title: The value of dual-time-point 18F-FDG PET/CT for identifying axillary lymph node metastasis in breast cancer patients.
abstract: OBJECTIVE
  The sensitivity of 18-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) for detecting axillary lymph node (ALN) metastases in breast cancer is reported to be low. Several studies have shown, however, that dual-time-point (18)F-FDG PET imaging provides improved accuracy in the diagnosis of certain primary tumours when compared with single-scan imaging. The purpose of this study was to assess whether the use of dual-time-point (18)F-FDG PET/CT scans could improve the diagnostic accuracy of ALN metastasis in breast cancer.
  
  
  METHODS
  The study included 171 breast cancer patients who underwent pre-operative (18)F-FDG PET/CT scans at 2 time-points, the first at 1 h after radiotracer injection and the second 3 h after injection. Where (18)F-FDG uptake was in the ALN perceptibly increased, the maximum standardised uptake values for both time-points (SUVmax1 and SUVmax2) and the retention index (RI) were calculated. Correlation between the PET/CT results and post-operative histological results was assessed.
  
  
  RESULTS
  The performance of 1 h and 3 h PET/CT scans was equal, with sensitivity 60.3% and specificity 84.7%, in detecting ALN metastasis. Out of 171 patients, 60 had ALNs with increased (18)F-FDG uptake on 1 h or 3 h images. There was no significant difference in RI between the metastatic ALN-positive group and the node-negative group. The area under the receiver operating characteristic (ROC) curve for SUVmax1 was 0.90 (p<0.001) and 0.87 for SUVmax2 (p<0.001).
  
  
  CONCLUSIONS
  Dual time-point imaging did not improve the overall performance of (18)F-FDG PET/CT in detecting ALN metastasis in breast cancer patients.
authors.affiliation: Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: W H
authors.initials: WH
authors.lastname: Choi
authors.forename: I R
authors.initials: IR
authors.lastname: Yoo
authors.forename: J H
authors.initials: JH
authors.lastname: O
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
authors.forename: S K
authors.initials: SK
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18