Document Detail


Impact of PET/CT in comparison with same day contrast enhanced CT in breast cancer management.
MedLine Citation:
PMID:  17515747     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the impact of F-18 fluorodeoxyglucose (FDG) positron emission tomography with fused computerized tomography (PET/CT) in comparison with same day contrast enhanced CT (CE-CT) in breast cancer management. METHOD: Seventy studies in 49 breast cancer patients, 17 for initial and 53 for restaging disease were included. All patients underwent PET/CT for diagnostic purposes followed by CE-CT scans of selected body regions. PET/CT was started approximately 90 minutes following IV injection of 10-15 mCi of F-18 FDG on a GE Discovery PET/CT system. Oral contrast was given before F-18 FDG injection. The CE-CT was performed according to departmental protocol. RESULTS: Out of a total of 257 lesions, 210 were concordant between PET/CT and CE-CT. There were 47 discordant lesions, which were verified by either biopsy (35) or follow-up (12 PET positive CE-CT negative lesions). PET/CT correctly identified 25 true positive (TP). CE-CT identified 2 TP lesions missed by PET/CT which were false negatives (FNs): one liver metastasis with necrosis, which was nonavid to FDG uptake because of necrosis and a second one missed on abdominal metastatic node, which did not change staging or treatment. PET/CT incorrectly identified 2 false positive lesions while CE-CT incorrectly identified 18 false positive. TP recurrence of the disease was found by PET/CT in 44% (15/34 pts), whereas 56% (19/34 pts) were free of disease. The CE-CT described progression of the disease in 1 true negative PET/CT study and no progression in 2 TP PET/CT studies. The sensitivity, specificity, accuracy, positive productive value, and negative productive value for PET/CT were 97.8%, 93.5%, 97.3%, 99.1%, 85% and for CE-CT were 87.6%, 42%, 82.1%, 91.6%, 31.7%. CONCLUSION: In this study, PET/CT played a more important role than CE-CT scans alone and provided an impact on the management of breast cancer patients.
Authors:
Elena Piperkova; Barbara Raphael; Mustafa E Altinyay; Ivan Castellon; Richard Libes; Nick Sandella; Sherif Heiba; Hussein Abdel-Dayem
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  32     ISSN:  0363-9762     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-22     Completed Date:  2007-07-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  429-34     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine and Cancer Center, St Vincent's Hospital and New York Medical College, New York, NY 10011, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Breast Neoplasms / radiography*,  radionuclide imaging*
Disease Progression
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Male
Middle Aged
Neoplasm Staging
Positron-Emission Tomography*
Predictive Value of Tests
Radiopharmaceuticals / diagnostic use
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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