[ 181F] Fluorodeoxyglucose (FDG)-Positron emission tomography (PET)/computed tomography (CT) in suspected recurrent breast cancer: A Prospective Comparative Study of Dual-Time-Point FDG-PET/CT, Contrast-Enhanced CT, and Bone Scintigraphy

Malene Grubbe Hildebrandt, Oke Gerke, Christina Baun, Kirsten Falch Braas, Jeanette Ansholm Hansen, Ziba Ahangarani Farahani, Henrik Petersen, Lisbet Brønsro Larsen, Sandra Duvnjak, Inguna Buskevica, Selma Bektas, Katrine Søe, Anne Marie Bak Jylling, Marianne Ewertz, Abass Alavi, Poul Flemming Høilund-Carlsen

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Purpose To prospectively investigate the diagnostic accuracy of [ 181F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) with dual-time-point imaging, contrastenhanced CT (ceCT), and bone scintigraphy (BS) in patients with suspected breast cancer recurrence. Patients and Methods One hundred women with suspected recurrence of breast cancer underwent 1-hour and 3-hour FDG-PET/CT, ceCT, and BS within approximately 10 days. The study was powered to estimate the precision of the individual imaging tests. Images were visually interpreted using a four-point assessment scale, and readers were blinded to other test results. The reference standard was biopsy along with treatment decisions and clinical follow-up (median, 17 months). Results FDG-PET/CT resulted in no false negatives and fewer false positives than the other imaging techniques. Accuracy of results were similar for 1-hour and 3-hour FDG-PET/CT. For distant recurrence, the area under the receiver operating curve was 0.99 (95% CI, 0.97 to 1) for FDG-PET/CT, 0.84 (95% CI, 0.73 to 0.94) for ceCT, and 0.86 (95% CI, 0.77 to 0.94) for the combined ceCT+BS. Of 100 patients, 22 (22%) were verified with distant recurrence, and 18 of these had bone involvement. Nineteen patients (19%) had local recurrence only. In exploratory analyses, diagnostic accuracy of FDG-PET/CT was better than ceCT alone or ceCT combined with BS in diagnosing distant, bone, and local recurrence, shown by a greater area under the receiver operating curve and higher sensitivity, specificity, and superior likelihood ratios. Conclusion FDG-PET/CT was accurate in diagnosing recurrence in breast cancer patients. It allowed for distant recurrence to be correctly ruled out and resulted in only a small number of false-positive cases. Exploratory findings suggest that FDG-PET/CT has greater accuracy than conventional imaging technologies in this patient group. [ampi]]copy; 2016 by American Society of Clinical Oncology.

Original languageEnglish
JournalJournal of Clinical Oncology
Volume34
Issue number16
Pages (from-to)1889-1897
ISSN0732-183X
DOIs
Publication statusPublished - 1. Jun 2016

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