Open AccessFDG‐PET/CT Compared with Conventional Imaging in the Detection of Distant Metastases of Primary Breast Cancer
Author(s) -
Niikura Naoki,
Costelloe Colleen M.,
Madewell John E.,
Hayashi Naoki,
Yu TseKuan,
Liu Jun,
Palla Shana L.,
Tokuda Yutaka,
Theriault Richard L.,
Hortobagyi Gabriel N.,
Ueno Naoto T.
Publication year - 2011
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2011-0089
Subject(s) - medicine , positron emission tomography , breast cancer , nuclear medicine , radiology , breast imaging , cancer , biopsy , occult , mammography , pathology , alternative medicine
Purpose. Evidence from studies with small numbers of patients indicates that 18 F‐fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) accurately detects distant metastases in the staging of primary breast cancer. We compared the sensitivity and specificity of PET/CT and conventional imaging (CT, ultrasonography, radiography, and skeletal scintigraphy) for the detection of distant metastases in patients with primary breast cancer. Patients and Methods. We performed a retrospective review that identified 225 patients with primary breast cancer seen from January 2000 to September 2009 for whom PET/CT data were available for review. Imaging findings were compared with findings on biopsy, subsequent imaging, or clinical follow‐up. Sensitivity and specificity in the detection of distant metastases were calculated for PET/CT and conventional imaging. Fisher's exact tests were used to test the differences in sensitivity and specificity between PET/CT and conventional imaging. Results. The mean patient age at diagnosis was 53.4 years (range, 23–84 years). The sensitivity and specificity in the detection of distant metastases were 97.4% and 91.2%, respectively, for PET/CT and 85.9% and 67.3%, respectively, for conventional imaging. The sensitivity and specificity of PET/CT were significantly higher than those of conventional imaging ( p = .009 and p < .001, respectively). Eleven cases of distant metastases detected by PET/CT were clinically occult and not evident on conventional imaging. Conclusion. PET/CT has higher sensitivity and specificity than conventional imaging in the detection of distant metastases of breast cancer. A prospective study is needed to determine whether PET/CT could replace conventional imaging to detect distant metastases in patients with primary breast cancer.