Dual-Time 18F-FDG PET/CT Imaging in Initial Locoregional Staging of Breast Carcinoma: Comparison with Conventional Imaging and Pathological Prognostic Factors

Abstract

The aims of this retrospective study were to consider the diagnostic role of dual-time 18 F-fluorodeoxyglucose positron emission tomography and computed tomography ( 18 F-FDG PET/CT) in detection of breast carcinoma and axillary lymph node (ALN) status and to evaluate the primary tumor 18 F-FDG uptake pattern. Preoperative staging was performed by 18 F-FDG PET/CT in 78 female patients with breast carcinoma. Conventional imaging results were evaluated by breast magnetic resonance imaging (MRI) of 79 lesions in 78 patients, bilateral mammography (MMG) of 40 lesions in 40 patients, and breast ultrasonography (USG) of 47 lesions in 46 patients. The primary tumor detection rate using 18 F-FDG PET/CT was higher than those using MRI, USG, and MMG. The sensitivity and specificity of 18 F-FDG PET/CT scans for detecting multifocality were higher than those of MRI. The specificity of ALN metastasis detection with MRI was higher than that with 18 F-FDG PET/CT, but 18 F-FDG PET/CT had higher sensitivity. Higher 18 F-FDG uptake levels were detected in patients with ALN metastasis, histologic grade 3, estrogen-progesterone-negative receptor status, lymphatic invasion, and moderate to poor prognostic groups. There was no statistical difference for the retention index in categorical pathological parameters except for progesterone-negative status.In conclusion, 18 F-FDG PET/CT scans may be a valuable imaging technique for evaluating primary tumor and axillary status in staging breast carcinoma and 18 F-FDG uptake may be a prognostic factor that indicates aggressive tumor biology and poor prognosis. Dual-time imaging in breast carcinoma staging may not be used for predicting pathological criteria and the aggressiveness of primary lesions.

PET/CT and MRI for Identifying Axillary Lymph Node Metastases in Breast Cancer Patients: Systematic Review and Meta‐Analysis

“…The literature search identified 369 articles ( Fig. 1) and 11 of these studies [32][33][34][35][36][37][38][39][40][41][42] were included in the meta-analysis. The details of the study characteristics and FP/FN/TP/TN are presented in Tables 1-3, respectively.…”

“…The reference standards were SLNB and/or ALND (n = 7) and histopathology (no mention of this detail, n = 4). Most studies [33][34][35][36][37][38][39][40][41] enrolled patients with confirmed invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), or other specific types (n = 9). One study 42 included breast cancer subtypes with low FDG avidity (mucinous carcinoma [MC], tubular carcinoma [TC], and ILC) and another study 32 did not mention the histopathological type.…”

“…The total sample size of the included studies was 1206 lesions in 1203 patients assessed using PET/CT and 1189 lesions in 1186 patients assessed using MRI, as some patients had bilateral lesions. Most reports [33][34][35][36][37][38][39][40]42 described the features indicative of metastatic ALN. One report 41 did not mention this detail of MRI and another 32 did not describe features of PET/CT.…”

Contribution of Fluorodeoxyglucose-Positron Emission Tomography Late Imaging to Diagnosis and Correlation with Histopathology in Invasive Lobular Breast Cancer

“…The majority of cases are more common IDC in nearly all of the researches. In 6 studies investigating the contribution of late imaging with FDG-PET in breast cancer, the first bibliography of 2/56, 3/66, 13/86, 2/53, 8/48 and 2/38, respectively, was included in the studies and the rate was only 9% (30/347) (18)(19)(20)(24)(25)(26).…”

“…It is known that late imaging contributes to the diagnosis in malignancies, where the imaging quality will be optimal as much as the radiopharmaceutical half-life allows (12). There are many studies reporting that late image in FDG-PET in breast cancer significantly increases sensitivity and specificity (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). However, these studies mostly consist of IDC patients.…”