2-fluoro-2-deoxy-D-glucose positron emission tomography versus conventional imaging for the diagnosis of breast cancer and lymph node metastases.

CONTEXT: Proper preoperative staging is vital in the treatment of breast cancer patients. Fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) and conventional diagnostic modalities including ultrasonography (US), mammography (MG), and magnetic resonance imaging (MRI) play a greater role.

AIMS: To evaluate the diagnostic accuracy of FDG-PET in detecting primary breast cancer as compared with US, MG, and MRI, and in axillary lymph nodes (ALNs) staging in Chinese women.

SETTINGS AND

DESIGN

It is a study of diagnostic accuracy.

SUBJECTS AND

METHODS

Thirty-one female patients, with biopsy established breast carcinoma, were recruited and analyzed retrospectively. All patients underwent 18F-FDG-PET, MG, US, and MRI. FDG-PET/CT for the diagnosis of primary breast cancer and detecting ALNs metastases were compared with MG, US, and MRI.

STATISTICAL ANALYSIS USED: Sensitivity, specificity, positive-predictive value (PPV), and negative-predictive value (NPV) of FDG-PET imaging for primary breast cancers and ALN staging were analyzed using standard statistical analyses.

RESULTS

In 31 patients with cytologically established invasive breast carcinoma, the sensitivities of US, MG, MRI, and FDG-PET/CT were 90% (28/31), 84% (26/31), 97% (30/31), and 94% (29/31), respectively. The sensitivity, specificity, overall accuracy, PPV, and NPV of US, MRI, and FDG-PET/CT in ALN staging (maximum standardized uptake value cutoff at 1.5) were 80%, 86%, 84%, 80%, and 90%; 90%, 95%, 94%, 90%, and 95%; and 90%, 86%, 87%, 90%, and 95%, respectively.

CONCLUSIONS

US and MRI should remain the first line for the diagnosis of breast cancer. Both MRI and FDG-PET/CT could accurately diagnose the primary breast cancer and stage the axilla lymph nodes, but further large population study is needed.