title: Performance of 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography and integrated PET/CT in restaged breast cancer patients.
abstract: 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.
authors.affiliation: Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center, UCLA David Geffen School of Medicine, Los Angeles, CA 90095-6942, USA.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Fueger
authors.forename: Wolfgang A
authors.initials: WA
authors.lastname: Weber
authors.forename: Andrew
authors.initials: A
authors.lastname: Quon
authors.forename: Tyler L
authors.initials: TL
authors.lastname: Crawford
authors.forename: M S
authors.initials: MS
authors.lastname: Allen-Auerbach
authors.forename: B S
authors.initials: BS
authors.lastname: Halpern
authors.forename: Osman
authors.initials: O
authors.lastname: Ratib
authors.forename: Michael E
authors.initials: ME
authors.lastname: Phelps
authors.forename: Johannes
authors.initials: J
authors.lastname: Czernin
mesh_terms: 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
chemical_list: D019788:Fluorodeoxyglucose F18