title: ¹⁸F-FDG PET/CT imaging versus dynamic contrast-enhanced CT for staging and prognosis of inflammatory breast cancer.
abstract: OBJECTIVE
  Inflammatory breast cancer (IBC) is the most aggressive type of breast cancer with a poor prognosis. Locoregional staging is based on dynamic contrast-enhanced (DCE) CT or MRI. The aim of this study was to compare the performances of FDG PET/CT and DCE CT in locoregional staging of IBC and to assess their respective prognostic values.
  
  
  METHODS
  The study group comprised 50 women (median age: 51 ± 11 years) followed in our institution for IBC who underwent FDG PET/CT and DCE CT scans (median interval 5 ± 9 days). CT enhancement parameters were net maximal enhancement, net early enhancement and perfusion.
  
  
  RESULTS
  The PET/CT scans showed intense FDG uptake in all primary tumours. Concordance rate between PET/CT and DCE CT for breast tumour localization was 92%. No significant correlation was found between SUVmax and CT enhancement parameters in primary tumours (p > 0.6). PET/CT and DCE CT results were poorly correlated for skin infiltration (kappa = 0.19). Ipsilateral foci of increased axillary FDG uptake were found in 47 patients (median SUV: 7.9 ± 5.4), whereas enlarged axillary lymph nodes were observed on DCE CT in 43 patients. Results for axillary node involvement were fairly well correlated (kappa = 0.55). Nineteen patients (38%) were found to be metastatic on PET/CT scan with a significant shorter progression-free survival than patients without distant lesions (p = 0.01). In the primary tumour, no statistically significant difference was observed between high and moderate tumour FDG uptake on survival, using an SUVmax cut-off of 5 (p = 0.7 and 0.9), or between high and low tumour enhancement on DCE CT (p > 0.8).
  
  
  CONCLUSIONS
  FDG PET/CT imaging provided additional information concerning locoregional involvement to that provided by DCE CT on and allowed detection of distant metastases in the same whole-body procedure. Tumour FDG uptake or CT enhancement parameters were not correlated and were not found to have any prognostic value.
authors: Service de Médecine nucléaire, Saint-Cloud, France. laurence.champion@curie.net.
authors: Laurence
authors: L
authors: Champion
authors: Florence
authors: F
authors: Lerebours
authors: Pascal
authors: P
authors: Cherel
authors: Veronique
authors: V
authors: Edeline
authors: Anne-Laure
authors: AL
authors: Giraudet
authors: Myriam
authors: M
authors: Wartski
authors: Dominique
authors: D
authors: Bellet
authors: Jean-Louis
authors: JL
authors: Alberini
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000175:diagnosis*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
references: J Clin Oncol. 2006 Feb 10;24(5):769-77
references: 16391297
references: Clin Cancer Res. 2004 Dec 1;10(23):7965-71
references: 15585631
references: Clin Imaging. 1992 Jul-Sep;16(3):183-6
references: 1498705
references: Br J Radiol. 2011 Jul;84(1003):612-20
references: 21081579
references: Eur J Nucl Med Mol Imaging. 2009 Mar;36(3):416-21
references: 18818917
references: J Clin Oncol. 2002 Jan 15;20(2):379-87
references: 11786564
references: Cancer. 2009 Nov 1;115(21):5038-47
references: 19645022
references: Cancer. 2010 Jun 1;116(11 Suppl):2748-54
references: 20503405
references: Ann Oncol. 2011 Mar;22(3):515-523
references: 20603440
references: Surg Today. 2010 Nov;40(11):1023-6
references: 21046499
references: J Nucl Med. 2011 Jan;52(1):48-55
references: 21149474
references: J Nucl Med. 2010 Apr;51(4):543-50
references: 20237034
references: AJR Am J Roentgenol. 2011 Oct;197(4):W769-76
references: 21940550
references: Breast Cancer Res. 2000;2(6):423-9
references: 11250736
references: J Nucl Med. 2012 Apr;53(4):512-20
references: 22343501
references: Eur J Nucl Med. 1998 Oct;25(10):1429-34
references: 9818284
references: Radiology. 2007 Sep;244(3):727-35
references: 17709827
references: Clin Breast Cancer. 2002 Jan;2(4):304-10
references: 11899363
references: Semin Oncol. 2008 Feb;35(1):51-63
references: 18308146
references: Eur Radiol. 2001;11(10):2058-70
references: 11702142
references: Eur J Nucl Med Mol Imaging. 2002 Oct;29(10):1317-23
references: 12271413
references: Breast Cancer Res Treat. 2008 Jun;109(3):417-26
references: 17653852
references: J Nucl Med. 2011 Oct;52(10):1526-34
references: 21880576
references: Clin Cancer Res. 2002 Dec;8(12):3857-62
references: 12473600
references: J Nucl Med. 2001 Jan;42(1):9-16
references: 11197987
references: Clin Breast Cancer. 2010 Aug 1;10(4):275-80
references: 20705559
references: J Nucl Med. 2009 Feb;50(2):231-8
references: 19164229
references: Eur Radiol. 2004 Nov;14(11):2038-45
references: 15316743
references: Br J Surg. 2009 Feb;96(2):166-70
references: 19160365
references: Breast Dis. 2005-2006;22:45-54
references: 16735786
references: Radiol Med. 2010 Feb;115(1):70-82
references: 20017008
references: J Comput Assist Tomogr. 2009 May-Jun;33(3):422-5
references: 19478638
references: Lancet Oncol. 2012 Apr;13(4):375-84
references: 22377126
references: Breast Cancer Res. 2003;5(3):136-9
references: 12793894