Desouza Karen, Fessas Petros, Spurrell Emma, Papadimitraki Elisavet, Raja Fharat, Roylance Rebecca, Ottaviani Diego, Franks Joanna, Betal Dibendu, Babar Mahwash, Athanasiou Irene, Cariati Massimilano, Patani Neill, Hadad Sirwan, Kayani Yusuf, Walls Darren, Scott Catherine, Rega Marilena, Arshad Mubarik, Bomanji Jamshed, Vöö Stefan
Cancer Division, Department of Oncology, University College London Hospitals NHS Foundation Trust (UCLH).
Surgery and Cancer Integrated Clinical Service Unit, Whittington Health NHS Trust.
Nucl Med Commun. 2025 Aug 1;46(8):772-779. doi: 10.1097/MNM.0000000000001997. Epub 2025 Jun 4.
Pregnancy-associated breast cancer (PABC) is a complex condition affecting 1 in 3000 pregnancies worldwide. While clinical management has improved, the optimal staging approach for PABC remains uncertain. 18 F-fluorodeoxyglucose PET (FDG-PET) imaging is a standard diagnostic tool for many cancers. However, its use in PABC staging is controversial due to potential radiation risks to the foetus.
This retrospective case series analysed clinical data from six patients with high-risk PABC who underwent FDG-PET imaging for staging between 2022 and 2023. FDG-PET was based on locally implemented ultra-low-dose imaging protocols. The radiation doses to the foetus were dosimetrically estimated based on dose-per-unit activity values and correlated with postpartum neonatal outcomes.
The median foetal radiation dose was 0.975 mGy (range 0.6-1.5 mGy) and was below the threshold for deterministic toxicities. PET imaging upstaged nodal involvement in 33% of patients and influenced treatment decisions. FDG-PET imaging provided valuable staging information in all cases. No adverse foetal effects were observed.
Ultra-low-dose FDG-PET imaging is a valuable tool providing accurate staging information to guide treatment decisions. The low radiation dose associated with this technique makes it a clinically acceptable modality for cancer staging in pregnant women. A larger case series is needed to precisely quantify foetal radiation doses and assess long-term safety.
妊娠相关乳腺癌（PABC）是一种复杂的病症，在全球每3000例妊娠中就有1例受其影响。虽然临床管理有所改善，但PABC的最佳分期方法仍不明确。18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）成像对于许多癌症来说是一种标准的诊断工具。然而，由于对胎儿存在潜在辐射风险，其在PABC分期中的应用存在争议。
本回顾性病例系列分析了2022年至2023年间6例接受FDG-PET成像进行分期的高危PABC患者的临床数据。FDG-PET基于当地实施的超低剂量成像方案。根据单位活度值对胎儿的辐射剂量进行剂量学估计，并与产后新生儿结局相关联。
胎儿辐射剂量中位数为0.975毫戈瑞（范围为0.6 - 1.5毫戈瑞），低于确定性毒性阈值。PET成像使33%的患者淋巴结受累分期上调，并影响了治疗决策。FDG-PET成像在所有病例中都提供了有价值的分期信息。未观察到对胎儿的不良影响。
超低剂量FDG-PET成像是一种有价值的工具，可提供准确的分期信息以指导治疗决策。与该技术相关的低辐射剂量使其成为孕妇癌症分期临床上可接受的方式。需要更大的病例系列来精确量化胎儿辐射剂量并评估长期安全性。
