Carkaci Selin, Macapinlac Homer A, Cristofanilli Massimo, Mawlawi Osama, Rohren Eric, Gonzalez Angulo Ana M, Dawood Shaheenah, Resetkova Erika, Le-Petross Huong T, Yang Wei-Tse
Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030-4009, USA.
J Nucl Med. 2009 Feb;50(2):231-8. doi: 10.2967/jnumed.108.056010. Epub 2009 Jan 21.
Our objective was to retrospectively evaluate 18F-FDG PET/CT in the initial staging of inflammatory breast cancer (IBC).
The institutional review board waived informed consent and approved this study, which was compliant with the Health Insurance Portability and Accountability Act. The cases of 41 women with a mean age of 50 y (range, 25-71 y) and newly diagnosed IBC who underwent 18F-FDG PET/CT at diagnosis were retrospectively reviewed. All PET/CT images were analyzed visually and semiquantitatively by 2 physicians. The maximum standardized uptake value in the primary breast, regional nodes (axillary, subpectoral, supraclavicular, internal mammary), and extranodal regions was documented. The accuracy of PET/CT image interpretation was assessed by histopathologic analysis, if available; concurrent or subsequent imaging findings (contrast-enhanced CT, contrast-enhanced MRI, sonography, or PET/CT follow-up); or clinical follow-up.
All patients presented with unilateral IBC. PET/CT showed hypermetabolic uptake in the skin in all patients, in the affected breast in 40 (98%), in the ipsilateral axillary nodes in 37 (90%), and in the ipsilateral subpectoral nodes in 18 (44%). Twenty patients (49%) were found to have distant metastases at staging, 7 (17%) of whom were not known to have metastases before undergoing PET/CT. Disease sites included bone, liver, contralateral axilla, lung, chest wall, pelvis, and the subpectoral, supraclavicular, internal mammary, mediastinal, and abdominal nodes.
PET/CT should be considered in the initial staging of IBC, as the technique provided valuable information on locoregional and distant disease in this preliminary retrospective study.
我们的目的是回顾性评估18F-FDG PET/CT在炎性乳腺癌(IBC)初始分期中的应用。
机构审查委员会豁免了知情同意并批准了本研究,该研究符合《健康保险流通与责任法案》。对41例平均年龄50岁(范围25 - 71岁)且新诊断为IBC并在诊断时接受18F-FDG PET/CT检查的女性病例进行回顾性分析。所有PET/CT图像由2名医生进行视觉和半定量分析。记录原发乳腺、区域淋巴结(腋窝、胸肌下、锁骨上、内乳)和结外区域的最大标准化摄取值。PET/CT图像解读的准确性通过组织病理学分析(如有)、同期或后续影像学检查结果(增强CT、增强MRI、超声或PET/CT随访)或临床随访进行评估。
所有患者均为单侧IBC。PET/CT显示所有患者皮肤均有高代谢摄取,40例(98%)患侧乳腺有高代谢摄取,37例(90%)同侧腋窝淋巴结有高代谢摄取,18例(44%)同侧胸肌下淋巴结有高代谢摄取。20例患者(49%)在分期时发现有远处转移,其中7例(17%)在接受PET/CT检查前未知有转移。疾病部位包括骨、肝、对侧腋窝、肺、胸壁、骨盆以及胸肌下、锁骨上、内乳、纵隔和腹部淋巴结。
在IBC的初始分期中应考虑使用PET/CT,因为在这项初步回顾性研究中该技术提供了有关局部区域和远处疾病的有价值信息。