FDG‐PET/CT Compared with Conventional Imaging in the Detection of Distant Metastases of Primary Breast Cancer |
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| Authors: | Naoki Niikura Colleen M. Costelloe John E. Madewell Naoki Hayashi Tse‐Kuan Yu Jun Liu Shana L. Palla Yutaka Tokuda Richard L. Theriault Gabriel N. Hortobagyi Naoto T. Ueno |
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| Affiliation: | 1. eDepartment of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, Japan;2. bDiagnostic Radiology,;3. Departments of aBreast Medical Oncology,;4. cRadiation Oncology Treatment, and;5. dBiostatistics, The University of Texas MD Anderson Cancer Center, Houston Texas, USA |
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| Abstract: | Purpose.Evidence from studies with small numbers of patients indicates that 18F-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.Patients and 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.Conclusion.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. |
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| Keywords: | Breast cancer PET/CT Primary staging |
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