Dual time point 2-deoxy-2-[18F]fluoro-d-glucose PET/CT: Nodal staging in locally advanced breast cancer

García Vicente, A.M.; Soriano Castrejón, Á.; Cruz Mora, M.Á.; Ortega Ruiperez, C.; Espinosa Aunión, R.; León Martín, A.; González Ageitos, A.; Van Gómez López, O.

doi:10.1016/j.remnie.2013.12.001

ISSN: 2253-8089

The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles. The works may be submitted in Spanish or English and are subjected to a peer review process. In 2009, it became the leading Spanish journal in the field of Medical Imaging on having an Impact Factor , awarded by the Journal Citation Reports.

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Vol. 33. Issue 1.

Pages 1-5 (January - February 2014)

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Vol. 33. Issue 1.

Pages 1-5 (January - February 2014)

Original article

DOI: 10.1016/j.remnie.2013.12.001

Dual time point 2-deoxy-2-[18F]fluoro-d-glucose PET/CT: Nodal staging in locally advanced breast cancer

PET-TC con 2-deoxi-2-[18F]fluor-d-glucosa en doble fase: estadificación ganglionar en cáncer de mama localmente avanzado

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A.M. García Vicentea,

Corresponding author

angarvice@yahoo.es

Corresponding author.

, Á. Soriano Castrejóna, M.Á. Cruz Morab, C. Ortega Ruiperezc, R. Espinosa Auniónd, A. León Martíne, A. González Ageitosf, O. Van Gómez Lópeza

a Nuclear Medicine Department, University General Hospital, Ciudad Real, Spain

b Oncology Department, Virgen de la Salud Hospital, Toledo, Spain

c Oncology Department, Virgen de la Luz Hospital, Cuenca, Spain

d Oncology Department, La Mancha Centro Hospital, Alcázar de San Juan, Ciudad Real, Spain

e Investigation Unit, University General Hospital, Ciudad Real, Spain

f Oncology Department, Nuestra Sra. del Prado Hospital, Talavera de la Reina, Toledo, Spain

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Figures (2)

Tables (3)

Table 1. Statistical diagnostic parameters in lymph node status of conventional diagnostic imaging, metabolic imaging and combined.

Table 2. Metabolic lymph node involvement: distribution of extra-axillary locations.

Table 3. Distribution of cN and mN.

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Abstract

Aim

To assess dual time point 2-deoxy-2-[18F]fluoro-d-glucose 18FFDG PET-CT accuracy in nodal staging and in detection of extra-axillary involvement.

Material and methods

Dual time point [18F] FDG PET/CT scan was performed in 75 patients. Visual and semiquantitative assessment of lymph nodes was performed. Semiquantitative measurement of SUV and ROC-analysis were carried out to calculate SUVmax cut-off value with the best diagnostic performance. Axillary and extra-axillary lymph node chains were evaluated.

Results

Sensitivity and specificity of visual assessment was 87.3% and 75%, respectively. SUVmax values with the best sensitivity were 0.90 and 0.95 for early and delayed PET, respectively. SUVmax values with the best specificity were 1.95 and 2.75, respectively. Extra-axillary lymph node involvement was detected in 26.7%.

Conclusion

FDG PET/CT detected extra-axillary lymph node involvement in one-fourth of the patients. Semiquantitative lymph node analysis did not show any advantage over the visual evaluation.

Keywords:

18FFDG PET/CT

Locally advanced breast cancer

Dual time point PET

Lymph node staging

Resumen

Objetivo

Valorar la precision diagnóstica de la PET-CT con 2-deoxi-2-[18F]fluor-d-glucosa [18F] FDG en doble fase en la estadificación ganglionar y en la detección de afectación extra-axilar.

Material y métodos

Se realizó una [18F] FDG PET-TC en doble fase a 75 pacientes. Se valoraron los ganglios linfáticos de forma visual y semicuantitativa. Se realizaron medidas del SUV y análisis ROC para calcular el valor de SUV max con la mejor precisión diagnóstica. Se evaluaron los niveles axilares y extra-axilares.

Resultados

La sensibilidad y especificidad del análisis visual fue del 87.3% y 75% respectivamente. Los valores de SUVmax con la mejor sensibilidad fueron de 0.90 y 0.95 para el PET en fase precoz y tardía respectivamente. Los valores de SUV max con la mejor especificidad fueron de 1.95 y 2.75 respectivamente. Se detectó afectación ganglionar extra-axilar en el 26.7%.

Conclusión

La PET-TC con FDG detectó afectación ganglionar extra-axilar en una cuarta parte de las pacientes. El análisis semicuantitativo no pareció aportar ninguna ventaja sobre la valoración visual.

Palabras clave:

[18F] FDG PET-TC

Cáncer de mama localmente avanzado

PET en doble fase

Estadificación ganglionar

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