scholarly journals Comparison of diagnostic sensitivity of 18F-fluoroestradiol and 18F-fluorodeoxyglucose positron emission tomography/computed tomography for breast cancer recurrence in patients with a history of estrogen receptor-positive primary breast cancer

2020 ◽  
Author(s):  
Sun Young Chae ◽  
Hye Joo Son ◽  
Dong Yun Lee ◽  
Eonwoo Shin ◽  
Jungsu S. Oh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fdg Pet ◽  
Primary Breast Cancer ◽  
Cancer Recurrence ◽  
Emission Tomography ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Er Positive ◽  
Fdg Pet Ct

Abstract Background To compare the diagnostic sensitivity of [ 18 F]fluoroestradiol ([ 18 F]FES) and [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT) for breast cancer recurrence in patients with estrogen receptor (ER)-positive primary breast cancer. Methods Our database of consecutive patients enrolled in a previous prospective cohort study to assess [ 18 F]FES PET/CT was reviewed to identify eligible patients who had ER-positive primary breast cancer with suspected first recurrence at presentation and who underwent [ 18 F]FDG PET/CT. The sensitivity of qualitative [ 18 F]FES and [ 18 F]FDG PET/CT interpretations was assessed, comparing them with histological diagnoses. Results Of the 46 enrolled patients, 45 were confirmed as having recurrent breast cancer, while one was diagnosed with chronic granulomatous inflammation. Forty (89%) patients were ER-positive, four (9%) were ER-negative, and one (2%) patient did not undergo an ER assay. The sensitivity of [ 18 F]FES PET/CT was 71.1% (32/45, 95% CI: 55.7–83.6), while that of [ 18 F]FDG PET/CT was 80.0% (36/45, 95% CI: 65.4–90.4) with a threshold of positive interpretation, and 93.3% (42/45, 95% CI: 81.7–98.6) when a threshold of equivocal was used. There was no significant difference in sensitivity between [ 18 F]FES and [ 18 F]FDG PET/CT ( P =0.48) with a threshold of positive [ 18 F]FDG uptake, but the sensitivity of [ 18 F]FDG was significantly higher than [ 18 F]FES ( P =0.013) with a threshold of equivocal [ 18 F]FDG uptake. One patient with a benign lesion showed negative [ 18 F]FES but positive [ 18 F]FDG uptake. Conclusions The restaging of patients who had ER-positive primary breast cancer and present with recurrent disease may include [ 18 F]FES PET/CT as an initial test when standard imaging studies are equivocal or suspicious.

scholarly journals Comparison of diagnostic accuracy of 18F-fluoroestradiol and 18F-fluorodeoxyglucose positron emission tomography/computed tomography for breast cancer recurrence in patients with a history of estrogen receptor-positive primary breast cancer

2020 ◽  
Author(s):  
Sun Young Chae ◽  
Hye Joo Son ◽  
Dong Yun Lee ◽  
Eonwoo Shin ◽  
Jungsu S. Oh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diagnostic Accuracy ◽  
Fdg Pet ◽  
Primary Breast Cancer ◽  
Cancer Recurrence ◽  
Positron Emission ◽  
Pet Ct ◽  
Er Positive ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract Background To compare the diagnostic accuracy of 18F-fluoroestradiol (18F-FES) and 18F-fluorodoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for breast cancer recurrence in patients with estrogen receptor (ER)-positive primary breast cancer.Methods Our database of consecutive patients enrolled in a previous prospective cohort study to assess 18F-FES PET/CT was reviewed to identify eligible patients who had ER-positive primary breast cancer with suspected first recurrence at presentation and who underwent 18F-FDG PET/CT. The diagnostic accuracy of qualitative 18F-FES and 18F-FDG PET/CT interpretations was assessed, comparing them with histological diagnoses.Results Of the 46 enrolled patients, 45 were confirmed as having recurrent breast cancer, while one was diagnosed with chronic granulomatous inflammation. Forty (89%) patients were ER-positive, four (9%) were ER-negative, and one (2%) patient did not undergo an ER assay. The sensitivity of 18F-FES PET/CT was 71.1% (32/45, 95% CI: 55.7–83.6), while that of 18F-FDG PET/CT was 80.0% (36/45, 95% CI: 65.4–90.4) when malignant interpretation was defined as positive, and 93.3% (42/45, 95% CI: 81.7–98.6) when an equivocal or malignant interpretation was considered positive. There was no significant difference in sensitivity between 18F-FES and 18F-FDG PET/CT (P=0.48) when malignant 18F-FDG interpretation was considered positive, but the sensitivity of 18F-FDG was significantly higher than 18F-FES (P=0.013) when equivocal or malignant interpretation was considered positive. One patient with a benign lesion showed negative 18F-FES but malignant 18F-FDG uptake.Conclusions The restaging of patients who had ER-positive primary breast cancer and present with recurrent disease may include 18F-FES 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.

Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Interpretation Criteria for Assessment of Antibiotic Treatment Response in Pyogenic Spine Infection

2015 ◽  
Vol 66 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Silvia A. Riccio ◽  
Angel K.M. Chu ◽  
Harvey R. Rabin ◽  
Reinhard Kloiber
Keyword(s):  
Soft Tissue ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Active Infection ◽  
Spine Infection ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Purpose The objective of the study was to determine if fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can assess the response of patients with pyogenic spine infection to antibiotic treatment in a clinically useful time frame. Methods Twenty-eight patients with suspected pyogenic spine infection had baseline 18F-FDG PET/CT. Patients with proven or probable infection were divided into good and poor responders to antibiotic therapy based on clinical criteria. These patients had a follow-up 18F-FDG PET/CT 6-8 weeks later. Results Six of 28 patients were deemed negative for infection based on 18F-FDG PET/CT. Two patients were excluded because of discrepancies in interpretation. Of the 20 patients deemed positive for infection, 13 had a pathogen isolated and all showed 18F-FDG uptake in bone and/or soft tissue at baseline. Patients with a poor clinical response to treatment had persistent 18F-FDG uptake in bone and/or soft tissue on follow-up. Patients with good clinical response had uptake confined to the margins of the destroyed disc. None of these patients had recurrent infection, even if antibiotics had already been discontinued at the time of the follow-up scan. Conclusions 18F-FDG uptake confined to the margins of a destroyed disc after antibiotic therapy of pyogenic spine infection must not be considered indicative of persistent infection and likely represents mechanically induced inflammation. 18F-FDG uptake in bone or soft tissue does indicate active infection. Quantification of activity could not reliably differentiate patients with active infection from those without active infection and those who had had a successful response to therapy. The pattern of activity is critical to accurate interpretation.

scholarly journals Virtual Navigator Real-Time Ultrasound Fusion Imaging with Positron Emission Tomography/Computed Tomography for Preoperative Breast Cancer

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1289
Author(s):  
Mio Mori ◽  
Kazunori Kubota ◽  
Tomoyuki Fujioka ◽  
Leona Katsuta ◽  
Yuka Yashima ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Fusion Imaging ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

We used virtual navigator real-time ultrasound (US) fusion imaging with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to identify a lesion that could not be detected on the US alone in a preoperative breast cancer patient. Of the patient’s two lesions of breast cancer, the calcified lesion could not be identified by US alone. By fusing US with 18F-FDG PET/CT, which had been performed in advance, the location of the lesion could be estimated and marked, which benefited planning an appropriate surgery. The fusion of US and 18F-FDG PET/CT was a simple and noninvasive method for identifying the lesions detected by 18F-FDG PET/CT.

scholarly journals Physiological Appearance of Hybrid FDG–Positron Emission Tomography/Computed Tomography Imaging Following Uncomplicated Endovascular Aneurysm Sealing Using the Nellix Endoprosthesis

