Current Role and Future Prospects of Positron Emission Tomography (PET)/Computed Tomography (CT) in the Management of Breast Cancer

Abstract

Breast cancer has become the most diagnosed cancer in women globally, with 2.3 million new diagnoses each year. Accurate early staging is essential for improving survival rates with metastatic spread from loco regional to distant metastasis, decreasing mortality rates by 50%. Current guidelines do not advice the routine use of positron emission tomography (PET)-computed tomography (CT) in the staging of early breast cancer in the absence of symptoms. However, there is a growing body of evidence to suggest that the use of PET-CT in this early stage can benefit the patient by improving staging and as a result treatment and outcomes, as well as psychological burden, without increasing costs to the health service. Ongoing research in PET radiomics and artificial intelligence is showing promising future prospects in its use in diagnosis, staging, prognostication, and assessment of responses to the treatment of breast cancer. Furthermore, ongoing research to address current limitations of PET-CT by improving techniques and tracers is encouraging. In this narrative review, we aim to evaluate the current evidence of the usefulness of PET-CT in the management of breast cancer in different settings along with its future prospects, including the use of artificial intelligence (AI), radiomics, and novel tracers.

Prostate-Specific Membrane Antigen Positron Emission Tomography Oncological Applications beyond Prostate Cancer in Comparison to Other Radiopharmaceuticals

“…According to current oncological guidelines [50] and the growing body of clinical evidence, [ 18 F]FDG PET/CT is, to date, the most commonly used radiopharmaceutical in breast cancer (BC) patients. Other radiopharmaceuticals, such as 18 F-labeled estradiol ([ 18 F]FES) or 89 Zr-labeled Trastuzumab ([ 64 Cu]Cu-DOTA-trastuzumab), have been proposed for the evaluation of the receptor status [51,52]. Recent research developments in nuclear medicine are driving efforts toward more specific imaging-based analysis, which implies more tailored treatment.…”