4.3 Review

PET/CT Variants and Pitfalls in Breast Cancers

期刊

SEMINARS IN NUCLEAR MEDICINE
卷 51, 期 5, 页码 474-484

出版社

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.semnuclmed.2021.04.005

关键词

-

向作者/读者索取更多资源

Evaluation of F-18 Fluorodeoxyglucose (FDG) with Positron Emission Tomography (PET) in breast cancer patients requires consideration of normal variants and potential pitfalls, such as increased glucose metabolism in benign breast diseases and malignancies other than breast cancer. Inflammatory changes can also impact the accuracy of PET/CT in breast cancer staging, highlighting the importance of careful evaluation and comparison with anatomical imaging.
There are a number of normal variants and pitfalls which are important to consider when evaluating F-18 Fluorodeoxyglucose (FDG) with Positron Emission Tomography (PET) in breast cancer patients. Although FDG-PET is not indicated for the initial diagnosis of breast cancer, focally increased glucose metabolism within breast tissue represents a high likelihood for a neoplastic process and requires further evaluation. Focally increased glucose metabolism is not unique to breast cancer. Other malignancies such as lymphoma, metastases from solid tumors as well as inflammatory changes also may demonstrate increased glucose metabolism either within the breast or at other sites throughout the body. Importantly, benign breast disease may also exhibit increased glucose metabolism, limiting the specificity of FDG-PET. Breast cancer has a wide range of metabolic activity attributed to tumor heterogeneity and breast cancer subtype. Intracellular signaling pathways regulating tumor glucose utilization contribute to these pitfalls of PET/ CT in breast cancer. The evaluation of axillary lymph nodes by FDG-PET is less accurate than sentinel lymph node procedure, however is very accurate in identifying level II and III axillary lymph node metastases or retropectoral metastases. It is important to note that non-malignant inflammation in lymph nodes are often detected by modern PET/CT technology. Therefore, particular consideration should be given to recent vaccinations, particularly to COVID-19, which can commonly result in increased metabolic activity of axillary nodes. Whole body FDG-PET for staging of breast cancer requires specific attention to physiologic variants of FDG distribution and a careful comparison with co-registered anatomical imaging. The most important pitfalls are related to inflammatory changes including sarcoidosis, sarcoid like reactions, and other granulomatous diseases as well as secondary neoplastic processes. Semin Nucl Med 51:474-484 (c) 2021 Published by Elsevier Inc.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.3
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据