Quantification of FDG-PET/CT with delayed imaging in patients with newly diagnosed recurrent breast cancer

Abstract Background [18F]-fluorodeoxyglucose-positron emission tomography/computed tomography ([18F]FDG-PET/CT) has been implemented sporadically in hospital settings as the standard of care examination for recurrent breast cancer. We aimed to explore the clinical impact of implementing [18F]FDG-PET/CT for patients with clinically suspected recurrent breast cancer and validate the diagnostic accuracy. Methods Women with suspected distant recurrent breast cancer were prospectively enrolled in the study between September 2017 and August 2019. [18F]FDG-PET/CT was performed, and the appearance of incidental benign and malignant findings was registered. Additional examinations, complications, and the final diagnosis were registered to reflect the clinical consequence of such findings. The diagnostic accuracy of [18F]FDG-PET/CT as a stand-alone examination was analyzed. Biopsy and follow-up were used as a reference standard. Results [18F]FDG-PET/CT reported breast cancer metastases in 72 of 225 women (32.0%), and metastases were verified by biopsy in 52 (52/225, 23.1%). Prior probability and posterior probability of a positive test for suspected metastatic cancer and incidental malignancies were 27%/85% and 4%/20%, respectively. Suspected malignant incidental findings were reported in 46 patients (46/225, 20.4%), leading to further examinations and final detection of nine synchronous cancers (9/225, 4.0%). These cancers originated from the lung, thyroid, skin, pancreas, peritoneum, breast, kidney, one was malignant melanoma, and one was hematological cancer. False-positive incidental malignant findings were examined in 37/225 patients (16.4%), mainly in the colon (n = 12) and thyroid gland (n = 12). Ten incidental findings suspicious for benign disease were suggested by [18F]FDG-PET/CT, and further examinations resulted in the detection of three benign conditions requiring treatment. Sensitivity, specificity, and AUC-ROC for diagnosing distant metastases were 1.00 (0.93–1.0), 0.88 (0.82–0.92), and 0.98 (95% CI 0.97–0.99), respectively. Conclusion [18F]FDG-PET/CT provided a high posterior probability of positive test, and a negative test was able to rule out distant metastases in women with clinically suspected recurrent breast cancer. One-fifth of patients examined for incidental findings detected on [18F]FDG-PET/CT were diagnosed with clinically relevant conditions. Further examinations of false-positive incidental findings in one of six women should be weighed against the high accuracy for diagnosing metastatic breast cancer. Trial registration Clinical.Trials.gov. NCT03358589. Registered 30 November 2017—Retrospectively registered, http://www.ClinicalTrials.gov

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Carcinoma en Cuirasse from Recurrent Breast Cancer seen on FDG-PET/CT

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.159456 ◽

2015 ◽

Vol 5 ◽

pp. 35 ◽

Cited By ~ 1

Author(s):

Aung Zaw Win ◽

Carina Mari Aparici

Keyword(s):

Breast Cancer ◽

Fdg Pet ◽

Ductal Carcinoma ◽

Recurrent Breast Cancer ◽

Left Breast ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Pet Ct ◽

Recurrent Breast ◽

Fdg Pet Ct

Our patient was a 36-year-old female diagnosed with Grade II ER+/PR−/Her-2 − ductal carcinoma in situ (DCIS) in the left breast. She underwent left lumpectomy and received treatment with tamoxifen and radiotherapy. Three years later, she presented with multiple diffused skin nodules on the chest and upper left arm. 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) exam showed widespread metastasis in the chest, upper left arm, left axillary lymph nodes, and left suprascapular muscle. FDG-PET/CT imaging of breast carcinoma en cuirasse is very rare. FDG-PET/CT is useful in detecting recurrent breast cancer.

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The utility of 18 F-FDG PET/CT for suspected recurrent breast cancer: impact and prognostic stratification

Cancer Imaging ◽

10.1186/1470-7330-14-13 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 21

Author(s):

Alexandre Cochet ◽

Steven David ◽

Kate Moodie ◽

Elizabeth Drummond ◽

Gaelle Dutu ◽

...

Keyword(s):

Breast Cancer ◽

Fdg Pet ◽

Recurrent Breast Cancer ◽

Pet Ct ◽

Prognostic Stratification ◽

Recurrent Breast ◽

Fdg Pet Ct

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Benefits And Harms Of Implementing [18F]FDG-PET/CT For Diagnosing Recurrent Breast Cancer: A Prospective Clinical Study

10.21203/rs.3.rs-571795/v1 ◽

2021 ◽

Author(s):

Marianne Vogsen ◽

Jeanette Dupont Jensen ◽

Oke Gerke ◽

Anne Marie Bak Jylling ◽

Jon Thor Asmussen ◽

...

