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Annals of Oncology Advance Access published online on March 19, 2008
Annals of Oncology, doi:10.1093/annonc/mdn057
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Comparison between positron emission tomography using 2-[fluorine-18]fluoro-2-deoxy-D-glucose, conventional imaging and computed tomography for staging of breast cancer

S. Mahner1,*, S. Schirrmacher1, W. Brenner2, L. Jenicke2, C. R. Habermann3, N. Avril1 and J. Dose-Schwarz1

1 Department of Gynecologic Oncology
2 Department of Nuclear Medicine
3 Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

* Correspondence to: Dr S. Mahner, Department of Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany. Tel: +49-40-42803-2510; Fax: +49-40-42803-4355; E-mail: s.mahner{at}uke.uni-hamburg.de

Background: The presence, extent and localization of distant metastases are key prognostic factors in breast cancer patients and play a central role in therapeutic decision making. The aim of this study was to compare the diagnostic performance of positron emission tomography using 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG–PET) with that of computed tomography (CT) and conventional imaging including chest radiography, abdominal ultrasound and bone scintigraphy.

Patients and methods: A total of 119 consecutive patients with newly diagnosed locally advanced disease (n = 69) or previous history of breast cancer (n = 50) who had clinical suspicion of metastatic disease underwent FDG–PET, CT and conventional imaging procedures. Imaging results were retrospectively compared with histopathology and clinical follow-up which served as a reference standard.

Results: FDG–PET detected distant metastases with a sensitivity of 87% and a specificity of 83%. In contrast, the sensitivity and specificity of combined conventional imaging procedures were 43% and 98%, respectively. CT revealed a sensitivity of 83% and a specificity of 85%.

Conclusions: In breast cancer, FDG–PET is superior to conventional imaging procedures for detection of distant metastases. Although FDG–PET and CT provided similar diagnostic accuracy, the information was often found to be complementary. With increasing availability of FDG–PET/CT, prospective studies are needed to determine whether it could potentially replace the array of conventional imaging procedures used today.

breast cancer, CT, FDG–PET, imaging, metastasis, staging

Received for publication December 16, 2007. Revision received February 7, 2008. Accepted for publication February 8, 2008.


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