scholarly journals PET/CT analysis of 21 patients with breast cancer: physiological distribution of 18F-choline and diagnostic pitfalls

2018 ◽  
Vol 46 (8) ◽  
pp. 3138-3148 ◽  
Author(s):  
Fathinul Fikri Ahmad Saad ◽  
Mohd Hazeman Zakaria ◽  
Bahunu Appanna
Keyword(s):  
Breast Cancer ◽  
Premenopausal Women ◽  
Axial Skeleton ◽  
Left Breast ◽  
Whole Body ◽  
Appendicular Skeleton ◽  
Choline Uptake ◽  
Physiological Uptake ◽  
Positron Emission ◽  
Pet Ct

Objectives 18F-choline is a useful tracer for detecting tumours with high lipogenesis. Knowledge of its biodistribution pattern is essential to recognise physiological variants. The aim of this study was to describe the physiologic distribution of 18F-choline and pitfalls in patients with breast cancer. Methods Twenty-one consecutive patients with breast cancer (10 premenopausal and 11 postmenopausal women; mean age, 52.82 ± 10.71 years) underwent 18F-choline positron emission tomography (PET)/computed tomography (CT) for staging. Whole-body PET/CT was acquired after 40 minutes of 18F-choline uptake. Acquired PET images were measured semiquantitatively. Results All patients showed pitfalls unrelated to breast cancer. These findings were predominantly caused by physiological glandular uptake in the liver, spleen, pancreas, bowels, axial skeleton (85%-100%), inflammation and benign changes (4.76%), appendicular skeleton (4.76%–19.049%), and site contamination (61.9%). In <1%, a concomitant metastatic neoplasm was found. The breast showed higher physiological uptake in premenopausal compared with postmenopausal woman (18F-choline maximum standardised uptake values [g/dL] of the right breast = 2.04 ± 0.404 vs 1.59 ± 0.97 and left breast = 2.00 ± 0.56 vs 1.93 ± 1.28, respectively). Conclusion 18F-choline uptake was higher in premenopausal women. Physiological 18F-choline uptake was observed in many sites, representing possible pathologies.

scholarly journals Texture Analysis in the Diagnosis of Primary Breast Cancer: Comparison of High-Resolution Dedicated Breast Positron Emission Tomography (dbPET) and Whole-Body PET/CT

2020 ◽  
Vol 7 ◽  
Author(s):  
Yoko Satoh ◽  
Kenji Hirata ◽  
Daiki Tamada ◽  
Satoshi Funayama ◽  
Hiroshi Onishi
Keyword(s):  
Breast Cancer ◽  
Positron Emission Tomography ◽  
High Resolution ◽  
Texture Analysis ◽  
Texture Features ◽  
Emission Tomography ◽  
Whole Body ◽  
Tumor Characteristics ◽  
Positron Emission ◽  
Pet Ct

Objective: This retrospective study aimed to compare the ability to classify tumor characteristics of breast cancer (BC) of positron emission tomography (PET)-derived texture features between dedicated breast PET (dbPET) and whole-body PET/computed tomography (CT).Methods: Forty-four BCs scanned by both high-resolution ring-shaped dbPET and whole-body PET/CT were analyzed. The primary BC was extracted with a standardized uptake value (SUV) threshold segmentation method. On both dbPET and PET/CT images, 38 texture features were computed; their ability to classify tumor characteristics such as tumor (T)-category, lymph node (N)-category, molecular subtype, and Ki67 levels was compared. The texture features were evaluated using univariate and multivariate analyses following principal component analysis (PCA). AUC values were used to evaluate the diagnostic power of the computed texture features to classify BC characteristics.Results: Some texture features of dbPET and PET/CT were different between Tis-1 and T2-4 and between Luminal A and other groups, respectively. No association with texture features was found in the N-category or Ki67 level. In contrast, receiver-operating characteristic analysis using texture features' principal components showed that the AUC for classification of any BC characteristics were equally good for both dbPET and whole-body PET/CT.Conclusions: PET-based texture analysis of dbPET and whole-body PET/CT may have equally good classification power for BC.

scholarly journals Molecular Imaging in Breast Cancer: From Whole-Body PET/CT to Dedicated Breast PET

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
B. B. Koolen ◽  
W. V. Vogel ◽  
M. J. T. F. D. Vrancken Peeters ◽  
C. E. Loo ◽  
E. J. Th. Rutgers ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Malignant Tumors ◽  
Volume Effect ◽  
Whole Body ◽  
Response Monitoring ◽  
Breast Cancer Patients ◽  
Dedicated Breast Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Elevated Glucose

Positron emission tomography (PET), with or without integrated computed tomography (CT), using 18F-fluorodeoxyglucose (FDG) is based on the principle of elevated glucose metabolism in malignant tumors, and its use in breast cancer patients is frequently being investigated. It has been shown useful for classification, staging, and response monitoring, both in primary and recurrent disease. However, because of the partial volume effect and limited resolution of most whole-body PET scanners, sensitivity for the visualization of small tumors is generally low. To improve the detection and quantification of primary breast tumors with FDG PET, several dedicated breast PET devices have been developed. In this nonsystematic review, we shortly summarize the value of whole-body PET/CT in breast cancer and provide an overview of currently available dedicated breast PETs.

