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KMID : 1148920100440030170
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Nuclear Medicine and Molecular Imaging
2010 Volume.44 No. 3 p.170 ~ p.176
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18F-FDG PET/CT with Contrast Enhancement for Evaluation of Axillary Lymph Node Involvement in T1 Breast Cancer
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Kong Eun-Jung
Chun Kyung-Ah
Cho Ihn-Ho
Lee Soo-Jung
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Abstract
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Background: 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography ((PET) safely predicts axillary status in patients with breast cancer, but is not sufficiently accurate in early breast cancer patients. This study analyzed the value of 18F-FDG PET/computed tomography (CT) with contrast enhancement in detecting axillary lymph node involvement in T1 breast cancer patients.
Methods: Contrast-enhanced 18F-FDG PET/CT was performed within 20 days of surgery in 143 breast cancer patients with tumors ≤2 cm in size. The patients underwent either axillary lymph node dissection (ALND) or sentinel lymph node biopsy (SLNB), and histopathology reports were used to provide the definitive diagnosis against which the contrast-enhanced 18F-FDG PET/CT study results were compared.
Results: The sensitivity, specificity, and negative and positive predictive values of contrast-enhanced 18F-FDG PET/CT in detecting axillary involvement were 70.0%, 92.2%, 88.8%, and 77.8%, respectively, in the entire series of 143 patients, with eight false-positive and 12 false negative results. The false-negative results were associated with the number of metastatic lymph nodes and the rate of FDG uptake.
Conclusion: Contrast-enhanced 18F-FDG PET/CT cannot replace histologic staging using SLNB in patients with breast cancer, but 18F-FDG PET/CT increases the sensitivity for predicting axillary node metastasis, and allows for a selective approach to either ALND or SLNB, even in patients with T1 breast cancer.
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KEYWORD
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Breast cancer, Axillary lymph node, FDG, PET/CT
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