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KEY FACTS
Terminology
Imaging
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Positron emission tomography/computed tomography (PET/CT)
Definitions
- Coregistration of PET with CT allows combined functional and anatomic imaging with single scanner
- Megabecquerel (MBq): Unit of radioactivity = 10⁶ disintegrations per second
- 1 millicurie (mCi) = 3.7 x 10⁷ disintegrations/sec = 37 MBq
- Standardized uptake value (SUV): Activity concentration in tissue (MBq/kg)/[injected activity (MBq)/ body weight (kg)]
- Most common parameter used to measure tracer accumulation activity concentration in tissue
- To measure SUV, a 2D or 3D region of interest (ROI) is positioned centrally within a target (i.e., tumor)
- 2 common ways of reporting SUV
- SUVmean: Incorporates information from multiple voxels, making it less sensitive to image noise
- Sensitive to ROI definition and subject to intra-/interobserver variability
- SUVmax: Highest voxel value within ROI
- Independent of ROI definition if included in ROI, but more susceptible to noise
- Most commonly used because it is less observer-dependent and more reproducible than SUVmean
- SUVmean: Incorporates information from multiple voxels, making it less sensitive to image noise
IMAGING
Physiology
Guidelines in Imaging Breast Cancer
Breast Cancer Detection
Locoregional Staging
Distant Metastasis
Restaging/Recurrence
Treatment Response
Inflammatory Breast Cancer
PATHOLOGY
Pathology-Related Imaging Issues
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Lee H et al: Predicting response to neoadjuvant chemotherapy in patients with breast cancer: combined statistical modeling using clinicopathological factors and FDG PET/CT texture parameters. Clin Nucl Med. 44(1):21-29, 2019
- Chen W et al: Quantitative assessment of metabolic tumor burden in molecular subtypes of primary breast cancer with FDG PET/CT. Diagn Interv Radiol. 24(6):336-41, 2018
- Ellmann S et al: Prediction of early metastatic disease in experimental breast cancer bone metastasis by combining PET/CT and MRI parameters to a Model-Averaged Neural Network. Bone. 120:254-61, 2018
- Henry KE et al: Clinical potential of human epidermal growth factor receptor 2 and human epidermal growth factor receptor 3 imaging in breast cancer. PET Clin. 13(3):423-35, 2018
- Kurland BF et al: Heterogeneity in metastatic breast cancer 18F-fluoroestradiol uptake: Clinically actionable, biologically illuminating? J Nucl Med. 59(8):1210-11, 2018
- Nienhuis HH et al: 18F-Fluoroestradiol Tumor Uptake Is Heterogeneous and Influenced by Site of Metastasis in Breast Cancer Patients. J Nucl Med. 59(8):1212-18, 2018
- Salem K et al: 18F-16α-17β-Fluoroestradiol Binding Specificity in Estrogen Receptor-Positive Breast Cancer. Radiology. 286(3):856-64, 2018
- Groheux D et al: 18FDG-PET/CT for predicting the outcome in ER+/HER2- breast cancer patients: comparison of clinicopathological parameters and PET image-derived indices including tumor texture analysis. Breast Cancer Res. 19(1):3, 2017
- Melsaether A et al: Breast PET/MR imaging. Radiol Clin North Am. 55(3):579-89, 2017
- Song BI et al: Predictive value of 18F-FDG PET/CT for axillary lymph node metastasis in invasive ductal breast cancer. Ann Surg Oncol. 24(8):2174-81, 2017
- Ulaner GA et al: 89Zr-Trastuzumab PET/CT for Detection of Human Epidermal Growth Factor Receptor 2-Positive Metastases in Patients With Human Epidermal Growth Factor Receptor 2-Negative Primary Breast Cancer. Clin Nucl Med. 42(12):912-17, 2017
- Groheux D et al: ¹⁸F-FDG PET/CT for Staging and Restaging of Breast Cancer. J Nucl Med. 57 Suppl 1:17S-26S, 2016
- Groheux D et al: Prognostic impact of 18F-FDG PET/CT staging and of pathological response to neoadjuvant chemotherapy in triple-negative breast cancer. Eur J Nucl Med Mol Imaging. 42(3):377-85, 2015
- Hogan MP et al: Comparison of 18F-FDG PET/CT for Systemic Staging of Newly Diagnosed Invasive Lobular Carcinoma Versus Invasive Ductal Carcinoma. J Nucl Med. 56(11):1674-80, 2015
- Kaushik A et al: Estimation of radiation dose to patients from (18) FDG whole body PET/CT investigations using dynamic PET scan protocol. Indian J Med Res. 142(6):721-31, 2015
- Shin KM et al: Incidental Breast Lesions Identified by (18)F-FDG PET/CT: Which Clinical Variables Differentiate between Benign and Malignant Breast Lesions? J Breast Cancer. 18(1):73-9, 2015
- Kalinyak JE et al: Breast cancer detection using high-resolution breast PET compared to whole-body PET or PET/CT. Eur J Nucl Med Mol Imaging. 41(2):260-75, 2014
- Carkaci S et al: (18)F-FDG PET/CT predicts survival in patients with inflammatory breast cancer undergoing neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging. Epub ahead of print, 2013
- Groheux D et al: 18F-FDG PET/CT in staging patients with locally advanced or inflammatory breast cancer: comparison to conventional staging. J Nucl Med. 54(1):5-11, 2013
