Impact of PET/CT in Comparison With Same Day Contrast Enhanced CT in Breast Cancer Management

Piperkova, E.; Raphael, Barbara; Altinyay, Mustafa; Castellon, Ivan; Libes, Richard; Sandella, Nick; Heiba, Sherif; Abdel‐Dayem, Hussein M.

doi:10.1097/rlu.0b013e31805375e0

Cited by 43 publications

(23 citation statements)

References 26 publications

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“…PET-CT has been compared with other imaging modalities for its diagnosis of recurrence. Piperkova et al reported that contrast-enhanced CT was inferior to PET-CT [15]. Schmidt et al described the results of comparison between whole-body MRI and FDG PET-CT in 2008 publication, in which both modalities were useful for detection of tumor recurrence.…”

Section: Discussionmentioning

confidence: 97%

Detection of isolated ipsilateral regional lymph node recurrences by F18-fluorodeoxyglucose positron emission tomography–CT in follow-up of postoperative breast cancer patients

Ohsumi

Inoue

Kiyoto

et al. 2011

Breast Cancer Res Treat

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Imaging diagnostic methods except for mammograms are not recommended for follow-up of postoperative breast cancer patients in order to detect small recurrences because of the poor survival improvement in earlier randomized trials. However, the use of new imaging modalities may improve survival by detection of small isolated regional lymph node recurrences which are potentially curable. Between April 2006 and December 2008, we used PET-CT to find small recurrences in follow-up of 1,907 postoperative breast cancer patients. A total of 3,280 PET-CT imagings were performed. The median age at PET-CT imaging was 58 years, with a median 48-month interval from definitive surgery to the PET-CT imaging. Twenty-two patients were found to have isolated ipsilateral regional recurrences only by PET-CT (axillary node recurrences in 6, infraclavicular node recurrences in 5, supraclavicular node recurrences in 6, and parasternal node recurrences in 5). All of those recurrences were missed by palpation or were nonpalpable. The pathological lymph node status at the definitive surgery for the primary breast cancer of 22 patients with the isolated ipsilateral regional lymph node recurrences was positive in 17 patients. If patients are limited to those who had pathologically positive node(s) at definitive surgery, the incidence of patients with isolated regional lymph node recurrences found only by PET-CT would be 2.6% (17/663 patients). Seventeen other asymptomatic cancers including contralateral breast cancers were found only by PET-CT. Early detection of isolated loco-regional recurrences of breast cancer is suggested to result in improved survival. Therefore, the use of PET-CT in follow-up of postoperative node-positive breast cancer patients may improve their survival because of early detection of isolated regional lymph node recurrences which are still potentially curable, and screening of other asymptomatic cancers.

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Section: Discussionmentioning

confidence: 97%

Detection of isolated ipsilateral regional lymph node recurrences by F18-fluorodeoxyglucose positron emission tomography–CT in follow-up of postoperative breast cancer patients

Ohsumi

Inoue

Kiyoto

et al. 2011

Breast Cancer Res Treat

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“…Positron emission tomography has gained widespread acceptance as a staging investigation in the diagnostic workup of many tumours and was shown to have the potential to clarify true stage grouping in up to one third of patients after conventional staging [1][2][3][4][8][9][10]. However, false-positive results may occur in about 10% of all patients [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

PET-CT-guided interventions in the management of FDG-positive lesions in patients suffering from solid malignancies: initial experiences

et al. 2009

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Positron emission tomography-computed tomography (PET-CT) has gained widespread acceptance as a staging investigation in the diagnostic workup of malignant tumours and may be used to visualize metabolic changes before the evolution of morphological changes. To make histology of PET findings without distinctive structural changes available for treatment decisions, we developed a protocol for multimodal image-guided interventions using an integrated PET-CT machine. We report our first experience in 12 patients admitted for staging and restaging of breast cancer, non-small cell lung cancer, cervical cancer, soft tissue sarcoma, and osteosarcoma. Patients were repositioned according to the findings in PET-CT and intervention was planned based on a subsequent single-bed PET-CT acquisition of the region concerned. The needle was introduced under CT guidance in a step-by-step technique and correct needle position in the centre of the FDG avid lesion was assured by repetition of a single-bed PET-CT acquisition before sampling. The metabolically active part of lesions was accurately targeted in all patients and representative samples were obtained in 92%. No major adverse effects occurred. We conclude that PET-CT guidance for interventions is feasible and may be promising to optimize the diagnostic yield of CTguided interventions and to make metabolically active lesions without morphological correlate accessible to percutaneous interventions.

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“…Both comparisons have reported a small-to-modest benefi t of FDG-PET/CT over either FDG-PET or CT alone for accurately detecting breast cancer metastasis. 46,47 Cited reasons for incorrect FDG-PET fi ndings were breast cancers with only mild hypermetabolic activity, benign infl ammatory lesions, and physiologic variants. 48 One area in which FDG-PET has been identifi ed as potentially lacking compared with more traditional imaging is in the detection of bone lesions compared with bone scan.…”

Section: Evaluating For Distant Metastasismentioning

confidence: 99%

Cost-Effective Staging of Breast Cancer

Borges¹,

Hardesty²

2011

Early Diagnosis and Treatment of Cancer Series: Breast Cancer

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Impact of PET/CT in Comparison With Same Day Contrast Enhanced CT in Breast Cancer Management

Abstract: In this study, PET/CT played a more important role than CE-CT scans alone and provided an impact on the management of breast cancer patients.

Cited by 43 publications

References 26 publications

Detection of isolated ipsilateral regional lymph node recurrences by F18-fluorodeoxyglucose positron emission tomography–CT in follow-up of postoperative breast cancer patients

Detection of isolated ipsilateral regional lymph node recurrences by F18-fluorodeoxyglucose positron emission tomography–CT in follow-up of postoperative breast cancer patients

PET-CT-guided interventions in the management of FDG-positive lesions in patients suffering from solid malignancies: initial experiences

Cost-Effective Staging of Breast Cancer

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