From palliative to curative intent: PET/CT findings in the light of breast cancer intrinsic subgroup

2019 ◽  
Vol 105 (6) ◽  
pp. NP79-NP82
Author(s):  
Maxime Brunet ◽  
Anne-Laure Cazeau ◽  
Houda Ben Rejeb ◽  
Vittorio Catena ◽  
Thomas Grellety
Keyword(s):  
Breast Cancer ◽  
Liver Lesion ◽  
Luminal A ◽  
Curative Intent ◽  
Palliative Intent ◽  
Ct Findings ◽  
Positron Emission ◽  
Pet Ct ◽  
Cancer Subtype ◽  
Contrast Ultrasound

Purpose: Among breast cancer subgroups, Luminal A is the subgroup with the best prognosis. We report the case of a young woman presenting with a localized luminal A breast cancer with a suspicious liver lesion on initial positron emission tomography (PET)/computed tomography (CT) scan staging. Case description: A 31-year-old woman presented with localized breast cancer accessible to curative treatment. However, PET/CT staging revealed an increase of focal activity in the liver, suspicious of a secondary malignant localization, changing the care towards palliative intent. Discrepancy between breast cancer luminal A subtype and the liver lesion led to further investigations (contrast ultrasound, magnetic resonance imaging, and biopsy), excluding a malignant process, and were in favor of toxic hepatitis, probably secondary to herbal tea consumption. Conclusions: Questioning PET/CT findings in light of the cancer subtype enabled us to rectify the diagnosis and allow this patient to be treated with curative intent.

Pathology-Confirmed Granuloma Mimicking Liver Metastasis of Breast Cancer

2014 ◽  
Vol 29 (1) ◽  
pp. e93-e97
Author(s):  
Ting Li ◽  
Minhao Fan ◽  
Ruohong Shui ◽  
Silong Hu ◽  
Yunyan Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Liver Metastasis ◽  
Liver Lesion ◽  
Subsequent Treatment ◽  
Position Emission Tomography ◽  
Surgical Biopsy ◽  
Solitary Lesion ◽  
Tissue Samples ◽  
Cancer History ◽  
Pet Ct

For patients with breast cancer, obtaining tissue samples from liver lesion becomes more and more important for both differential diagnosis and subsequent treatment. However, the procedure is not considered as mandatory routine and is not frequently performed. We here reported about a patient with breast cancer history and a solitary liver metastasis that was clinically diagnosed by both magnetic resonance imaging (MRI) and position emission tomography - computed tomography (PET-CT). However, pathologic diagnosis after partial hepatectomy (between sections VII and VIII) revealed multifocal granulomas. The case further addresses the importance of core needle biopsy, or surgical biopsy, for obtainment of a histological diagnosis, especially in the presence of a solitary lesion, even when the lesion has a typical medical imaging supporting metastasis, and uptake of radioactive 18F-fluorodeoxyglucose (18F-FDG) by PET-CT.

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.

scholarly journals FAPI-PET/CT: A New Direction For Diagnostic Imaging In Nuclear Medicine

2019 ◽  
pp. 48-54
Author(s):  
Pavel Korol ◽  
A. Samokhin ◽  
Oleg Shcherbina
Keyword(s):  
Breast Cancer ◽  
Standardized Uptake Value ◽  
Emission Tomography ◽  
Tumor Diseases ◽  
Positron Emission ◽  
Pet Ct ◽  
Routine Medical Practice ◽  
Technological Improvements ◽  
High Absorption ◽  
Prospects Of Application

The literature review addresses the prospects of application, FAPI-PET / CT, as a new method for diagnostic visualization of malignant tumor diseases. According to the study, a number of epidemiologically important tumor diseases, in particular breast cancer, esophagus, lungs, pancreas, tumors of the head and neck, colorectal cancer, have an extremely high absorption of FAPI in the execution of 68-Ga-FAPI-PET / CT. However, further technological improvements are required in order for FAPI-PET / CT imaging, by computing SUV, to become part of routine medical practice. Key words: positron emission tomography, radiopharmaceutical, fibroblast-associated protein, standardized uptake value.

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.

The use of Combined PET/CT for Localizing Recurrent Head and Neck Cancer: The Pittsburgh Experience

2005 ◽  
Vol 84 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Lee A. Zimmer ◽  
Carl Snyderman ◽  
Melanie B. Fukui ◽  
Todd Blodgett ◽  
Barry McCook ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Surgical Excision ◽  
Recurrent Cancer ◽  
Ct Findings ◽  
Positron Emission ◽  
Pet Ct ◽  
Pathologic Findings ◽  
Recurrent Head

We performed a retrospective study of 47 patients to ascertain the ability of combined positron-emission tomography and computed tomography (PET/CT) to localize recurrent head and neck cancer. When clinically warranted, biopsies were performed in an attempt to obtain pathologic confirmation of the PET/CT findings. Of the 47 patients, 33 exhibited PET/CT findings consistent with recurrent cancer. Of the 33 patients, 25 underwent either biopsy or surgical excision of disease in an attempt to obtain a pathologic confirmation. Biopsy analysis confirmed the PET/CT findings in 22 of these patients; in the remaining 3 patients, pathologic findings were inconsistent with the PET/CT diagnosis. Based on the subset of 25 patients who underwent pathologic testing, the sensitivity of combined PET/CT was 95% and the specificity was 60%. We conclude that combined PET/CT imaging is a valuable tool for localizing tumor recurrence in patients with head and neck cancer.

scholarly journals 18F-FDG PET/CT in the post-operative monitoring of patients with adrenocortical carcinoma

2015 ◽  
Vol 173 (6) ◽  
pp. 749-756 ◽  
Author(s):  
A Ardito ◽  
C Massaglia ◽  
E Pelosi ◽  
B Zaggia ◽  
V Basile ◽  
...  
Keyword(s):  
Adrenocortical Carcinoma ◽  
Fdg Pet ◽  
Management Strategy ◽  
Positive Likelihood Ratio ◽  
Lower Sensitivity ◽  
Ct Findings ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Operative Monitoring

ContextThe role of 18F-labeled 2-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the post-operative monitoring of patients with adrenocortical carcinoma (ACC) is still unclear.ObjectiveTo assess the accuracy of FDG PET/CT to diagnose ACC recurrence in a real world setting.Design and methodsRetrospective evaluation of data of 57 patients with presumed ACC recurrence at CT scan who underwent FDG PET/CT within a median time of 20 days. We compared the results of either FDG PET/CT or CT with a gold standard confirmation of recurrence (positive histopathology report of removed/biopsied lesions or radiological progression of target lesions at follow-up) to assess their diagnostic performance at different body sites to correctly categorize target lesions. We also assessed whether FDG PET/CT findings may be useful to inform the management strategy.ResultsIn 48 patients with confirmed ACC recurrence, we found that FDG PET/CT had lower sensitivity than CT in diagnosing liver and lung recurrences of ACC. FDG PET/CT had higher specificity than CT in categorizing liver lesions. FDG PET/CT had a greater positive likelihood ratio than CT to identify liver and abdominal ACC recurrences. The management strategy was changed based on FDG PET/CT findings in 12 patients (21.1%).ConclusionsThe greater sensitivity of CT may be partly expected due the specific inclusion criteria of the study; however, the greater specificity of FDG PET/CT was particularly useful in ruling out suspected ACC recurrences found by CT. Thus, use of FDG PET/CT as a second-line test in the post-operative surveillance of ACC patients following CT finding of a potential recurrence may have a significant impact on patient management.

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