18F-FDG PET/CT in staging patients with locally advanced or inflammatory breast cancer: comparison to conventional staging. Groheux, D., Giacchetti, S., Delord, M., Hindié, E., Vercellino, L., Cuvier, C., Toubert, M., Merlet, P., Hennequin, C., & Espié, M. J Nucl Med, 54(1):5–11, 2013.
18F-FDG PET/CT in staging patients with locally advanced or inflammatory breast cancer: comparison to conventional staging [link]Paper  abstract   bibtex   
UNLABELLED: The prognosis of patients with locally advanced breast cancer (LABC) remains poor. We prospectively investigated the impact of (18)F-FDG PET/CT at initial staging in this clinical setting and compared PET/CT performance with that of conventional distant work-up. METHODS: During 60 mo, consecutive patients with LABC (clinical T4 or N2-N3 disease) underwent (18)F-FDG PET/CT. The yield was assessed in the whole group and separately for noninflammatory and inflammatory cancer. The performance of PET/CT was compared with that of a conventional staging approach including bone scanning, chest radiography, or dedicated CT and abdominopelvic sonography or contrast-enhanced CT. RESULTS: 117 patients with inflammatory (n = 35) or noninflammatory (n = 82) LABC were included. (18)F-FDG PET/CT confirmed N3 nodal involvement in stage IIIC patients and revealed unsuspected N3 nodes (infraclavicular, supraclavicular, or internal mammary) in 32 additional patients. Distant metastases were visualized on PET/CT in 43 patients (46% of patients with inflammatory carcinoma and 33% of those with noninflammatory LABC). Overall, (18)F-FDG PET/CT changed the clinical stage in 61 patients (52%). Unguided conventional imaging detected metastases in only 28 of the 43 patients classified M1 with PET/CT (65%). (18)F-FDG PET/CT outperformed conventional imaging for bone metastases, distant lymph nodes, and liver metastases, whereas CT was more sensitive for lung metastases. The accuracy in diagnosing bone lesions was 89.7% for planar bone scanning versus 98.3% for (18)F-FDG PET/CT. The accuracy in diagnosing lung metastases was 98.3% for dedicated CT versus 97.4% for (18)F-FDG PET/CT. CONCLUSION: (18)F-FDG PET/CT had the advantage of allowing chest, abdomen and bone to be examined in a single session. Almost all distant lesions detected by conventional imaging were depicted with PET/CT, which also showed additional lesions.
@article{groheux_18f-fdg_2013,
	title = {{18F}-{FDG} {PET}/{CT} in staging patients with locally advanced or inflammatory breast cancer: comparison to conventional staging},
	volume = {54},
	issn = {1535-5667},
	shorttitle = {{18F}-{FDG} {PET}/{CT} in staging patients with locally advanced or inflammatory breast cancer: comparison to conventional staging},
	url = {http://dx.doi.org/10.2967/jnumed.112.106864},
	abstract = {UNLABELLED: The prognosis of patients with locally advanced breast cancer (LABC) remains poor. We prospectively investigated the impact of (18)F-FDG PET/CT at initial staging in this clinical setting and compared PET/CT performance with that of conventional distant work-up. METHODS: During 60 mo, consecutive patients with LABC (clinical T4 or N2-N3 disease) underwent (18)F-FDG PET/CT. The yield was assessed in the whole group and separately for noninflammatory and inflammatory cancer. The performance of PET/CT was compared with that of a conventional staging approach including bone scanning, chest radiography, or dedicated CT and abdominopelvic sonography or contrast-enhanced CT. RESULTS: 117 patients with inflammatory (n = 35) or noninflammatory (n = 82) LABC were included. (18)F-FDG PET/CT confirmed N3 nodal involvement in stage IIIC patients and revealed unsuspected N3 nodes (infraclavicular, supraclavicular, or internal mammary) in 32 additional patients. Distant metastases were visualized on PET/CT in 43 patients (46\% of patients with inflammatory carcinoma and 33\% of those with noninflammatory LABC). Overall, (18)F-FDG PET/CT changed the clinical stage in 61 patients (52\%). Unguided conventional imaging detected metastases in only 28 of the 43 patients classified M1 with PET/CT (65\%). (18)F-FDG PET/CT outperformed conventional imaging for bone metastases, distant lymph nodes, and liver metastases, whereas CT was more sensitive for lung metastases. The accuracy in diagnosing bone lesions was 89.7\% for planar bone scanning versus 98.3\% for (18)F-FDG PET/CT. The accuracy in diagnosing lung metastases was 98.3\% for dedicated CT versus 97.4\% for (18)F-FDG PET/CT. CONCLUSION: (18)F-FDG PET/CT had the advantage of allowing chest, abdomen and bone to be examined in a single session. Almost all distant lesions detected by conventional imaging were depicted with PET/CT, which also showed additional lesions.},
	number = {1},
	journal = {J Nucl Med},
	author = {Groheux, David and Giacchetti, Sylvie and Delord, Marc and Hindié, Elif and Vercellino, Laetitia and Cuvier, Caroline and Toubert, Marie-Elisabeth and Merlet, Pascal and Hennequin, Christophe and Espié, Marc},
	year = {2013},
	pages = {5--11},
}

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