Document Type : Original Paper, Oncology
Authors
1
department of Oncology and Nuclear medicine, faculty of medicine, Cairo university, Cairo, Egypt
2
Oncology and Nuclear Medicine Department, Kasr Al-Aini Hospital, Cairo University, Egypt.
3
Nuclear Medicine Consultant in El-Galaa Hospital & Maadi Armed Forced Hospital.
Abstract
Objective: We aimed to assess the role of FDG PET/CT in detection of tumor recurrence in breast cancer patients with raised serum tumor markers and/or negative or equivocal abnormalities detected in other diagnostic imaging modalities. Patients and Methods: This prospective study was done on 100 previously diagnosed and treated breast cancer patients, All of patients referred for FDG-PET/CT scans in view of increased their serum tumour markers and/or equivocal abnormalities in other diagnostic imaging modalities. Clinical follow-up, tumour markers, conventional imaging modalities and FDG-PET/CT whole body scan was performed for each patient. Results: PET/CT detected recurrence and/or metastases in 63 out of 100 patients, including 23 loco-regional recurrence, 11 solitary organ involvement, 29 multiple organ involvement, whereas, other radiological modalities detected lesions in only 51 patients, those were 12 loco-regional recurrence, 24 solitary organ involvement, 15 multiple organ involvement. Fifty patients out of 59 with true positive PET/CT had raised tumor markers,either carcino-embryonic antigen (CEA) or CA 15-3 , while 2 patients with raised tumor markers showed negative PET/CT study(FN). Forty eight patients had normal serum level of tumor markers, nine of them showed positive PET/CT study. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT were 96.7, 89.7, 93.7,94.2 and 94% respectively. These parameters were 72.1, 82, 86.3, 65.3 and 76% for conventional imaging modalities.
Conclusion: PET-CT is a powerful diagnostic method in the restaging of breast cancer and detection of metastases in patients with raised serum tumor markers and/or negative or equivocal radiologic imaging modalities, however conventional imaging modalities with multiphase CT or MRI are more sensitive in detection of early small lesions in liver and lung.
Keywords
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