Background. An increasing number of patients with breast cancer is being treated with preoperative chemotherapy. Evaluation of treatment response may be facilitated by positron emission tomography (PET) with 18F‐fluoro‐2‐deoxy‐D‐glucose (FDG). This noninvasive technique may allow prediction of the chemotherapy outcome in an early phase of the treatment. Methods. Prerequisites for treatment monitoring with PET are good FDG uptake in the tumor, high specificity, and a reliable quantification technique. These factors were studied in 20 patients with primary breast cancer, lymph node metastases, benign breast lesions, a combination of these abnormalities, or no abnormality. Results. In 10 of 11 patients with primary breast cancer, the tumor was visualized. The median tumor‐to‐normal‐tissue‐uptake ratio was 4.9. In all five patients with increased uptake in the lymphmode basin, pathologic proof of metastatic cancer was found. Of the patients with benign or no disease of the breast, slightly increased uptake was seen in one patient with fibrocystic disease. Conclusion. It is concluded that PET with FDG can be used for breast cancer imaging and staging.

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In patients with malignant gliomas, [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) may discriminate tumor progression from radionecrosis. We evaluated data from 50 patients undergoing FDG-PET for suspicion of tumor progression. Forty-nine were treated with surgery, 48 with radiotherapy, and 37 with chemotherapy. Twenty-one had intensive radiotherapy with either three daily treatments in two 5-day periods and intravenous carboplatin (17) or interstitial brachytherapy or stereotactic radiotherapy. Twenty underwent surgery after magnetic resonance imaging/FDG-PET; 9 demonstrated increased uptake of FDG and evidence of tumor, whereas 6 had decreased uptake and no evidence of tumor. In 5 patients, there was no correlation (all had intensive radiotherapy). In 17 patients who received bromodeoxyuridine intravenously just before surgery, the bromodeoxyuridine labeling index corresponded to the histological appearance in all but 2 patients (both had received intensive radiotherapy). In 30 patients without surgery, decreased uptake of FDG suggested prolonged survival; increased uptake of FDG did not predict survival. Eight of 10 with intensive radiotherapy had decreased label uptake. We conclude FDG-PET for evaluation of patients with possible recurrent tumors requires more study. In patients with intensive radiotherapy, FDG-PET results cannot be correlated accurately with tumor progression.

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