Impact of PET/CT in comparison with same day contrast enhanced CT in breast cancer management

Elena Piperkova, Barbara Raphael, Mustafa E. Altinyay, Ivan Castellon, Richard Libes, Nick Sandella, Sherif Heiba, Hussein Abdel-Dayem

Research output: Contribution to journalArticle

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Abstract

PURPOSE: To evaluate the impact of F-18 fluorodeoxyglucose (FDG) positron emission tomography with fused computerized tomography (PET/CT) in comparison with same day contrast enhanced CT (CE-CT) in breast cancer management. METHOD: Seventy studies in 49 breast cancer patients, 17 for initial and 53 for restaging disease were included. All patients underwent PET/CT for diagnostic purposes followed by CE-CT scans of selected body regions. PET/CT was started approximately 90 minutes following IV injection of 10-15 mCi of F-18 FDG on a GE Discovery PET/CT system. Oral contrast was given before F-18 FDG injection. The CE-CT was performed according to departmental protocol. RESULTS: Out of a total of 257 lesions, 210 were concordant between PET/CT and CE-CT. There were 47 discordant lesions, which were verified by either biopsy (35) or follow-up (12 PET positive CE-CT negative lesions). PET/CT correctly identified 25 true positive (TP). CE-CT identified 2 TP lesions missed by PET/CT which were false negatives (FNs): one liver metastasis with necrosis, which was nonavid to FDG uptake because of necrosis and a second one missed on abdominal metastatic node, which did not change staging or treatment. PET/CT incorrectly identified 2 false positive lesions while CE-CT incorrectly identified 18 false positive. TP recurrence of the disease was found by PET/CT in 44% (15/34 pts), whereas 56% (19/34 pts) were free of disease. The CE-CT described progression of the disease in 1 true negative PET/CT study and no progression in 2 TP PET/CT studies. The sensitivity, specificity, accuracy, positive productive value, and negative productive value for PET/CT were 97.8%, 93.5%, 97.3%, 99.1%, 85% and for CE-CT were 87.6%, 42%, 82.1%, 91.6%, 31.7%. CONCLUSION: In this study, PET/CT played a more important role than CE-CT scans alone and provided an impact on the management of breast cancer patients.

Original languageEnglish
Pages (from-to)429-434
Number of pages6
JournalClinical Nuclear Medicine
Volume32
Issue number6
DOIs
StatePublished - Jun 1 2007
Externally publishedYes

Fingerprint

Positron-Emission Tomography
Tomography
Breast Neoplasms
Fluorodeoxyglucose F18
Necrosis
Body Regions
Injections
Disease Progression
Neoplasm Metastasis
Biopsy
Recurrence
Sensitivity and Specificity

Keywords

  • Breast cancer staging
  • Contrast enhanced CT (CE-CT)
  • PET/CT
  • Restaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Piperkova, E., Raphael, B., Altinyay, M. E., Castellon, I., Libes, R., Sandella, N., ... Abdel-Dayem, H. (2007). Impact of PET/CT in comparison with same day contrast enhanced CT in breast cancer management. Clinical Nuclear Medicine, 32(6), 429-434. https://doi.org/10.1097/RLU.0b013e31805375e0

Impact of PET/CT in comparison with same day contrast enhanced CT in breast cancer management. / Piperkova, Elena; Raphael, Barbara; Altinyay, Mustafa E.; Castellon, Ivan; Libes, Richard; Sandella, Nick; Heiba, Sherif; Abdel-Dayem, Hussein.

In: Clinical Nuclear Medicine, Vol. 32, No. 6, 01.06.2007, p. 429-434.

Research output: Contribution to journalArticle

Piperkova, E, Raphael, B, Altinyay, ME, Castellon, I, Libes, R, Sandella, N, Heiba, S & Abdel-Dayem, H 2007, 'Impact of PET/CT in comparison with same day contrast enhanced CT in breast cancer management', Clinical Nuclear Medicine, vol. 32, no. 6, pp. 429-434. https://doi.org/10.1097/RLU.0b013e31805375e0
Piperkova, Elena ; Raphael, Barbara ; Altinyay, Mustafa E. ; Castellon, Ivan ; Libes, Richard ; Sandella, Nick ; Heiba, Sherif ; Abdel-Dayem, Hussein. / Impact of PET/CT in comparison with same day contrast enhanced CT in breast cancer management. In: Clinical Nuclear Medicine. 2007 ; Vol. 32, No. 6. pp. 429-434.
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abstract = "PURPOSE: To evaluate the impact of F-18 fluorodeoxyglucose (FDG) positron emission tomography with fused computerized tomography (PET/CT) in comparison with same day contrast enhanced CT (CE-CT) in breast cancer management. METHOD: Seventy studies in 49 breast cancer patients, 17 for initial and 53 for restaging disease were included. All patients underwent PET/CT for diagnostic purposes followed by CE-CT scans of selected body regions. PET/CT was started approximately 90 minutes following IV injection of 10-15 mCi of F-18 FDG on a GE Discovery PET/CT system. Oral contrast was given before F-18 FDG injection. The CE-CT was performed according to departmental protocol. RESULTS: Out of a total of 257 lesions, 210 were concordant between PET/CT and CE-CT. There were 47 discordant lesions, which were verified by either biopsy (35) or follow-up (12 PET positive CE-CT negative lesions). PET/CT correctly identified 25 true positive (TP). CE-CT identified 2 TP lesions missed by PET/CT which were false negatives (FNs): one liver metastasis with necrosis, which was nonavid to FDG uptake because of necrosis and a second one missed on abdominal metastatic node, which did not change staging or treatment. PET/CT incorrectly identified 2 false positive lesions while CE-CT incorrectly identified 18 false positive. TP recurrence of the disease was found by PET/CT in 44{\%} (15/34 pts), whereas 56{\%} (19/34 pts) were free of disease. The CE-CT described progression of the disease in 1 true negative PET/CT study and no progression in 2 TP PET/CT studies. The sensitivity, specificity, accuracy, positive productive value, and negative productive value for PET/CT were 97.8{\%}, 93.5{\%}, 97.3{\%}, 99.1{\%}, 85{\%} and for CE-CT were 87.6{\%}, 42{\%}, 82.1{\%}, 91.6{\%}, 31.7{\%}. CONCLUSION: In this study, PET/CT played a more important role than CE-CT scans alone and provided an impact on the management of breast cancer patients.",
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