Keyword(s):

Breast Cancer ◽

Diagnostic Accuracy ◽

Fdg Pet ◽

Incidental Findings ◽

Posterior Probability ◽

Distant Metastases ◽

Recurrent Breast Cancer ◽

Pet Ct ◽

Recurrent Breast ◽

Fdg Pet Ct

Abstract Background [18F]-fluorodeoxyglucose-positron emission tomography / computed tomography ([18F]FDG-PET/CT) has been implemented sporadically in hospital settings as the standard of care examination for recurrent breast cancer. We aimed to explore the clinical impact of implementing [18F]FDG-PET/CT for patients with clinically suspected recurrent breast cancer and validate the diagnostic accuracy. Methods Women with suspected distant recurrent breast cancer were prospectively enrolled in the study between September 2017 and August 2019. [18F]FDG-PET/CT was performed, and the appearance of incidental benign and malignant findings was registered. Additional examinations, complications, and the final diagnosis were registered to reflect the clinical consequence of such findings. The diagnostic accuracy of [18F]FDG-PET/CT as a stand-alone examination was analyzed. Biopsy and follow-up were used as a reference standard. Results [18F]FDG-PET/CT reported breast cancer metastases in 72 of 225 women (32.0%), and metastases were verified by biopsy in 52 (52/225, 23.1%). Prior probability and posterior probability of a positive test for suspected metastatic cancer and incidental malignancies were 27%/85% and 4%/20%, respectively. Suspected malignant incidental findings were reported in 46 patients (46/225, 20.4%), leading to further examinations and final detection of nine synchronous cancers (9/225, 4.0%). These cancers originated from the lung, thyroid, skin, pancreas, peritoneum, breast, kidney, one was malignant melanoma, and one was hematological cancer. False-positive incidental malignant findings were examined in 37/225 patients (16.4%), mainly in the colon (n = 12) and thyroid gland (n = 12). Ten incidental findings suspicious for benign disease were suggested by [18F]FDG-PET/CT, and further examinations resulted in the detection of three benign conditions requiring treatment. Sensitivity, specificity, and AUC-ROC for diagnosing distant metastases were 1.00 (0.93-1.0), 0.88 (0.82-0.92), and 0.98 (95% CI 0.97-0.99), respectively.Conclusion [18F]FDG-PET/CT provided a high posterior probability of positive test, and a negative test was able to rule out distant metastases in women with clinically suspected recurrent breast cancer. One-fifth of patients examined for incidental findings detected on [18F]FDG-PET/CT were diagnosed with clinically relevant conditions. Further examinations of false-positive incidental findings in one of six women should be weighed against the high accuracy for diagnosing metastatic breast cancer.Trial registration: Clinical.Trials.gov. NCT03358589. Registered 30 November 2017 - Retrospectively registered, http://www.ClinicalTrials.gov

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Role of F-18 FDG PET/CT in Patients with Suspected Recurrent Breast Cancer: Additional Value over Conventional Imaging Modalities

Archives of Breast Cancer ◽

10.32768/abc.20218288-93 ◽

2021 ◽

pp. 88-93

Author(s):

Mehrdad Bakhshayeshkaram ◽

Farahnaz Aghahosseini ◽

Sara Alavinejad ◽

Yalda Salehi ◽

Sharareh Seifi ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Fdg Pet ◽

Recurrent Breast Cancer ◽

Imaging Modalities ◽

Conventional Imaging ◽

Supraclavicular Lymph Nodes ◽

Pet Ct ◽

Recurrent Breast ◽

Fdg Pet Ct

Background: The aim of the present study was to investigate the added value of F-18 fludeoxyglucose (FDG) positron-emission tomography (PET)/computed tomography (CT) compared with conventional imaging modalities for the evaluation of locoregional and distant sites of recurrence in breast cancer patients. Methods: From May 2013 to September 2016, 109 patients with suspected recurrent breast cancer who underwent conventional imaging and F-18 FDG PET/CT with an interval of 6 weeks were consecutively enrolled (mean age: 52.66 years; range: 29?79). Histopathologic results and clinical follow up based on the gold-standard imaging modality or serial imaging were considered as the reference for verification of F-18 FDG PET/CT findings. Results: Of 109 patients, 81 were found to have at least one site of recurrence (74.31%). Local recurrence was correctly identified in 32/32 patients following PET/CT, which was higher than that on conventional imaging (20/32, 62.5%). PET/CT detected 27 additional nodal metastases compared with conventional imaging (59 vs. 32, 45.76%), most frequently in the hilar/mediastinal region (n=27), followed by the supraclavicular lymph nodes (n=20, 62.5%), internal mammary lymph nodes (n=6, 18.77%), and axillary basin (n=6, 18.77%). Additional sites of distant metastasis were identified in 41 patients (37.61%) following F-18 FDG PET/CT imaging, 48.78% of which were localized in the skeletal system (n=20), 21.95% in the liver (n=9), 12.19% in the lungs (n=5), 12.19% in the brain (n=5), and 4.87% in the adrenal glands (n=2). Conclusion: F-18 FDG PET/CT serves as a useful supplement to conventional imaging techniques by identifying additional sites of disease recurrence in patients with breast cancer, which may change the preferred treatment strategy, particularly in regions that are not routinely evaluated by conventional imaging.

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