The Role of Radiotracer Imaging in the Diagnosis and Management of Patients with Breast Cancer: Part 1—Overview, Detection, and Staging

Lee, Jean H.; Rosen, Eric L.; Mankoff, David A.

doi:10.2967/jnumed.108.053512

Cited by 46 publications

(27 citation statements)

References 104 publications

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“…À la différence du cancer bronchopulmonaire où les lésions sont à point de départ médullaire et lytiques, celles du cancer du sein sont dans 15 % des cas blastiques ou mixtes. Plusieurs travaux ont rapporté la supériorité du FdG/ TEP pour la détection des métastases osseuses par rapport à la scintigraphie conventionnelle, mais avec une moindre performance pour les lésions blastiques, soulignant l'importance d'une lecture simultanée des images de scanner, voire d'un complément d'examen par…la scintigraphie conventionnelle [3,27]. La supério-rité du FdG/TEP tient à sa capacité à dépister les lésions au stade de l'atteinte médullaire ou les lésions plus avancées à prédominance lytique.…”

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Role of positron emission tomography with fluorine 18 in the assessment of bony metastases

Even-Sapir

Foult

2010

Oncologie

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18F-fluoride is a positronemitting bone-seeking agent, the uptake of which reflects blood flow and remodeling of bone. Taking advantage of the favorable pharmacokinetic properties of the tracer combined with the high performance of PET technology, 18F-fluoride PET is a highly sensitive imaging modality for detection of benign and malignant osseous abnormalities. 18F-fluoride not only detects osteoblastic lesions but also detects lytic and early marrow-based metastases, by identifying their accompanying reactive osteoblastic changes, even when minimal. The instant fusion of 18F-fluoride data with morphological data of CT using hybrid PET/CT systems improves the specificity of 18F-fluoride PET in cancer patients, accurately differentiating between benign and malignant sites of uptake. 18F-fluoride PET and PET/CT is, however, not widely used in clinical practice. The limited availability of 18F-fluoride PET and PET/CT systems is a major factor. However, it has been stated by some experts that 18F-fluoride PET/CT is expected to replace 99m-Tc-MDP bone scintigraphy or act as a solving problem technology in specific clinical scenarios.Keywords: F18-Fluoride -PET/ CT -Bone metastasis -Osteoblastic lesions -Bone scintigraphy Résumé : Le fluor-18 (18F) est un radioélément ayant une forte affinité pour les tissus osseux, émet-teur de positons, dont la fixation reflète le flux sanguin et le remodelage osseux. Combinant les propriétés pharmacocinétiques favorables de ce traceur et les hautes performances de la technologie TEP, la 18F-TEP est une technique d'imagerie hautement sensible pour la détection des lésions osseuses bénignes et malignes. Le 18F permet de détecter non seulement les lésions ostéoblastiques, mais aussi les lésions lytiques et les métastases médullaires préco-ces, en identifiant les changements ostéoblastiques réactifs qui les accompagnent, même lorsqu'ils sont minimes. La fusion instantanée des données du 18F et des données morphologiques de la TDM, au moyen de systèmes hybrides TEP/TDM, améliore la spécificité de la 18F-TEP chez les patients atteints de cancer, en permettant de distinguer avec préci-sion les sites de fixation bénins des sites malins. La 18F-TEP et la TEP/TDM ne sont toutefois pas largement utilisées dans la pratique clinique. Cela est principalement dû à la faible disponibilité du 18F et des systèmes TEP/TDM. Cependant, certains experts affirment que la 18F-TEP/TDM devrait remplacer la scintigraphie osseuse au 99mTc-MDP ou constituer une technologie permettant la résolu-tion de problèmes, dans des situations cliniques spécifiques.