2020 ◽  
Vol 27 (3) ◽  
pp. 509-515
Author(s):  
Erik Groot Jebbink ◽  
Leo H. van Den Ham ◽  
Beau B. J. van Woudenberg ◽  
Riemer H. J. A. Slart ◽  
Clark J. Zeebregts ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Graft Infection ◽  
Emission Tomography ◽  
Visual Examination ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

Purpose: To investigate the physiological uptake of hybrid fluorine-18-fluorodeoxyglucose (FDG)–positron emission tomography/computed tomography (PET/CT) before and after an uncomplicated endovascular aneurysm sealing (EVAS) procedure as a possible tool to diagnose EVAS graft infection and differentiate from postimplantation syndrome. Materials and Methods: Eight consecutive male patients (median age 78 years) scheduled for elective EVAS were included in the prospective study ( ClinicalTrials.gov identifier NCT02349100). FDG-PET/CT scans were performed in all patients before the procedure and 6 weeks after EVAS. The abdominal aorta was analyzed in 4 regions: suprarenal, infrarenal neck, aneurysm sac, and iliac. The following parameters were obtained for each region: standard uptake value (SUV), tissue to background ratio (TBR), and visual examination of FDG uptake to ascertain its distribution. Demographic data were obtained from medical files and scored based on reporting standards. Results: Visual examination showed no difference between pre- and postprocedure FDG uptake, which was homogenous. In the suprarenal region no significant pre- and postprocedure differences were observed for the SUV and TBR parameters. The infrarenal neck region showed a significant decrease in the SUV and no significant decrease in the TBR. The aneurysm sac and iliac regions both showed a significant decrease in SUV and TBR between the pre- and postprocedure scans. Conclusion: Physiological FDG uptake after EVAS was stable or decreased with regard to the preprocedure measurements. Future research is needed to assess the applicability and cutoff values of FDG-PET/CT scanning to detect endograft infection after EVAS.

Fusion of Metabolic Function and Morphology: Sequential [18F]Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Studies Yield New Insights Into the Natural History of Bone Metastases in Breast Cancer

2007 ◽  
Vol 25 (23) ◽  
pp. 3440-3447 ◽  
Author(s):  
Yong Du ◽  
Ian Cullum ◽  
Tim M. Illidge ◽  
Peter J. Ell
Keyword(s):  
Bone Metastases ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Mixed Pattern ◽  
Fdg Pet Ct ◽  
Morphology Changes

Purpose By monitoring bone metastases with sequential [18F]fluorodeoxyglucose positron-emission tomography/computed tomography ([18F]FDG-PET/CT) imaging, this study investigates the clinical relevance of [18F]FDG uptake features of bone metastases with various radiographic appearances. Patients and Methods Bone metastases were found in 67 of 408 consecutive patients with known/suspected recurrent breast cancer on [18F]FDG-PET/CT, characterized by CT morphology changes and/or bony [18F]FDG uptake. Twenty-five of the patients had sequential [18F]FDG-PET/CT examinations (86 studies) over an average follow-up period of 23 months. The temporal changes in [18F]FDG uptake and corresponding CT morphology features of 146 bone lesions identified in these 25 patients were followed up and correlated with therapeutic outcome retrospectively. Results The 146 lesions were classified as osteolytic (77), osteoblastic (41), mixed-pattern (11), or no change/negative (17) on CT. The majority of the osteolytic (72; 93.5%) and mixed-pattern lesions (nine; 81.8%), but fewer of the osteoblastic lesions (25; 61%), showed increased [18F]FDG uptake. After treatment, 58 osteolytic lesions (80.5%) became [18F]FDG negative and osteoblastic on CT and only 14 relatively large lesions (19.5%) remained [18F]FDG avid. Of the 25 [18F]FDG-avid osteoblastic lesions, 13 (52%) became [18F]FDG negative, but 12 (48%) remained [18F]FDG avid and increased in size on CT. Five of the mixed-pattern lesions remained [18F]FDG avid after treatment. All 17 CT-negative lesions became [18F]FDG negative; however, nine of them became osteoblastic. None of the initially [18F]FDG-negative lesions showed [18F]FDG avidity during follow-up. Conclusion [18F]FDG uptake reflects the immediate tumor activity of bone metastases, whereas the radiographic morphology changes vary greatly with time among patients.

