The Role of PET/CT for Evaluating Breast Cancer

Abstract

Positron emission tomography combined with computed tomography (PET/CT) has been receiving increasing attention during the recent years for making the diagnosis, for determining the staging and for the follow-up of various malignancies. The PET/CT findings of 58 breast cancer patients (age range: 34 79 years old, mean age: 50 years) were retrospectively compared with the PET or CT scans alone. PET/CT was found to be better than PET or CT alone for detecting small tumors or multiple metastases, for accurately localizing lymph node metastasis and for monitoring the response to chemotherapy in breast cancer patients.maging modalities like computed tomography (CT) and magnetic resonance (MR) imaging rely on detecting anatomic changes for the diagnosis, staging and follow-up of cancer patients. However, positron emission tomography (PET) has the ability to demonstrate abnormal metabolic activity, and 18F-2-deoxy-D-glucose (FDG) PET provides important tumor-related qualitative and quantitative metabolic information that may be critical for the diagnosis and follow-up (1 3). Moreover, the combination of PET and computed tomography (PET/CT) allows the functional PET and anatomical CT images to be acquired under identical conditions and then they are rapidly co-registered. This combined system has advantages over CT alone as functional information is added to morphological data, and this combined system has advantages over PET alone because pathological areas of tracer uptake are better localized and the image acquisition time is reduced (4 7). Moreover, the limited specificity of PET that's due to the increased glucose metabolic activities of benign tumors and inflammatory tissues (such as those of tuberculosis) can be partially overcome by PET/CT (8,9).In this study, we investigated the role of PET/CT for evaluating breast cancer. PATIENT SELECTIONFifty-eight female patients with known breast cancer (age range: 34 79 years old, mean age: 50 years), and who underwent PET/CT examinations at our facility between April 2003 and June 2005 were enrolled in this study. The PET/CT examinations were performed for the initial tumor staging, for suspected recurrence after breast operation and for follow-up after chemotherapy.

Male Breast Cancer

“…The extent of the disease should be evaluated via laboratory examination, pulmonary X-ray, bone scintigraphy and dominal computed tomography (CT) (71). Positron emission tomography -computed tomography (PET-CT) is better than PET or computed tomography (CT) alone for assessing the extent of the disease, and especially for accurately identifying small metastases and lymph node metastases as well as the response to chemotherapy (72).…”

Initial evaluation of inflammatory breast cancer with fluorodeoxyglucose positron emission tomography

“…[3] The major roles for PET/CT in breast cancer are detecting and localizing metastasis, monitoring the response to treatment, and early detection of recurrence. [4] FDG PET/CT imaging provides additional information regarding lymph node or distant metastases in IBC patients and should be considered in the initial staging.…”

Positron Emission Tomography for Benign and Malignant Disease

“…Pre-operative PET-CT had a PPV of 100% in determining axillary lymph node staging, which the authors concluded accurately upstages patients and would reduce the number of unnecessary SLNB. Several other studies have concluded that preoperative whole-body PET-CT could be used to evaluate patients for regional lymph node metastasis as well as distant metastasis20, 24. They conclude that PET-CT is useful in correctly upstaging patients and, hence, avoiding unnecessary procedures such as SLNB in the presence of axillary lymph node metastases.…”

“…Two preliminary studies indicate PEM to have a sensitivity of 80–86% and a specificity of 91–100%, a significant improvement over conventional mammography22, 23. One of the major limitations of PET-CT in evaluating breast cancer is decreased sensitivity for small tumors24. While PEM requires a specialized piece of equipment, one advantage is that it may be able to detect smaller tumors than PET-CT, leading to earlier diagnosis25.…”