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“…En effet, comme le 99m-MDP, ce traceur s'accumule aussi sur les lésions en cours de réparation, à la différence du FdG qui ne se fixe que sur les tissus tumoraux actifs. Une réponse de type flare a également été observée, ainsi qu'une absence de modification de la captation du 18F lors de la réponse thérapeutique pré-coce [2,19,27,39].…”

Section: Naf Tepunclassified

Role of positron emission tomography with fluorine 18 in the assessment of bony metastases

Even-Sapir

Foult

2010

Oncologie

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“…Uptake of this radiopharmaceutical in malignant tissues depends on blood flow, metabolic activity, and membrane potential (6). Sestamibi imaging was noted to be particularly helpful in patients with dense breast tissue, breast implants, a palpable mass with negative mammography findings, or a history of prior breast surgery (1).…”

Section: Nuclear Breast Imaging With Conventional Devicesmentioning

confidence: 99%

“…18 F-FDG, a mainstay of current oncologic practice, shows uptake in many breast tumors, especially those that are more advanced (6). 18 F-fluoroestradiol is an estrogen analog that is used to indicate the estrogen status of a breast cancer.…”

Section: Nuclear Breast Imaging With Conventional Devicesmentioning

confidence: 99%

Breast Imaging Devices for Nuclear Medicine

Prekeges

2012

Journal of Nuclear Medicine Technology

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Breast cancer has long been a significant cause of morbidity and mortality. Mammography is the first-line imaging examination used to detect breast cancer; it has high sensitivity but only moderate specificity. The currently used secondary imaging modalities, sonography and MRI, cannot weed out all the falsepositive lesions that mammography identifies as potentially malignant. Further, many patients do not image well on mammography, so there is a significant need for alternative imaging methods. Recently, technologies using small-field, pixelated detectors optimized for breast imaging have become available for both single-photon-emitting and positron-emitting radiopharmaceuticals. This article addresses the construction and functionality of several detector types and their application to imaging of the breast. Technical aspects of nuclear breast imaging will be discussed briefly. The article concludes with an assessment of the position of nuclear medicine imaging of the breast within the overall diagnostic scheme for breast cancer detection.

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“…Whole-body 18 F-FDG PET has limited sensitivity for breast cancer and is not well suited for detecting small, well-differentiated in situ breast carcinoma (17). Dedicated PET systems can address some of these limitations and offer higher spatial resolution, shorter imaging times, reduced attenuation, and a compact footprint, and they can be integrated with biopsy procedures.…”

Section: Organ-and Disease-specific Camerasmentioning

confidence: 99%

A Bridge Not Too Far: Linking Disciplines Through Molecular Imaging Probes

Valliant

2016

J. Nucl. Med. Technol.

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CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than September 2016. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test.The field of nuclear medicine will rely increasingly on the discovery, proper evaluation, and clinical use of molecular imaging probes and on collaborations. Collaborations will include new initiatives among experts already involved in the field and with researchers, technologists, and clinicians from different areas of science and medicine. This article serves to highlight some of the opportunities in which molecular imaging and nuclear medicine in conjunction with probe development, new imaging technologies, and multidisciplinary collaborations can have a significant impact on health care and basic science from the perspective of a person involved in probe development. The article emphasizes breast cancer, but the concepts are readily applied to other areas of medicine and medical research. Nucl ear medicine is a unique field in that it relies on habitual collaboration between groups possessing disparate expertise. Nuclear medicine physicians work collaboratively on a daily basis with imaging physicists and nuclear medicine technologists who directly and indirectly rely on partnerships with biologists, chemists, engineers, and medical research teams to develop, validate, and produce radiopharmaceuticals. The future of nuclear medicine involves exploiting the full potential of molecular imaging and targeted radiotherapy and will require building on the existing culture of collaboration. To be truly successful, nuclear medicine will need to form bridges to groups outside the present sphere of collaboration-the underlying theme of this article.Society is facing challenging times that will shape the future of probe development. There has been a significant downturn in the world's economy that is affecting economic decisions made by consumers and governments, particularly with respect to health care. The world is in the midst of a protracted and ongoing isotope shortage, both an acute shortage associated with the shutdown of the reactor at Chalk River, limiting the supply of 99 Mo and 99m Tc, and a chronic underfunding of cyclotron laboratories. Economic pressures are affecting the way decisions are made about which new diagnostic technologies will ultimately be funded. This effect is true in public, private, and hybrid-model health-care systems, in which groups developing new probes must be conscious about both the healt...

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The Role of Radiotracer Imaging in the Diagnosis and Management of Patients with Breast Cancer: Part 1—Overview, Detection, and Staging

Cited by 46 publications

References 104 publications

Role of positron emission tomography with fluorine 18 in the assessment of bony metastases

Role of positron emission tomography with fluorine 18 in the assessment of bony metastases

Breast Imaging Devices for Nuclear Medicine

A Bridge Not Too Far: Linking Disciplines Through Molecular Imaging Probes

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