title: [18F]Fluorodeoxyglucose (FDG)-Positron Emission Tomography (PET)/Computed Tomography (CT) in Suspected Recurrent Breast Cancer: A Prospective Comparative Study of Dual-Time-Point FDG-PET/CT, Contrast-Enhanced CT, and Bone Scintigraphy.
abstract: To prospectively investigate the diagnostic accuracy of [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) with dual-time-point imaging, contrast-enhanced CT (ceCT), and bone scintigraphy (BS) in patients with suspected breast cancer recurrence.
  
  
  
  One hundred women with suspected recurrence of breast cancer underwent 1-hour and 3-hour FDG-PET/CT, ceCT, and BS within approximately 10 days. The study was powered to estimate the precision of the individual imaging tests. Images were visually interpreted using a four-point assessment scale, and readers were blinded to other test results. The reference standard was biopsy along with treatment decisions and clinical follow-up (median, 17 months).
  
  
  
  FDG-PET/CT resulted in no false negatives and fewer false positives than the other imaging techniques. Accuracy of results were similar for 1-hour and 3-hour FDG-PET/CT. For distant recurrence, the area under the receiver operating curve was 0.99 (95% CI, 0.97 to 1) for FDG-PET/CT, 0.84 (95% CI, 0.73 to 0.94) for ceCT, and 0.86 (95% CI, 0.77 to 0.94) for the combined ceCT+BS. Of 100 patients, 22 (22%) were verified with distant recurrence, and 18 of these had bone involvement. Nineteen patients (19%) had local recurrence only. In exploratory analyses, diagnostic accuracy of FDG-PET/CT was better than ceCT alone or ceCT combined with BS in diagnosing distant, bone, and local recurrence, shown by a greater area under the receiver operating curve and higher sensitivity, specificity, and superior likelihood ratios.
  
  
  
  FDG-PET/CT was accurate in diagnosing recurrence in breast cancer patients. It allowed for distant recurrence to be correctly ruled out and resulted in only a small number of false-positive cases. Exploratory findings suggest that FDG-PET/CT has greater accuracy than conventional imaging technologies in this patient group.
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA. Malene.grubbe.hildebrandt@rsyd.dk.
authors.forename: Malene Grubbe
authors.initials: MG
authors.lastname: Hildebrandt
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Oke
authors.initials: O
authors.lastname: Gerke
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Christina
authors.initials: C
authors.lastname: Baun
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Falch
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Jeanette Ansholm
authors.initials: JA
authors.lastname: Hansen
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Ziba Ahangarani
authors.initials: ZA
authors.lastname: Farahani
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Henrik
authors.initials: H
authors.lastname: Petersen
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Lisbet Brønsro
authors.initials: LB
authors.lastname: Larsen
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Duvnjak
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Inguna
authors.initials: I
authors.lastname: Buskevica
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Selma
authors.initials: S
authors.lastname: Bektas
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Katrine
authors.initials: K
authors.lastname: Søe
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Anne Marie Bak
authors.initials: AM
authors.lastname: Jylling
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Marianne
authors.initials: M
authors.lastname: Ewertz
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
authors.affiliation: Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, and Poul Flemming Høilund-Carlsen, Odense University Hospital; Oke Gerke and Marianne Ewertz, University of Southern Denmark, Odense, Denmark; and Abass Alavi, University of Pennsylvania, Philadelphia, PA.
authors.forename: Poul Flemming
authors.initials: PF
authors.lastname: Høilund-Carlsen
mesh_terms: D001842:Bone and Bones / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D019788:Fluorodeoxyglucose F18