Positron emission tomography in breast cancer: 18F- FDG and other radiopharmaceuticals

Iakovou, Ioannis; Giannoula, Evanthia; Gkantaifi, Areti; Levva, Sofia; Frangos, Savvas

doi:10.1186/s41824-018-0039-x

Cited by 7 publications

(4 citation statements)

References 99 publications

(104 reference statements)

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“…It is also used for the detection of dense breasts and lesions of 1 cm or less. It has limited use in clinical practice because of high dose exposure of radionuclide to patients hence only used I clinical trial investigation of breast cancer [44]. Positron emission mammography or PEM uses a lower dose of radionuclide and having a high spatial resolution as compared to PET.…”

Section: Radionuclide Methodsmentioning

confidence: 99%

Advanced and futuristic approaches for breast cancer diagnosis

et al. 2020

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Background Breast cancer is the most frequent cancer and one of the most common causes of death in women, impacting almost 2 million women each year. Tenacity or perseverance of breast cancer in women is very high these days with an extensive increasing rate of 3 to 5% every year. Along with hurdles faced during treatment of breast tumor, one of the crucial causes of delay in treatment is invasive and poor diagnostic techniques for breast cancer hence the early diagnosis of breast tumors will help us to improve its management and treatment in the initial stage. Main body Present review aims to explore diagnostic techniques for breast cancer that are currently being used, recent advancements that aids in prior detection and evaluation and are extensively focused on techniques that are going to be future of breast cancer detection with better efficiency and lesser pain to patients so that it helps to a physician to prevent delay in treatment of cancer. Here, we have discussed mammography and its advanced forms that are the need of current era, techniques involving radiation such as radionuclide methods, the potential of nanotechnology by using nanoparticle in breast cancer, and how the new inventions such as breath biopsy, and X-ray diffraction of hair can simply use as a prominent method in breast cancer early and easy detection tool. Conclusion It is observed significantly that advancement in detection techniques is helping in early diagnosis of breast cancer; however, we have to also focus on techniques that will improve the future of cancer diagnosis in like optical imaging and HER2 testing.

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Section: Radionuclide Methodsmentioning

confidence: 99%

Advanced and futuristic approaches for breast cancer diagnosis

et al. 2020

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“…[ 18 F]FDG is considered a suboptimal radiopharmaceutical for imaging breast cancer as it is non-specific with substantial variations in uptake between breast tumour characteristics and breast cancer subgroups [22][23][24][25][26]. The use of tumour-specific tracers, targeting, for example, ER (e.g.…”

Section: Limitationsmentioning

confidence: 99%

Intraoperative [18F]FDG flexible autoradiography for tumour margin assessment in breast-conserving surgery: a first-in-human multicentre feasibility study

et al. 2021

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Introduction In women undergoing breast-conserving surgery (BCS), 20–25% require a re-operation as a result of incomplete tumour resection. An intra-operative technique to assess tumour margins accurately would be a major advantage. A novel method for intraoperative margin assessment was developed by applying a thin flexible scintillating film to specimens—flexible autoradiography (FAR) imaging. A single-arm, multi-centre study was conducted to evaluate the feasibility of intraoperative [18F]FDG FAR for the assessment of tumour margins in BCS. Methods Eighty-eight patients with invasive breast cancer undergoing BCS received ≤ 300 MBq of [18F]FDG 60–180 min pre-operatively. Following surgical excision, intraoperative FAR imaging was performed using the LightPath® Imaging System. The first 16 patients were familiarisation patients; the remaining 72 patients were entered into the main study. FAR images were analysed post-operatively by three independent readers. Areas of increased signal intensity were marked, mean normalised radiances and tumour-to-tissue background (TBR) determined, agreement between histopathological margin status and FAR assessed and radiation dose to operating theatre staff measured. Subgroup analyses were performed for various covariates, with thresholds set based on ROC curves. Results Data analysis was performed on 66 patients. Intraoperative margin assessment using FAR was completed on 385 margins with 46.2% sensitivity, 81.7% specificity, 8.1% PPV, 97.7% NPV and an overall accuracy of 80.5%, detecting both invasive carcinoma and DCIS. A subgroup analysis based on [18F]FDG activity present at time of imaging revealed an increased sensitivity (71.4%), PPV (9.3%) and NPV (98.4%) in the high-activity cohort with mean tumour radiance and TBR of 126.7 ± 45.7 photons/s/cm2/sr/MBq and 2.1 ± 0.5, respectively. Staff radiation exposure was low (38.2 ± 38.1 µSv). Conclusion [18F]FDG FAR is a feasible and safe technique for intraoperative tumour margin assessment. Further improvements in diagnostic performance require optimising the method for scintillator positioning and/or the use of targeted radiopharmaceuticals. Trial registration: Identifier: NCT02666079. Date of registration: 28 January 2016. URL: https://clinicaltrials.gov/ct2/show/NCT02666079. ISRCTN registry: Reference: ISRCTN17778965. Date of registration: 11 February 2016. URL: http://www.isrctn.com/ISRCTN17778965.