FDG-PET/CT in the diagnosis of recurrent breast cancer

2012 ◽  
Vol 53 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Ryusuke Murakami ◽  
Shin-ichiro Kumita ◽  
Tamiko Yoshida ◽  
Keiichi Ishihara ◽  
Tomonari Kiriyama ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Predictive Value ◽  
Cancer Recurrence ◽  
Final Diagnosis ◽  
Recurrent Breast Cancer ◽  
Whole Body ◽  
Positron Emission ◽  
Pet Ct ◽  
The Difference ◽  
Recurrent Breast

Background An advantage of PET/CT has been demonstrated for diagnosis of several tumor entities. In patients with breast cancer, early diagnosis and accurate restaging of recurrence after surgery is important for selection of the most appropriate therapeutic strategy. Purpose To evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) using 18F-fluorodeoxyglucose (FDG), for follow-up of patients with suspected recurrent breast cancer. Material and Methods Forty-seven patients with suspected recurrent breast cancer underwent PET/CT. The PET and PET/CT images were interpreted without knowledge of the results of other diagnostic modalities, and compared with each other with reference to the final diagnosis. Results Twenty-five (53%) patients suffered tumor recurrence. The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET/CT were 96%, 91%, 92%, 95%, and 94%, respectively. In comparison with PET, PET/CT had a higher sensitivity and accuracy (96% vs. 80% and 94% vs. 81%, respectively). The difference in diagnostic accuracy between PET/CT and PET was significant ( P < 0.05). Conclusion The present findings indicate that PET/CT is an accurate, sensitive and reliable modality for screening and detection of breast cancer recurrence. PET/CT appears to be an effective surveillance tool, as it is able to cover the whole body in a single procedure and shows good performance.

scholarly journals The diagnostic significance of breast incidentalomas detected on whole-body fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography

2015 ◽  
Vol 01 (02) ◽  
pp. 092-096
Author(s):  
Shelly Sharma ◽  
Ankur Pruthi
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Emission Tomography ◽  
Whole Body ◽  
Diagnostic Significance ◽  
Focal Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
The Mean ◽  
Fdg Pet Ct

ABSTRACT Objective: The objective of this study was to establish the diagnostic significance of breast incidentalomas detected on whole-body fluorine-18 (18F) fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Materials and Methods: We retrospectively analyzed the data of 3868 patients who underwent 18F FDG PET/CT at our institution, for the presence of hypermetabolic focus in the breasts. Patients with known breast cancer or with the previous history of breast cancer were excluded from the study. Ten out of remaining 3868 patients had abnormal focal uptake in the breast. We, therefore, enrolled these 10 patients with histopathology confirmation in this study. Results: Among all 3868 patients, 10 (0.25%) patients demonstrated incidental focal uptake in breast parenchyma. All of these 10 patients were females. Histopathology examination confirmed malignancy in 8 out of 10 patients (80%), these included invasive ductal cancer in 4 patients, non-Hodgkin's lymphoma in 2 patients, and metastasis from rectal cancer and endometrial cancer, respectively, in 2 patients. Of the 10 patients, 2 (20%) had lesions that were confirmed to be benign. Both of these were proven to be fibroadenomas. The mean maximum standardized uptake value (SUVmax) on FDG-PET/CT scans was 1.35 ± 1.2 in the benign cases versus 3.8 ± 1.83 in the malignant cases. This difference was statistically insignificant (P = 0.056). All malignant lesions had SUVmax 2.0 or greater. The mean size differed significantly between the benign and malignant groups (2.55 ± 0.63 vs. 1.31 ± 0.44 cm) (P = 0.005) with benign lesions being bigger in size. Conclusion: Unexpected focal areas of hypermetabolic activity discovered in the breast at the time of PET/CT are associated with a high likelihood of malignancy in as many as 80% of cases. Therefore, any suspicious activity discovered in the breast on PET/CT should be evaluated until a diagnosis is found.

