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ORIGINAL ARTICLES  BREAST CANCER II 

The Quarterly Journal of Nuclear Medicine 1998 March;42(1):1-7

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Overview of the current status of PET in breast cancer imaging

Wahl R. L.

From the Division of Nuclear Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA


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Present lim­i­ta­tions of avail­able pro­ce­dures for the diag­no­sis of ­breast can­cer ­have stim­u­lat­ed the devel­op­ment of new meth­ods ­based on Positron Emission Tomography (PET). PET can be ­used to eval­u­ate pri­mary ­lesions, region­al­ly met­a­stat­ic and system­ic metas­ta­ses of ­breast can­cer by use of trac­ers includ­ing 15O-­water 62Cu ­PTSM, [11C]L-methi­o­nine, [18F]flu­or­de­ox­y­glu­cose and [18F]flu­o­ro-17-estrad­i­ol, for the assess­ment of ­blood ­flow, metab­olism and recep­tor den­sity. FDG-PET is an excel­lent clin­i­cal meth­od to ­detect pri­mary ­breast ­lesions ­over 1 cm in diam­e­ter and to char­ac­ter­ize ­such ­lesions. Several ­reports ­have ­also indi­cat­ed var­i­ous ­degrees of sen­si­tiv­ity and spec­i­fic­ity of PET-FDG in detect­ing axil­lary ­lymph ­nodes. However, the pre­cise ­role of PET in stag­ing ­breast can­cer ­remains to be ­defined in care­ful pros­pec­tive stud­ies. Prospective eval­u­a­tion of PET dur­ing ­breast can­cer chem­o­hor­mo­no­ther­a­py dem­on­strat­ed a ­decline in FDG ­uptake in ­patients respon­sive to treat­ment, ­while no sig­nif­i­cant ­decline in FDG ­uptake is ­seen in the non-respond­ing ­patients exam­ined ­post initi­a­tion of treat­ment. PET may be use­ful ­when ­used in com­bi­na­tion ­with oth­er tech­niques of mor­pho­log­i­cal imag­ing, for the prop­er char­ac­ter­iza­tion of hyper­met­a­bo­lic tis­sue. Additional stud­ies includ­ing ­large pop­u­la­tions ­with ­known or sus­pect­ed ­breast can­cer ­will ­enhance the clin­i­cal ­role of ­this tech­nique for solv­ing dif­fi­cult diag­nos­tic ques­tions.

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