الفهرس | Only 14 pages are availabe for public view |
Abstract Cancer breast is a leading cause of death and the most common cancer in women, its prevention remains a challenge, thus early and accurate diagnosis are mandatory to achieve this target. PET-CT provides the needed information about both the metabolic activity as well the anatomical location of the neoplasm combining the advantages of both conventional methods, CT and PET. The present study evaluated 30 female patients with breast cancer who were previously operated by PET/CT for post-operative follow up. The patients were subdivided into 3 groups according to the referring cause for PET-CT post-operative follow up. Group-1 presented with nonconclusive CT findings, group-2 presented with elevated tumor markers and group-3 presented for follow up after chemotherapy and/or radiotherapy For group-1, the sensitivity of CT alone was 90%, the added functional imaging of PET in combined PET-CT raised it to 100%, while the specificity of CT alone was 12.5%, and in combined PET-CT reached 100%. The sensitivity of CT alone in group-2 was calculated to be 57%, and PET in combined PET-CT raised this percentage to reach 100%, while the overall specificity for CT alone and for combined PET-CT was the same100%. In the 3rd group, the sensitivity of CT alone and of combined PET-CT was the same 83.3%, while the overall specificity of CT alone was 84.21%, and that of combined PET-CT reached 100%. The overall relatively low combined PET/CT sensitivity for this group was caused by one false negative osteogenic bone metastasis that was neither detected by CT nor combined PET/CT, and was only detected by bone scintigraphy. FDG-PET-CT is generally more sensitive in the detection of distant metastases than conventional imaging, and is therefore a more accurate method of determining recurrence of the disease. One exception is the detection of sclerotic bone metastases as these lesions are often not metabolically active enough to be detected by FDG-PET. Bone scintigraphy could help in such cases. FDG-PET-CT is highly useful for monitoring response to therapeutic interventions. This technique can identify response to therapy earlier than any other imaging method currently available which greatly improves patient management by allowing termination of ineffective and toxic therapies. PET-CT proved to be helpful in the evaluation of anatomic regions that have been previously treated by surgery or radiation in which the discrimination between post-treatment scar and recurrent tumor can be problematic Finally, we recommend combined FDG-PET-CT as the investigation of choice for post-operative follow up of breast cancer patients, as it has superior results over equivocal findings of the conventional imaging, greatest role in detection of newly developed lesions in patients with rising tumor markers and for its greatest impact on detection of the disease progression. |