Patrick Veit MD, Abstract Co-Author: Nothing to Disclose

Hrvoje Stergar MD, Abstract Co-Author: Nothing to Disclose

Thomas Beyer PhD, Abstract Co-Author: Nothing to Disclose

Elke Anni Maria Hauth, Abstract Co-Author: Nothing to Disclose

Michael Forsting MD, Abstract Co-Author: Nothing to Disclose

Hilmar Kuehl MD, Presenter: Nothing to Disclose

Gerald Antoch MD, Abstract Co-Author: Nothing to Disclose

To compare the value of combined PET/CT, PET+CT viewed side by side, CT alone and PET alone concerning the rTNM stage and influence on therapy in patients with recurrent breast cancer.

58 patients with suspicion of recurrent breast cancer underwent whole-body [18F]-2-Fluoro-2-deoxy-D-glucose (FDG) PET/CT. Images of combined PET/CT, PET+CT, PET alone and CT alone were evaluated by four different, blinded reader teams and diagnostic accuracies of the four imaging procedures for assessing the rTNM stage and their influence on therapy were compared. Histology (25 patients) and a mean clinical follow-up of 456 days served as the standard of reference. Differences between the staging procedures were tested for statistical significance by McNemar’s test.

The overall TNM tumor stage was correctly determined in 54/ 58 patients (93%) with PET/CT, in 52/58 (90%) with PET+CT, in 46/58 (79%) with PET and in 49/58 (84%) patients with CT alone. Combined PET/CT was more accurate in rTNM stage than PET alone (p< 0.05), but no statistically significant difference was detected compared to CT alone (p=0.06) or PET+CT (p=0.5). PET/CT changed the therapy in 2 patients compared to PET+CT, in 8 patients compared to PET alone and in 5 patients compared to CT alone. Concerning the change in patient management differences between PET/CT and PET alone were statistically significant (p<0.05), no statistical significance was found when comparing PET/CT with PET+CT (p=0.05)and CT alone (p=0.06).

Combined PET/CT proved to be more accurate in assessing the rTNM than PET alone with an impact on patient management in patients with recurrent breast cancer. There was a trend to more accurate staging compared to CT alone, though this did not prove to be of statistical significance. Thus, further studies evaluating larger patients populations are needed.

Veit, P, Stergar, H, Beyer, T, Hauth, E, Forsting, M, Kuehl, H, Antoch, G, Whole-Body FDG-PET/CT for Re-Staging in Patients with Recurrent Breast Cancer.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4418007.html