Performance of 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography and integrated PET/CT in restaged breast cancer patients.
OBJECTIVE
This study was conducted to compare the clinical stage derived from 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) positron emission tomography (PET) to that of integrated PET/computed tomography (CT) in restaged breast cancer patients.


METHODS
Fifty-eight female patients (age range 29-80 years, mean age +/-SD, 53.3 +/- 11.7 years) underwent PET/CT restaging for breast cancer. Two experienced nuclear medicine physicians interpreted PET images. A radiologist was added for reading PET/CT studies. A patient-based analysis was performed. Histopathological findings, correlative imaging studies, changes in number, size, and hypermetabolic activity of suspicious lesions and/or patient outcome served as standard of reference for determining the diagnostic accuracy of both modalities.


RESULTS
PET staged 79.3% (46/58) of the patients correctly, overstaged seven (12.1%), and understaged five patients (8.6%). Integrated PET/CT staged 89.7% (52/58) of the patients correctly, overstaged four (6.9%), and understaged two patients (3.4%). The staging accuracy of PET/CT was not significantly better than that of PET alone (p = 0.059). Lesions exhibiting mild hypermetabolic activity, benign inflammatory lesions, and physiological variants largely explained incorrect PET findings.


CONCLUSIONS
Integrated PET/CT only marginally improves the restaging accuracy over PET alone (p = 0.059) in breast cancer patients.
Fueger
Barbara J
BJ
Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center, UCLA David Geffen School of Medicine, Los Angeles, CA 90095-6942, USA.
Weber
Wolfgang A
WA
Quon
Andrew
A
Crawford
Tyler L
TL
Allen-Auerbach
M S
MS
Halpern
B S
BS
Ratib
Osman
O
Phelps
Michael E
ME
Czernin
Johannes
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods* / Q000592:standards; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18