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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2017 December;61(4):429-37

DOI: 10.23736/S1824-4785.17.02785-6

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

A comparative study of 18F-FDG PET/CT and ultrasonography in the diagnosis of breast cancer and axillary lymph node metastasis

Xinjia HE 1, Lixia SUN 2,Yanlei HUO 3, Mei SHAO 4, Chao MA 3

1 Department of Oncology, Affiliated Hospital of Medical College, Qingdao University, Qingdao, China; 2 Department of Internal Medicine, People’s Hospital of RiZhao, RiZhao, China; 3 Department of Surgery, Linyi People’s Hospital, Linyi, China; 4 Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China


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BACKGROUND: The aim of this study was to compare the diagnostic value of 18F-FDG-PET/CT (PET/CT) with ultrasonography (US) in detection of primary breast cancer and axillary lymph nodes (ALN) metastasis of breast cancer.
METHODS: One hundred and sixty four patients with breast carcinoma were recruited and analyzed retrospectively. All patients underwent PET-CT and US. The PET/CT scan results for the diagnosis of primary breast cancer were compared with US. The diagnostic accuracy of PET/CT in detecting ALN metastasis was compared with histopathology.
RESULTS: In 164 patients with cytologically established breast carcinoma, the sensitivity of PET/CT and US in the diagnosis of breast cancer were 86% (141/164), 91% (149/164), respectively. The sensitivity, specificity of PET/CT and US in ALN staging were 46% and 54%, 91% and 91%, respectively. The diagnostic accuracy of PET/CT correlated with the ALN size, the SUVmax of primary breast cancer (P=0.02 and 0.04).
CONCLUSIONS: PET/CT is very expensive, and not superior to US in detection of primary breast cancer and in ALN staging, but superior in detecting distant metastases. PET/CT cannot be recommended as a primary diagnostic procedure in early breast cancer. US should still remain the first line for the diagnosis of stage I breast cancer. In relation to the detection of axillary node metastases, both PET/CT and ultrasonography have poor sensitivity, and cannot replace staging by using the sentinel node procedure.


KEY WORDS: Breast neoplasms - Fluorodeoxyglucose F18 - Positron emission tomography computed tomography - Ultrasonography - Lymph nodes - Axilla

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