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

Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)

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.
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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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