Evaluation of 18 F-FDG PET/MRI, 18 F-FDG PET/CT, MRI, and CT in whole-body staging of recurrent breast cancer

2016 ◽  
Vol 85 (2) ◽  
pp. 459-465 ◽  
Author(s):  
Lino M. Sawicki ◽  
Johannes Grueneisen ◽  
Benedikt M. Schaarschmidt ◽  
Christian Buchbender ◽  
James Nagarajah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fdg Pet ◽  
Recurrent Breast Cancer ◽  
Whole Body ◽  
Pet Ct ◽  
Recurrent Breast ◽  
Fdg Pet Ct

scholarly journals Imaging Medullary Thyroid Carcinoma with Persistent Elevated Calcitonin Levels

2007 ◽  
Vol 92 (11) ◽  
pp. 4185-4190 ◽  
Author(s):  
Anne Laure Giraudet ◽  
Daniel Vanel ◽  
Sophie Leboulleux ◽  
Anne Aupérin ◽  
Clarisse Dromain ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Bone Scintigraphy ◽  
Axial Skeleton ◽  
Whole Body ◽  
Liver Imaging ◽  
Calcitonin Level ◽  
Medullary Thyroid ◽  
Positron Emission ◽  
Work Up

Abstract Purpose: Because calcitonin level remains elevated after initial treatment in many medullary thyroid carcinoma (MTC) patients without evidence of disease in the usual imaging work-up, there is a need to define optimal imaging procedures. Patients and Methods: Fifty-five consecutive elevated calcitonin level MTC patients were enrolled to undergo neck and abdomen ultrasonography (US); neck, chest, and abdomen spiral computed tomography (CT); liver and whole-body magnetic resonance imaging (MRI); bone scintigraphy; and 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/CT scan (PET). Results: Fifty patients underwent neck US, CT, and PET, and neck recurrence was demonstrated in 56, 42, and 32%, respectively. Lung and mediastinum lymph node metastases in the 55 patients were demonstrated in 35 and 31% by CT and in 15 and 20% by PET. Liver imaging with MRI, CT, US, and PET in 41 patients showed liver in 49, 44, 41, and 27% patients, respectively. Bone metastases in 55 patients were demonstrated in 35% by PET, 40% by bone scintigraphy, and 40% by MRI; bone scintigraphy was complementary with MRI for axial lesions but superior for the detection of peripheral lesions. Ten patients had no imaged tumor site despite elevated calcitonin level (median 196 pg/ml; range 39–816). FDG uptake in neoplastic foci was higher in progressive patients but with a considerable overlap with stable ones. Conclusion: The most efficient imaging work-up for depicting MTC tumor sites would consist of a neck US, chest CT, liver MRI, bone scintigraphy, and axial skeleton MRI. FDG PET scan appeared to be less sensitive and of low prognostic value.

POSITRON EMISSION TOMOGRAPHY WITH 18F -FDG IN THE DIAGNOSIS OF PROSTHETIC HEART VALVE ENDOCARDITIS

2021 ◽  
Vol 5 (1) ◽  
pp. 1151-1160
Author(s):  
A.S. Lukashevich ◽  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Prosthetic Heart Valve ◽  
Emission Tomography ◽  
Whole Body ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Purpose. The purpose of the article is to evaluate the diagnostic significance of positron emission tomography / computed tomography with 18F -fluorodeoxyglucose (18F -FDG PET/CT) for the diagnosis of prosthetic endocarditis. Methods of research. The study included 82 patients with suspected prosthetic endocarditis in accordance with the criteria proposed by Duke University [1-5]. The patients received hospital treatment at the State Institution RSPC "Cardiology" from January 2016 to March 2021. The study was of a prospective, non-randomized, single-center cohort design. The duration of the monitor period was 12 months from the moment of patients’ inclusion in the study. Whole-body positron emission tomography / computed tomography (PET/CT) examinations were performed in 82 patients. 27 patients were selected for surgical treatment. Conservative treatment group included 16 patients. 27 patients were selected into the observation group, they were suspected to have prosthetic heart valve infection in the primary referral and underwent PET/CT scanning, according to which the diagnosis of prosthetic endocarditis was excluded. The event under the study did not develop in this group during the year of observation. Results and conclusion. The history of infective endocarditis was not statistically significant and did not increase the risk of developing prosthetic endocarditis in the sample presented. The Duke criteria are less reliable in establishing the diagnosis of prosthetic endocarditis. The median number of days from the date of the first prosthesis implantation to the onset of prosthetic endocarditis was about 4 years. This study revealed that the development of the infectious process in the area of the prosthesis was noted in a more distant postoperative period compared to literature data. Histological confirmation of infection was noted in 100% (27 patients) of cases in reoperated patients. The presence of a more formidable complication such as valve ring abscess located mainly in the projection of the aortic valve ring was quite common in both groups. Presepsin and Interleukin-6 have a statistically significant (U = 394,50 p = 0,01 and U = 94,50 p = 0.004) value in the prognosis of prosthetic endocarditis. Considering the data obtained from ROC analysis, it can be said that the cut-off point at which it is possible to diagnose prosthetic endocarditis based on PETCT is 2.85. The presented methods for the interpretation of whole-body FDG-PET/CT images of patients with suspected infectious complications after cardiac surgery, as well as with the presence of prosthetic endocarditis, show high sensitivity and specificity.

