Detection of locoregional and distant recurrences in breast cancer patients by using FDG PET
Detection of locoregional and distant recurrences in breast cancer patients by using FDG PET
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DOI：
10.1148/radiographics.22.1.g02ja055
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发表时间：
2002-01-01
期刊：
影响因子：
5.5
通讯作者：
Livingston, RB
中科院分区：
文献类型：
--
作者：
Eubank, WB;Mankoff, DA;Livingston, RB
乳腺癌复发病例可能给肿瘤学团队带来相当大的诊断和治疗挑战。预后和管理决策基于对疾病真实程度的了解。传统的分期方法，包括体格检查、肿瘤标志物水平评估、横截面成像和骨闪烁扫描，可能无法可靠地证明所有病例的疾病程度。体格检查和横断面成像（计算机断层扫描 [CT] 或磁共振成像）可能存在问题，因为 (a) 既往手术和放射治疗的后遗症可能难以与复发性肿瘤区分开来，(b) 早期转移性疾病（小病灶）可能难以与太小而无法表征的良性病灶区分开。使用 2-[氟-18]氟-2-脱氧-D-葡萄糖 (FDG) 进行正电子发射断层扫描 (PET) 可以帮助澄清体检和横截面成像中不确定的发现。 FDG PET 在检测疾病淋巴扩散至局部区域和纵隔淋巴结方面比 CT 更敏感。 FDG PET 也可以轻松检测到远处部位的转移，包括肺、骨和肝脏。 FDG PET 已被证明在复发性乳腺癌的重新分期中是准确的，并且可能有助于指导这些病例的治疗。
Cases of recurrence of breast cancer can pose considerable diagnostic and therapeutic challenges for the oncologic team. The prognosis and management decisions are based on knowledge of the true extent of disease. Conventional staging methods, including physical examination, assessment of levels of tumor markers, cross-sectional imaging, and bone scintigraphy, may not reliably demonstrate the extent of disease in all cases. Physical examination and cross-sectional imaging (computed tomography [CT] or magnetic resonance imaging) can be problematic because (a) the sequelae of previous surgery and radiation therapy can be difficult to distinguish from recurrent neoplasms and (b) early metastatic disease (small lesions) can be difficult to distinguish from benign lesions that are too small to characterize. Positron emission tomography (PET) with 2- [fluorine-18] fluoro-2-deoxy-D-glucose (FDG) can help clarify inconclusive findings from physical examination and cross-sectional imaging. FDG PET is more sensitive than CT in detection of lymphatic spread of disease to locoregional and mediastinal nodes. Metastases at distant sites including the lung, bone, and the liver are also readily detected at FDG PET. FDG PET has been proved accurate in restaging cases of recurrent breast cancer and will likely aid in directing therapy in these cases.