Nassar Lara, Kassas Mutaz, Abi-Ghanem Alain S, El-Jebai Malak, Al-Zakleet Safaa, Baassiri Amro S, Naccoul Rami Abou, Barakat Andrew, Tfayli Arafat, Assi Hazem, Berjawi Ghina, Estrada-Lobato Enrique, Giammarile Francesco, Vinjamuri Sobhan, Haidar Mohamad
Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut 1107-2020, Lebanon.
Yale Cancer Center, Yale School of Medicine, New Haven, CT 06520-8028, USA.
Diagnostics (Basel). 2023 Jan 19;13(3):367. doi: 10.3390/diagnostics13030367.
Supine [18F]Fluorodeoxyglucose (FDG) positron emission technology/computed tomography (PET/CT) is a commonly used modality for the initial staging of breast cancer, and several previous studies have shown superior sensitivity and specificity of prone FDG PET/CT in comparison to its supine counterpart. This retrospective study included 25 females with breast cancer referred for staging. They underwent supine FDG PET/CT followed by prone FDG PET/CT. The outcomes were: number of primary breast lesions, anatomical site of FDG-avid lymph nodes (LNs), and number and type of bone lesions, with SUVmax of all corresponding parameters. Performance was superior in prone acquisition compared to supine acquisition, with the respective results: 29 vs. 22 breast tumor lesions detected, 62 vs. 27 FDG-avid axillary LNs detected, sensitivity of 68% vs. 57%, specificity of 64% vs. 53%. The detection rate of axillary LNs in the prone position was significantly higher ( = 0.001). SUVmax for breast tumor lesions ( = 0.000) and number of detected axillary LNs ( = 0.002) were significantly higher in prone acquisition. Five patients were upstaged after experts read the prone acquisition. Prone FDG PET/CT acquisition is a promising technique in detecting primary breast lesions and metastatic LNs possibly missed in supine acquisition, which may lead to change in patient staging and management.
仰卧位[18F]氟脱氧葡萄糖（FDG）正电子发射断层显像技术/计算机断层扫描（PET/CT）是乳腺癌初始分期常用的检查方式，此前多项研究表明，俯卧位FDG PET/CT相较于仰卧位具有更高的敏感性和特异性。这项回顾性研究纳入了25例因分期检查而转诊的乳腺癌女性患者。她们先进行了仰卧位FDG PET/CT检查，随后进行俯卧位FDG PET/CT检查。结果包括：原发性乳腺病变数量、FDG摄取阳性淋巴结（LN）的解剖部位、骨病变的数量和类型，以及所有相应参数的最大标准化摄取值（SUVmax）。与仰卧位采集相比，俯卧位采集的表现更优，具体结果如下：检测到的乳腺肿瘤病变分别为29个和22个，检测到的FDG摄取阳性腋窝LN分别为62个和27个，敏感性分别为68%和57%，特异性分别为64%和53%。俯卧位时腋窝LN的检出率显著更高（P = 0.001）。俯卧位采集时乳腺肿瘤病变的SUVmax（P = 0.000）和检测到的腋窝LN数量（P = 0.002）显著更高。在专家阅片俯卧位采集图像后，有5例患者的分期上调。俯卧位FDG PET/CT采集是一种很有前景的技术，可检测出仰卧位采集可能遗漏的原发性乳腺病变和转移性LN，这可能会导致患者分期和治疗方案的改变。
