title: Comparison of 18F-FDG positron emission tomography/computed tomography and computed tomography in patients with already-treated breast cancer: diagnostic and prognostic implications.
abstract: OBJECTIVE
  The purpose of the study was to assess the comparison of 18F-FDG PET/CT and CT in patients with breast cancer (BC) already treated with primary therapy, in evaluating the diagnostic and prognostic values.
  
  
  METHODS
  We retrospectively studied 190 patients (187 women and 3 men, mean age 61±11 years) with previous BC (all stages) after surgery and other primary treatments. They underwent within three months CT and 18F-FDG PET/CT examinations for the evaluation of disease status. Disease relapse was confirmed by clinical evaluation and/or radiological findings. Survival curves of disease-free survival (DFS) and overall survival (OS) were computed using Kaplan-Meier method. Cox analysis regression was used to determine predictive factors of DFS and OS.
  
  
  RESULTS
  Of the overall 190 patients, 82 (43%) had evidence of clinical and/or imaging disease relapse, while 108 (57%) did not. Sensitivity, specificity, negative predictive and positive predictive values for disease relapse or progression were of 89% vs. 77%, 73% vs. 53%, 90% vs. 75% and 72% vs. 55%, respectively for PET/CT and CT. DFS curves were significantly different in patients with both negative and positive PET/CT and CT (log-rank test 33.6; P<0.0001 and 12.7; P=0.003, respectively). OS curves were similar in patients with positive/negative PET/CT and CT (P=NS). By both univariate and multivariate Cox regression analysis positive PET/CT was found to be related to the disease recurrence (HR 0.18 and 0.20, both P<0.0001, respectively).
  
  
  CONCLUSIONS
  PET/CT is more accurate than CT in identification of disease relapse in a large population of BC patients. In women at high-risk of recurrence, PET/CT imaging can provide the early detection of BC metastases, tailoring a proper treatment.
authors.affiliation: Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto (IOV - IRCCS), Padua, Italy. laura.evangelista@tin.it
authors.forename: L
authors.initials: L
authors.lastname: Evangelista
authors.forename: Z
authors.initials: Z
authors.lastname: Baretta
authors.forename: L
authors.initials: L
authors.lastname: Vinante
authors.forename: E
authors.initials: E
authors.lastname: Bezzon
authors.forename: V
authors.initials: V
authors.lastname: De Carolis
authors.forename: A R
authors.initials: AR
authors.lastname: Cervino
authors.forename: M
authors.initials: M
authors.lastname: Gregianin
authors.forename: C
authors.initials: C
authors.lastname: Ghiotto
authors.forename: G
authors.initials: G
authors.lastname: Saladini
authors.forename: F
authors.initials: F
authors.lastname: Pomerri
authors.forename: P C
authors.initials: PC
authors.lastname: Muzzio
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D018567:Breast Neoplasms, Male / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000706:statistics & numerical data*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D049268:Positron-Emission Tomography; D015995:Prevalence; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18