scholarly journals The role of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography in the differential diagnosis of pericardial disease

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Cheol Won Hyeon ◽  
Hyun Kyung Yi ◽  
Eun Kyoung Kim ◽  
Sung-Ji Park ◽  
Sang-Chol Lee ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Fdg Pet ◽  
Diagnostic Yield ◽  
Emission Tomography ◽  
Pericardial Disease ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractThis study aimed to assess the role of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) in the differential diagnosis of pericardial disease. The diagnosis is often troublesome because pericardial fluid analysis or biopsy does not always provide answers. 18FDG-PET/CT can visualize both inflammation and malignancy and offers a whole-body assessment. Patients who visited the Pericardial Disease Clinic of Samsung Medical Center with an 18FDG-PET/CT order code were extracted. Exclusion criteria were as follows: (1) the purpose of the differential diagnosis was not pericardial disease; (2) the patient had a known advanced-stage malignancy; (3) the patient already have confirmative diagnosis using a serology, pericardial effusion analysis or biopsy. The analysis included 107 patients. The most common final diagnosis was idiopathic (n = 46, 43.0%), followed by tuberculosis (n = 30, 28.0%) and neoplastic (n = 11, 10.3%). A maximum standardized uptake value (SUVmax) ≥ 5 typically indicates tuberculosis or neoplastic pericarditis except in just one case of autoimmune pericarditis); especially all of the SUVmax scores ≥ 10 had tuberculosis. The diagnostic yield of pericardial biopsy was very low (10.2%). Interestingly, all of the pericardium with an SUVmax < 4.4 had nondiagnostic results. In contrast, targeted biopsies based on 18FDG uptake demonstrated a higher diagnostic yield (38.7%) than pericardium. The sensitivity of 18FDG-PET/CT was 63.6%. The specificity was 71.9%. The positive predictive value was 20.6%. The negative predictive value 94.5%, and the accuracy was 71.0% for excluding malignancy based upon the FDG uptake patterns. It is possible to explore the differential diagnosis in some patients with difficult pericardiocentesis or pericardial biopsy in a noninvasive manner using on the SUVmax or uptake patterns. In addition, the biopsy strategy depending on 18FDG uptake is helpful to achieve biopsy more safely and with a higher yield. 18FDG-PET may enhance the diagnostic efficacy in patients with pericardial disease.

scholarly journals False Positive 18F-FDG Uptake in Mediastinal Lymph Nodes Detected with Positron Emission Tomography in Breast Cancer: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Gamze Uğurluer ◽  
Mustafa Kibar ◽  
Sinan Yavuz ◽  
Akin Kuzucu ◽  
Meltem Serin
Keyword(s):  
Breast Cancer ◽  
Positron Emission Tomography ◽  
Lymph Nodes ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Mediastinal Lymph Nodes ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Breast cancer is the most frequently diagnosed cancer among females. It is accepted that lymph node involvement with metastatic tumor and the presence of distant metastasis are the most important prognostic factors. Accurate staging is important in determining prognosis and appropriate treatment. Positron emission tomography with computed tomography detects malignancies using 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG PET CT) with high accuracy and they contribute to decisions regarding diagnosis, staging, recurrence, and treatment response. Here, we report a case of false positive metastatic mediastinal lymph nodes that were diagnosed by 18F-FDG PET CT in a 40-year-old breast cancer patient who had undergone preoperative evaluation. Right paratracheal, prevascular, aorticopulmonary, precarinal, subcarinal, hilar, and subhilar multiple conglomerated mediastinal lymph nodes were revealed in addition to left breast mass and axillary lymph nodes. Mediastinoscopy was performed with biopsy and pathology was reported as granulomatous lymphadenitis. In conclusion, any abnormal FDG accumulation in unusual lymph nodes must be evaluated carefully and confirmed histopathologically.

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