Whole-body PET/CT-mammography for staging breast cancer: initial results

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.

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Simultaneous Whole-Body PET/MR Imaging in Comparison to PET/CT in Pediatric Oncology: Initial Results

Radiology ◽

10.1148/radiol.14131732 ◽

2014 ◽

Vol 273 (1) ◽

pp. 220-231 ◽

Cited By ~ 123

Author(s):

Jürgen F. Schäfer ◽

Sergios Gatidis ◽

Holger Schmidt ◽

Brigitte Gückel ◽

Ilja Bezrukov ◽

...

Keyword(s):

Mr Imaging ◽

Pediatric Oncology ◽

Whole Body ◽

Pet Ct ◽

Initial Results

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Abstract P2-05-01: A Comparative Study of 18F-Fluoride PET/CT and Whole-Body High Resolution CT (HRCT) for the Detection of Bone Metastases in Patients with Advanced Breast Cancer

10.1158/0008-5472.sabcs10-p2-05-01 ◽

2010 ◽

Author(s):

A DeCensi ◽

A Piccardo ◽

V Altrinetti ◽

L Bacigalupo ◽

E Biscaldi ◽

...

Keyword(s):

Breast Cancer ◽

High Resolution ◽

Comparative Study ◽

Advanced Breast Cancer ◽

Bone Metastases ◽

Advanced Breast ◽

Whole Body ◽

High Resolution Ct ◽

Pet Ct ◽

18F Fluoride

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FDG PET-CT in breast cancer: A single institution experience from India.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e11027 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e11027-e11027

Author(s):

Nalini K Rao ◽

Basavalinga S Ajaikumar ◽

Kumar G Kallur ◽

P S Sridhar ◽

Bhattacharjee Somorat ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Fdg Pet ◽

Treatment Plan ◽

Whole Body ◽

Breast Cancer Patients ◽

Term Survival ◽

New Findings ◽

Pet Ct ◽

Fdg Pet Ct

e11027 Background: Whole body FDG PET CT is a useful tool in diagnosis, staging and prognosis; and its timely use is critical for early intervention and achieving long term survival in patients with early and advanced breast cancer. Methods: In this observational retrospective study, we report FDG PET CT findings of all breast cancer patients enrolled in our hospital based cancer registry between the years 2008 to 2011. Results: One thousand and fifty three women underwent a total of 1638 scans. Two hundred and forty five scans (14.96%) were done for staging /restaging/diagnosis, 1208 (73.75%) were for response evaluation to chemotherapy and 185 (11.29%) were for surveillance. The median age at diagnosis was 53 years. We identified a possible synchronous breast primary in 28 (2.66%) women and a probable new or existing second non-breast primary in 21(1.99%) women. Internal nodal metastasis was identified in 76 (7.21%) women at diagnosis. There were 26 (2.47%) patients with multicentric tumors. There was an increased uptake in the thyroid gland in 49(2.99%) and in the adrenal in 41 (2.50%) women. There were other random ‘Incidental findings of concern’ in 7 (0.37%) of women, diagnosed either on the CT or PET-CT component. Findings on PET-CT, including- upstaging of the breast primary and unexpected new findings, unrelated to the breast primary, changed the treatment plan in approximately 7% -10% of the patients. We did find that PET-CT did not impact early tumors; however, it did contribute in, 1) the assessment of internal mammary nodes, 2) prognostication based on tumor burden and, 3) aggressive management of oligometastases. Conclusions: Whole body FDG PET CT is a useful tool for staging and prognostication in breast cancer patients. However, the timing of such scans for surveillance needs to be defined for early detection of progression to have an impact on survival.

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Detection of metastases in breast cancer: Is whole body PET/MR better than PET/CT?

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.26_suppl.15 ◽

2014 ◽

Vol 32 (26_suppl) ◽

pp. 15-15

Author(s):

Eleonora Teplinsky ◽

Akshat Pujara ◽

Francisco J. Esteva ◽

Linda Moy ◽

Amy Melsaether ◽

...

Keyword(s):

Breast Cancer ◽

Treatment Response ◽

Metastatic Lesion ◽

Lesion Detection ◽

Whole Body ◽

Reference Standard ◽

Therapeutic Implications ◽

Metastatic Setting ◽

Pet Ct ◽

Pathology Reports

15 Background: Whole body PET/CT is commonly utilized in breast cancer (BC) patients (pts). Limitations include assessment of treatment response in bone metastases (mets), high physiologic uptake in brain and liver, and cumulative radiation exposure. The site of mets can have prognostic and therapeutic implications. PET/MR, an exciting new hybrid technology, delivers less radiation than PET/CT. Our aim was to compare the differences in metastatic lesion detection using PET/CT & PET/MR in all BC subtypes. Methods: After a single 18-FDG injection, pts had whole body PET/CT for staging and assessment of treatment response. They were transported to another NYU facility & then underwent whole body PET/MR. PET/MR & PET/CT images were each read by a radiologist blinded to prior exams or reports. Number of mets (up to 6) per organ was recorded. 2 experienced radiologists unblinded to imaging and pathology reports served as the “reference standard”. Results: Forty-eight BC pts underwent PET/CT & PET/MR (28 in metastatic setting, 5 for staging & 15 to rule out recurrence). Median age: 55; range 32-79 with 31 ER+/HER2-, 8 ER+/HER2+, 2 ER-/HER2+, 6 ER-/HER2+, 1 unknown. 20 pts had no distant mets on scan. In the remaining 28 pts, the reference standard detected 9 liver, 18 bone, 7 lung/pleura, 5 brain & 10 lymph node (LN) metastases; some patients had ≥1 metastatic site. PET/CT had more false positives (FP) and false negatives (FN) in the detection of mets (Table). PET/MR had 1 FP in the liver. PET/MR accurately detected 2 bone (ER+/HER2-), 3 liver (ER+/HER2-), 2 LN (1 ER+/HER2+; 1 ER+/HER2-) and 5 brain lesions (1 ER+/HER2-; 3 ER-/HER2+; 1 ER+/HER2+) in 10 unique pts that were not identified on PET/CT. 1 liver (ER+/HER2-) and 2 brain mets (ER-/HER2+) identified on PET/MR were previously unknown. Conclusions: Our preliminary data suggest that PET/MR outperformed PET/CT in detecting mets in the liver, brain, LN & possibly bone. Prospective studies of PET/MR are warranted to determine whether early detection of mets, including occult brain mets in HER2+ pts, impacts survival.[Table: see text]

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

Journal of Oncology ◽

10.1155/2012/438647 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 34

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.

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