Andrei Iagaru MD, Presenter: Nothing to Disclose

Vidya Malini, Abstract Co-Author: Nothing to Disclose

Erik Supratik Mittra MD, PhD, Abstract Co-Author: Nothing to Disclose

Andrew Quon MD, Abstract Co-Author: Research grant, Genentech, Inc

Debra Masako Ikeda MD, Abstract Co-Author: Nothing to Disclose

Bruce L. Daniel MD, Abstract Co-Author: Nothing to Disclose

Ross McDougall MD, Abstract Co-Author: Nothing to Disclose

Sanjiv Sam Gambhir MD, PhD, Abstract Co-Author: Board of Directors, Lumera Corporation Stockholder, Lumera Corporation Stockholder, Pfizer Inc Consultant, Spectrum Dynamics Ltd Stockholder, Spectrum Dynamics Ltd Grant, Johnson & Johnson (ALZA Corporation) Committee member, Amgen Inc Scientific Advisory Board, Novartis AG (Chiron) Scientific Advisory Board, Siemens AG (PETNET Solutions) Royalties, Reed Elsevier Scientific Advisory Board, Genentech, Inc Scientific Advisory Board, General Electric Company Grant, General Electric Company (Amersham plc) Research collaboration, GlaxoSmithKline plc Scientific Advisory Board, GlaxoSmithKline plc Scientific Advisory Board, Intronn Inc Research collaboration, Intronn Inc Grant, Intronn Inc Scientific Advisory Board, Lumen Therapeutics Consultant, MediGene AG Scientific Advisory Board, MediGene AG Consultant, Millennium Pharmaceuticals, Inc Research collaboration, Pfizer Inc Grant, Pfizer Inc Consultant, Koninklijke Philips Electronics NV Scientific Advisory Board, Koninklijke Philips Electronics NV Consultant, Pathwork Diagnostics (Predicant Biosciences) Grant, Bayer AG Speaker, Siemens AG Scientific Advisory Board, Varian Medical Systems, Inc Scientific Advisory Board, VisualSonics Inc

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

18F FDG PET/CT is a powerful modality for diagnosis, staging and assessing response to therapy in cancers, including breast cancer (BC). Breast MRI (bMRI) gaines a major role in management of high risk BC patients (pts). The role of PET/CT in addition to bMRI in BC is not completely elucidated. Therefore, we were prompted to review our experience with PET/CT and bMRI.

This retrospective study involved 181 women with BC, 28-83 years-old (average: 55.8±12.4), who had PET/CT from Jan 2003 to Dec 2006. 47 pts also had bMRI at the time of PET/CT. Reinterpretation of the studies for accuracy and data analysis from medical records were performed. Sensitivity and specificity were calculated using a 2x2 table with pathology results (84.1% of the pts) or clinical follow-up (15.9% of the pts) as gold standard.

Tumor size at cancer presentation ranged 0.8-10.0 cm (average: 2.8±1.9). PET/CT as a single exam had a sensitivity of 81.5% (95%CI: 68.9-89.9) for breast disease, 76.3% (95%CI: 60.6-87.2) for axilla and 92.9% (95%CI: 84.2-97.3) for metastases. The specificities were 98.4% (95%CI: 94.1-99.9), 97.9% (95%CI: 93.7-99.6) and 90% (95%CI: 82.8-94.5), respectively. For the 47 patients with both exams, sensitivities and specificities for breast disease detection were 83.3% (95%CI: 65.9-93.1) and 94.1% (95%CI: 71.1-99.9) for PET/CT, and 87.5% (95%CI: 71.3-95.6) and 93.3% (95%CI: 68.2-99.9) for bMRI. In this sub-group, PET/CT identified axillary lesions in 14 pts (80% sensitive, 93.8% specific) and distant metastases in 11 pts (90% sensitive, 94.6% specific).

FDG PET/CT performs well for breast disease and distant metastases identification in this patient population. However, its sensitivity for axillary staging is limited, despite good specificity. BMRI appears more sensitive than PET/CT for breast lesions detection, probably due to higher resolution. The specificities of bMRI and PET/CT are similar. PET/CT as a whole body examination detected distant metastases in 36.5% of the 181 pts.

PET/CT should be used as a complimentary imaging tool in the evaluation of patients with locally advanced breast cancer, since a whole body staging may be achieved in a single exam

Iagaru, A, Malini, V, Mittra, E, Quon, A, Ikeda, D, Daniel, B, McDougall, R, Gambhir, S, et al, , et al, , 18F FDG PET/CT Evaluation of Patients with Breast Cancer.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5004282.html