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Breast Cancer
Study Background:
A 70 year old female with a history of breast cancer was seen by her oncologist as part of a routine follow-up. A subsequently ordered PET scan revealed enlarged lymph nodes in the right axilla, mediastinum, and hilum, as well as involved lymph nodes in the pre-tracheal and pre-carinal regions.
PET Imaging:
Following the injection of 611 MBq of FDG, images of the head, neck, and torso were acquired with the GE Advance (7 minute emission, 2 minute transmission per bed position). Data were reconstructed using an OSEM algorithm and segmented attenuation correction. The PET study demonstrated no FDG uptake in the area corresponding to the left apical lung nodule. However, there was marked increased metabolic activity in lymph nodes throughout the chest, right axilla, and the axial skeleton consistent with metastatic breast carcinoma.
Recurrent Breast Cancer:
PET is a valuable diagnostic tool in the evaluation of recurrent breast carcinoma. Although conventional imaging modalities such as CT, ultrasound, and MR are useful in demonstrating anatomic abnormalities, PET is oftentimes more accurate in detecting and determining the extent of tumor recurrence. In particular, PET has been shown to be more sensitive than CT or MR in identifying lymph node involvement and bone metastases. This is due in large part to the ability of PET to elucidate the underlying metabolic changes in tissue. Accurately determining the extent of metastatic disease is important and greatly influences clinical treatment choice(s) of chemotherapy, radiation, surgery, and/or palliation.
Reference:
Vranjesevic D, Filmont JE, Meta J, et al. Whole-body 18F-FDG PET and conventional imaging for predicting the outcome in previously treated breast cancer patients. J Nucl Med 2002; 43:325-329.
Images courtesy of:
Aultman Hospital, Canton, OH and neo•pet, LLC, Oakwood Village, OH
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