The Added Value of FDG PET/CT in Assessment of Pleural Metastases in Breast Cancer Patients

Document Type : Original Article

Authors

1 Nuclear Medicine and radiotherapy department, national cancer institute, Cairo University

2 Nuclear Medicine unit, National Cancer Institute, Cairo University

3 Professor of Nuclear Medicine, Faculty of Medicine, Cairo University.

4 Nuclear Medicine Unit, National Cancer Institute, Cairo University

Abstract

Abstract
Background and purpose of work: The purpose of this study was to investigate the viability of using 18 F fluorodeoxyglucose (FDG) positron emission computed tomography (PET/CT) to detect breast cancer pleural metastases and how this information relates to patient survival and outcome.
Methods: 537 patients with pathologically confirmed breast cancer who had received PET/CT scanning at various phases of the disease were included in a retrospective research. 115 patients exhibited a variety of pleural lesions, which were subsequently verified or excluded by cytological analysis, a follow-up PET/CT scan, or other traditional radiology. The prognosis and OS were then correlated with these findings.
Findings: The average age of the 115 patients is 53±12. Nine patients (86.1%) had additional distant sites of metastases. Analyses of various types of pleural involvement revealed that 40% had effusion, 22% had nodular thickening, 33.3% had diffuse thickening, and 4.7% had a combination of these patterns. PET/CT had a 93% accuracy rate for detecting pleural metastases linked to breast cancer, with sensitivity and specificity of 92.5% and 94.1%, respectively. Pleural metastases were negatively correlated with overall survival and prognosis (p<0.001), and their association with additional distant metastases made the situation much worse (p<0.001).
Conclusions: The combined presence of large and FDG avid pleural lesions can be a sensitive marker to suspect pleural metastases. While reporting a worrisome pleural lesion, PET/CT qualitative and quantitative assessment is helpful as it can influence and help map out the therapeutic approach to enhance the overall prognosis and survival.

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