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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.03.2014 | Original Article

Detection of internal mammary lymph node metastasis with ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with stage III breast cancer

verfasst von: Min Jung Seo, Jong Jin Lee, Hye Ok Kim, Sun-Young Chae, Seol Hoon Park, Jin-Sook Ryu, Sei Hyun Ahn, Jong Won Lee, Byung Ho Son, Gyung-Yub Gong, Dae Hyuk Moon

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 3/2014

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Abstract

Purpose

The present study assessed the positive predictive value (PPV) of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of internal mammary node (IMN) metastasis in patients with clinical stage III breast cancer.

Methods

Patients who were diagnosed with clinical stage III breast cancer and underwent pretreatment ¹⁸F-FDG PET/CT were retrospectively analyzed. The ¹⁸F-FDG PET/CT scans were prospectively reviewed by two board-certified nuclear medicine physicians in a blinded manner. The intensities of IMNs were graded into four categories (no activity and lower, similar, and higher activities than that of the mediastinal blood pool). IMNs were measured from the combined CT (largest diameter of the short axis). Histologic data of the IMNs were obtained by ultrasonography-guided fine-needle aspiration biopsy or surgical excision. The PPV was calculated for pathologically confirmed IMNs. Visual grade, maximum standardized uptake values (SUV_max), and sizes were analyzed according to the pathology results.

Results

There were 249 clinical stage III breast cancer patients (age 48.0 ± 10.1 years, range 26–79 years) who had undergone initial ¹⁸F-FDG PET/CT prior to treatment. Excluding 33 cases of stage IV breast cancer, 62 of 216 patients had visible IMNs on ¹⁸F-FDG PET/CT, and histologic confirmation was obtained in 31 patients. There were 27 metastatic and four nonmetastatic nodes (PPV 87.1 %). Metastatic nodes mostly presented with visual grade 3 (83.9 %), and SUV_max and size were 3.5 ± 4.3 and 5.6 ± 2.0 mm, respectively.

Conclusion

¹⁸F-FDG PET/CT has a high PPV for IMN metastasis in clinical stage III breast cancer, indicating the possibility of metastasis in IMNs with FDG uptake similar to/lower than that of the blood pool or small-sized nodes.

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Titel: Detection of internal mammary lymph node metastasis with 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with stage III breast cancer
verfasst von: Min Jung Seo
Jong Jin Lee
Hye Ok Kim
Sun-Young Chae
Seol Hoon Park
Jin-Sook Ryu
Sei Hyun Ahn
Jong Won Lee
Byung Ho Son
Gyung-Yub Gong
Dae Hyuk Moon
Publikationsdatum: 01.03.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 3/2014
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2600-y

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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