title: FDG-PET/CT compared with conventional imaging in the detection of distant metastases of primary breast cancer.
abstract: OBJECTIVE
  Evidence from studies with small numbers of patients indicates that (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) accurately detects distant metastases in the staging of primary breast cancer. We compared the sensitivity and specificity of PET/CT and conventional imaging (CT, ultrasonography, radiography, and skeletal scintigraphy) for the detection of distant metastases in patients with primary breast cancer.
  
  
  METHODS
  We performed a retrospective review that identified 225 patients with primary breast cancer seen from January 2000 to September 2009 for whom PET/CT data were available for review. Imaging findings were compared with findings on biopsy, subsequent imaging, or clinical follow-up. Sensitivity and specificity in the detection of distant metastases were calculated for PET/CT and conventional imaging. Fisher's exact tests were used to test the differences in sensitivity and specificity between PET/CT and conventional imaging.
  
  
  RESULTS
  The mean patient age at diagnosis was 53.4 years (range, 23-84 years). The sensitivity and specificity in the detection of distant metastases were 97.4% and 91.2%, respectively, for PET/CT and 85.9% and 67.3%, respectively, for conventional imaging. The sensitivity and specificity of PET/CT were significantly higher than those of conventional imaging (p = .009 and p < .001, respectively). Eleven cases of distant metastases detected by PET/CT were clinically occult and not evident on conventional imaging.
  
  
  CONCLUSIONS
  PET/CT has higher sensitivity and specificity than conventional imaging in the detection of distant metastases of breast cancer. A prospective study is needed to determine whether PET/CT could replace conventional imaging to detect distant metastases in patients with primary breast cancer.
authors.affiliation: Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Naoki
authors.initials: N
authors.lastname: Niikura
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Costelloe
authors.forename: John E
authors.initials: JE
authors.lastname: Madewell
authors.forename: Naoki
authors.initials: N
authors.lastname: Hayashi
authors.forename: Tse-Kuan
authors.initials: TK
authors.lastname: Yu
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Shana L
authors.initials: SL
authors.lastname: Palla
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Richard L
authors.initials: RL
authors.lastname: Theriault
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hortobagyi
authors.forename: Naoto T
authors.initials: NT
authors.lastname: Ueno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis / Q000175:diagnosis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011859:Radiography; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed; D055815:Young Adult