Neoadjuvant Chemotherapy for Breast Cancer: Evaluation by PET / CT

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rania Ali Maarouf ◽  
Amgad S Abdel-Rahman ◽  
Samar Ibrahim Mohamed
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Therapeutic Response ◽  
Left Breast ◽  
Breast Lesions ◽  
Mean Values ◽  
Pet Ct ◽  
The Mean ◽  
Neo Adjuvant Chemotherapy ◽  
Fdg Pet Ct

Abstract Background Breast cancer (BC)is the most commonly occurring cancer in women and the second most common cancer overall.An increase in the rate of breast preservation has come to be expected because of tumor reduction using neo-adjuvant chemotherapy (NAC) for locally advanced cancer and it is important to accurately determine the effects of NAC. Patients and Methods This study was conducted on 30 female patients with histopathologically confirmed breast cancer referred for a PET/CT scan aiming to demonstrate the role of 18F-FDG PET/CT in detecting the pathological response to NAC in BC patients. Results No statistically significant differences were found between the baseline number of lesions and that after three cycles of chemotherapy. Also, no statistically significant differences were found between the mean values of baseline and after three cycles of chemotherapy of both liver activity and size of right breast lesions. Meanwhile, the mean values of SUV of right and left breast lesions as well as the size of left breast lesions were significantly lower after three cycles of chemotherapy when compared to their baseline values. And no statistically significant differences were found between complete and partial therapeutic response in the right breast lesions as well as between complete and no therapeutic response in the left breast lesions as regards baseline SUV and SUV after 3 cycles of chemotherapy. Conclusion It can be concluded that FDG-PET/CT is useful for evaluation of neo-adjuvant chemotherapy for breast cancer. However, more studies are needed to validate the results of the current study.

scholarly journals The Value of 18 Fluorine-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Breast Cancer Staging

2020 ◽  
Vol 8 (A) ◽  
pp. 970-975
Author(s):  
Ahmed Tawakol ◽  
Maha Khalil ◽  
Yasser G. Abdelhafez ◽  
Mai Hussein ◽  
Mohamed Fouad Osman
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Fdg Pet ◽  
Cancer Staging ◽  
Emission Tomography ◽  
Breast Cancer Staging ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

BACKGROUND: Accurate staging is important for management decisions in patients with newly diagnosed breast cancer. AIM: This study was conducted to evaluate the value of 18 fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging in breast cancer staging.. METHODS: A prospective study of 80 patients (1 male and 79 female) mean age 51.13 years with histologically confirmed breast cancer. The staging procedures included history, physical examination, mammography, and CT of neck, chest, abdomen, and pelvis; then, PET/CT was performed in a time interval <30 days. The findings of PET/CT were compared with those of the other conventional methods. RESULTS: The agreement between conventional methods (mammography, breast ultrasound, contrast-enhanced CT of the neck, chest, abdomen, and pelvis) and 18F FDG-PET/CT was 0.6 for assessing the T stage, 0.39 for N stage, and 0.75 for M stage. There was moderate agreement between CT and 18F FDG-PET/CT in the detection of nodal lesions (K=0.6) and pulmonary lesions (K=0.51), while a perfect agreement was noted for detecting osseous (K=0.82) and liver lesions (K=0.81). In total, 50 patients (62.5%) were concordantly staged between the conventional imaging and 18F-FDG PET/CT, while 30 patients (37.5%) showed a different tumor, node, and metastasis stage. The changes were driven by the detection of additional findings (n=26) or exclusion of findings (n=4), mainly at the lymph nodes (LNs) and/or distant sites. Regarding N status, 18F FDG-PET/CT revealed previously unknown regional lymphatic spread in supraclavicular (n=4; 5%), infraclavicular (n=11; 13.7%), and internal mammary (n=12; 15%) lymph node groups. 18F-FDG PET/CT changed M status in a total of four patients (5%); three of them were upstaged by detecting distant metastases, while osseous deposits were excluded in one patient leading to downstaging. CONCLUSION: 18F-FDG-PET/CT is considered a valuable imaging tool in the initial staging of breast cancer, which significantly impacts the overall American Joint Committee on Cancer staging in 37.5% of our study population.

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