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“…a suture, would allow better correlation between FAR and histopathology. 18 F-FDG is considered a suboptimal radiopharmaceutical for imaging breast cancer as it is non-speci c with substantial variations in uptake between breast tumour characteristics and breast cancer subgroups [21][22][23][24][25]. The use of tumour-speci c tracers, targeting for example ER (e.g.…”

Section: Limitationsmentioning

confidence: 99%

Intraoperative [18F]FDG  flexible autoradiography for tumour margin assessment in breast-conserving surgery – a first-in-human multicentre feasibility study

Jurrius

Grootendorst

Krotewicz

et al. 2021

Preprint

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Introduction In women undergoing breast-conserving surgery (BCS) 20-25% require a re-operation as a result of incomplete tumour resection. An intra-operative technique to assess tumour margins accurately would be a major advantage. A novel method for intraoperative margin assessment was developed by applying a thin flexible scintillating film to specimens - flexible autoradiography (FAR) imaging. A single arm, multi-centre study was conducted to evaluate the feasibility of intraoperative [18F]FDG FAR for the assessment of tumour margins in BCS.Methods Eighty-eight patients with invasive breast cancer undergoing BCS received ≤300 MBq of [18F]FDG 60-180 minutes pre-operatively. Following surgical excision, intraoperative FAR imaging was performed using the LightPath® Imaging System. The first 16 patients were familiarisation patients, the remaining 72 patients were entered into the main study. FAR images were analysed post-operatively by three independent readers. Areas of increased signal intensity were marked, mean normalised radiances and tumour-to-tissue background (TBR) determined, agreement between histopathological margin status and FAR assessed and radiation dose to operating theatre staff measured. Subgroup analyses were performed for various covariates, with thresholds set based on ROC curves.Results Data analysis was performed on 66 patients. Intraoperative margin assessment using FAR was completed on 385 margins with 46.2% sensitivity, 81.7% specificity, 8.1% PPV, 97.7% NPV and an overall accuracy of 80.5%, detecting both invasive carcinoma and DCIS. A subgroup analysis based on [18F]FDG activity present at time of imaging revealed an increased sensitivity (71.4%), PPV (9.3%) and NPV (98.4%) in the high-activity cohort with mean tumour radiance and TBR of 126.7 ± 45.7 photons/s/cm2/sr/MBq and 2.1 ± 0.5, respectively. Staff radiation exposure was low (38.2 ± 38.1 µSv). Conclusion [18F]FDG FAR is a feasible and safe technique for intraoperative tumour margin assessment. Further improvements in diagnostic performance require optimising the method for scintillator positioning and/or the use of targeted radiopharmaceuticals.

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Positron emission tomography in breast cancer: 18F- FDG and other radiopharmaceuticals

Cited by 7 publications

References 99 publications

Advanced and futuristic approaches for breast cancer diagnosis

Advanced and futuristic approaches for breast cancer diagnosis

Intraoperative [18F]FDG flexible autoradiography for tumour margin assessment in breast-conserving surgery: a first-in-human multicentre feasibility study

Intraoperative [18F]FDG  flexible autoradiography for tumour margin assessment in breast-conserving surgery – a first-in-human multicentre feasibility study

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Positron emission tomography in breast cancer: 18F- FDG and other radiopharmaceuticals

Cited by 7 publications

References 99 publications

Advanced and futuristic approaches for breast cancer diagnosis

Advanced and futuristic approaches for breast cancer diagnosis

Intraoperative [18F]FDG flexible autoradiography for tumour margin assessment in breast-conserving surgery: a first-in-human multicentre feasibility study

Intraoperative [18F]FDG&nbsp; flexible autoradiography for tumour margin assessment in breast-conserving surgery – a first-in-human multicentre feasibility study

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Intraoperative [18F]FDG flexible autoradiography for tumour margin assessment in breast-conserving surgery – a first-in-human multicentre feasibility study