estrogen, PR progesterone choose between SLNB and ALND. This triage has the potential to reduce the number of ALN dissections applied [13]. In a study performed by Reddy and Srivastava [14], PET/CT was compared with SLNB to evaluate axillary lymph node involvement in 37 patients with T1T2N0 breast carcinoma.…”

Section: Detecting Aln Metastasesmentioning

confidence: 99%

Dual-Time 18F-FDG PET/CT Imaging in Initial Locoregional Staging of Breast Carcinoma: Comparison with Conventional Imaging and Pathological Prognostic Factors

et al. 2016

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The aims of this retrospective study were to consider the diagnostic role of dual-time 18 F-fluorodeoxyglucose positron emission tomography and computed tomography ( 18 F-FDG PET/CT) in detection of breast carcinoma and axillary lymph node (ALN) status and to evaluate the primary tumor 18 F-FDG uptake pattern. Preoperative staging was performed by 18 F-FDG PET/CT in 78 female patients with breast carcinoma. Conventional imaging results were evaluated by breast magnetic resonance imaging (MRI) of 79 lesions in 78 patients, bilateral mammography (MMG) of 40 lesions in 40 patients, and breast ultrasonography (USG) of 47 lesions in 46 patients. The primary tumor detection rate using 18 F-FDG PET/CT was higher than those using MRI, USG, and MMG. The sensitivity and specificity of 18 F-FDG PET/CT scans for detecting multifocality were higher than those of MRI. The specificity of ALN metastasis detection with MRI was higher than that with 18 F-FDG PET/CT, but 18 F-FDG PET/CT had higher sensitivity. Higher 18 F-FDG uptake levels were detected in patients with ALN metastasis, histologic grade 3, estrogen-progesterone-negative receptor status, lymphatic invasion, and moderate to poor prognostic groups. There was no statistical difference for the retention index in categorical pathological parameters except for progesterone-negative status.In conclusion, 18 F-FDG PET/CT scans may be a valuable imaging technique for evaluating primary tumor and axillary status in staging breast carcinoma and 18 F-FDG uptake may be a prognostic factor that indicates aggressive tumor biology and poor prognosis. Dual-time imaging in breast carcinoma staging may not be used for predicting pathological criteria and the aggressiveness of primary lesions.

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Section: Detecting Aln Metastasesmentioning

confidence: 99%

Dual-Time 18F-FDG PET/CT Imaging in Initial Locoregional Staging of Breast Carcinoma: Comparison with Conventional Imaging and Pathological Prognostic Factors

et al. 2016

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“…In the study of Heusner et al, the primary tumour was FDG PET positive in 87% of cases [3]. However, 39% of patients had clinical stage T1.…”

Section: Primary Tumour Assessmentmentioning

confidence: 92%

“…PET/CT allows diagnosis of infraclavicular, supraclavicular and internal mammary node involvement and can depict occult distant metastases. Preliminary findings from Heusner and colleagues suggest that the information provided by FDG PET/ CT might be useful in extending the indication of SLNB to patients with tumours larger than 2-3 cm [3]. The role of PET in assessing response to neoadjuvant chemotherapy is also growing, and a baseline PET is necessary for that purpose.…”

Section: Assessing Distant Metastasesmentioning

confidence: 99%

Should FDG PET/CT be used for the initial staging of breast cancer?

Groheux

Hindié

Rubello

et al. 2009

Eur J Nucl Med Mol Imaging

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“…Several groups have demonstrated that, in most cases, FDG-PET or PET/CT has a low sensitivity (range 24-82 %) but a high specificity (range 80-100 %) and high positive predictive value (PPV) of more than 80 % [24][25][26][27][28][29][30][31][32][33]. In a review of 472 patients examined using FDG-PET/CT, the pooled sensitivity was relatively low (60 %) but the pooled specificity was very high (97 %) [34].…”

Section: Axillary Lymph Node Stagingmentioning

confidence: 99%

Present and future role of FDG-PET/CT imaging in the management of breast cancer

Kitajima

Miyoshi

2016

Jpn J Radiol

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by malignant cells, opened a new field in clinical oncologic imaging. Recently, integrated positron emission tomography/computed tomography (PET/CT), in which a full-ringdetector clinical PET scanner and multidetector-row helical CT scanner are combined, has made it possible to acquire both metabolic and anatomic imaging data using a single device in a single diagnostic session, and provides precise anatomic localization of suspicious areas of increased FDG uptake. When used in a clinical setting, FDG-PET/CT leads to a significant improvement in diagnostic accuracy and has had a considerable impact on patient management, including diagnosis, initial staging, optimization of treatment, restaging, monitoring of the response to therapy, and prognostication of various malignant tumors. We herein review the current and future roles of FDG-PET/CT in the management of breast cancer, discussing its usefulness and limitations for imaging in these patients. DiagnosisFDG-PET imaging has poor sensitivity (<50 %) for subcentimeter breast cancers [9,10]. This is due to the limited spatial resolution of PET and, in some cases, by tumor characteristics (e.g., low FDG avidity in grade 1 cancer, ductal carcinoma in situ, or lobular carcinoma) [1,2]. Specificity can also be altered by variations of FDG uptake in certain benign conditions, such as infection, fibroadenoma, ductal adenoma, inflammatory granulomatous mastitis, and fibrocystic changes [3].In order to improve specificity, some authors would obtain a second series of PET images centered on the breast approximately 2 h after FDG injection (dual-time imaging) [4]. Indeed, FDG uptake seems to increase with time in the case of malignancy, while some inflammatory lesions show stable or decreasing uptake [4]. However, dual-time Abstract Integrated positron emission tomography/computed tomography (PET/CT) with 2-[18F]fluoro-2-deoxyd-glucose (FDG) is a useful tool for acquisition of both glucose metabolic and anatomic imaging data using a single device in a single diagnostic session, and has opened a new field in clinical oncologic imaging. FDG-PET/CT has been used successfully for the diagnosis, initial staging, restaging, early treatment response assessment, evaluation of metastatic disease response, and prognostication of breast cancer as well as various malignant tumors. We herein review the current place and role of FDG-PET/CT in the management of breast cancer, focusing on its usefulness and limitations in the imaging of these patients.

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Diagnostic value of full-dose FDG PET/CT for axillary lymph node staging in breast cancer patients

Abstract: FDG PET/CT cannot replace invasive approaches for axillary staging but may extend the indication for SLNB.

Cited by 140 publications

References 38 publications

Dual-Time 18F-FDG PET/CT Imaging in Initial Locoregional Staging of Breast Carcinoma: Comparison with Conventional Imaging and Pathological Prognostic Factors

Dual-Time 18F-FDG PET/CT Imaging in Initial Locoregional Staging of Breast Carcinoma: Comparison with Conventional Imaging and Pathological Prognostic Factors

Should FDG PET/CT be used for the initial staging of breast cancer?

Present and future role of FDG-PET/CT imaging in the management of breast cancer

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