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PET/CT has advantages for advanced breast cancer cases

by Loren Bonner, DOTmed News Online Editor | January 04, 2013
PET/CT comparison study
courtesy SNMMI
A new study in the January issue of the Journal of Nuclear Medicine finds that 18F-FDG-PET/CT is successful in determining the prognostic stratification — or the rate of death from cancer — for patients with locally advanced breast cancer, when compared to conventional imaging.

Researchers from the Department of Nuclear Medicine at Saint-Louis Hospital in Paris studied a cohort of 117 patients with locally advanced breast cancer over a five-year period. Conventional imaging studies, such as bone scans, chest X-rays, and dedicated CT, were compared to results from 18F-FDG-PET/CT scans. 18F-FDG PET/CT detected distant metastases in 43 patients; conventional imaging only identified 28 patients with distant metastases.

"18F-FDG PET/CT had the advantage of examining chest, abdomen and bone in a single session. Almost all distant lesions detected by conventional imaging were also depicted with PET/CT, which also showed additional lesions," said Dr. David Groheux, lead author of the study, in an e-mail to DOTmed News.
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In addition, the 18F-FDG PET/CT findings impacted the recommended treatment for more than 50 percent of the patients in the study.

However, when 18F-FDG-PET/CT results might change patient management, especially so with isolated metastasis, confirmation by other imaging studies or biopsy is required, said Groheux.

"18F-FDG PET/CT may become the single most important distant staging modality in patients with locally advanced breast cancer," said Groheux.

18F-FDG PET/CT could also become a recommended first line imaging study for distant staging, rather than an optional study used in case of equivocal findings at conventional imaging, according to Groheux.

Currently, the National Comprehensive Cancer Network recommends a physical exam, bilateral mammogram, sonography or breast MRI imaging, as well as a chest CT, abdominal or pelvic diagnostic CT or MRI and bone scan to evaluate distant involvement of metastases.

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