- Groheux D et al: Performance of FDG PET/CT in the clinical management of breast cancer. Radiology. 266(2):388-405, 2013
- Kaushik A et al: Estimation of patient dose in (18)F-FDG and (18)F-FDOPA PET/CT examinations. J Cancer Res Ther. 9(3):477-83, 2013
- Rong J et al: Comparison of (18)FDG PET-CT and bone scintigraphy for detection of bone metastases in breast cancer patients. A meta-analysis. Surg Oncol. 22(2):86-91, 2013
- Adejolu M et al: False-positive lesions mimicking breast cancer on FDG PET and PET/CT. AJR Am J Roentgenol. 198(3):W304-14, 2012
- Cooper KL et al: Positron emission tomography (PET) for assessment of axillary lymph node status in early breast cancer: A systematic review and meta-analysis. Eur J Surg Oncol. 37(3):187-98, 2011
- Long NM et al: Causes and imaging features of false positives and false negatives on F-PET/CT in oncologic imaging. Insights Imaging. 2(6):679-698, 2011
- Tateishi U et al: Neoadjuvant chemotherapy in breast cancer: prediction of pathologic response with PET/CT and dynamic contrast-enhanced MR imaging--prospective assessment. Radiology. 263(1):53-63, 2012
- Adams MC et al: A systematic review of the factors affecting accuracy of SUV measurements. AJR Am J Roentgenol. 195(2):310-20, 2010
- Carkaci S et al: Retrospective study of 18F-FDG PET/CT in the diagnosis of inflammatory breast cancer: preliminary data. J Nucl Med. 50(2):231-8, 2009
- Lavayssière R et al: Positron Emission Tomography (PET) and breast cancer in clinical practice. Eur J Radiol. 69(1):50-8, 2009
- Avril N et al: F-18 fluorodeoxyglucose-positron emission tomography imaging for primary breast cancer and loco-regional staging. Radiol Clin North Am. 45(4):645-57, vi, 2007
- Rosen EL et al: FDG PET, PET/CT, and breast cancer imaging. Radiographics. 27 Suppl 1:S215-29, 2007
- Avril N et al: Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: use and limitations. J Clin Oncol. 18(20):3495-502, 2000
- Smith RF et al: Characterization of anaerobic diphtheroids. Health Lab Sci. 5(2):95-9, 1968
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KEY FACTS
Terminology
Imaging
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Positron emission tomography/computed tomography (PET/CT)
Definitions
- Coregistration of PET with CT allows combined functional and anatomic imaging with single scanner
- Megabecquerel (MBq): Unit of radioactivity = 10⁶ disintegrations per second
- 1 millicurie (mCi) = 3.7 x 10⁷ disintegrations/sec = 37 MBq
- Standardized uptake value (SUV): Activity concentration in tissue (MBq/kg)/[injected activity (MBq)/ body weight (kg)]
- Most common parameter used to measure tracer accumulation activity concentration in tissue
- To measure SUV, a 2D or 3D region of interest (ROI) is positioned centrally within a target (i.e., tumor)
- 2 common ways of reporting SUV
- SUVmean: Incorporates information from multiple voxels, making it less sensitive to image noise
- Sensitive to ROI definition and subject to intra-/interobserver variability
- SUVmax: Highest voxel value within ROI
- Independent of ROI definition if included in ROI, but more susceptible to noise
- Most commonly used because it is less observer-dependent and more reproducible than SUVmean
- SUVmean: Incorporates information from multiple voxels, making it less sensitive to image noise
IMAGING
Physiology
Guidelines in Imaging Breast Cancer
Breast Cancer Detection
Locoregional Staging
Distant Metastasis
Restaging/Recurrence
Treatment Response
Inflammatory Breast Cancer
PATHOLOGY
Pathology-Related Imaging Issues
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Lee H et al: Predicting response to neoadjuvant chemotherapy in patients with breast cancer: combined statistical modeling using clinicopathological factors and FDG PET/CT texture parameters. Clin Nucl Med. 44(1):21-29, 2019
- Chen W et al: Quantitative assessment of metabolic tumor burden in molecular subtypes of primary breast cancer with FDG PET/CT. Diagn Interv Radiol. 24(6):336-41, 2018
- Ellmann S et al: Prediction of early metastatic disease in experimental breast cancer bone metastasis by combining PET/CT and MRI parameters to a Model-Averaged Neural Network. Bone. 120:254-61, 2018
- Henry KE et al: Clinical potential of human epidermal growth factor receptor 2 and human epidermal growth factor receptor 3 imaging in breast cancer. PET Clin. 13(3):423-35, 2018
- Kurland BF et al: Heterogeneity in metastatic breast cancer 18F-fluoroestradiol uptake: Clinically actionable, biologically illuminating? J Nucl Med. 59(8):1210-11, 2018
- Nienhuis HH et al: 18F-Fluoroestradiol Tumor Uptake Is Heterogeneous and Influenced by Site of Metastasis in Breast Cancer Patients. J Nucl Med. 59(8):1212-18, 2018
- Salem K et al: 18F-16α-17β-Fluoroestradiol Binding Specificity in Estrogen Receptor-Positive Breast Cancer. Radiology. 286(3):856-64, 2018
- Groheux D et al: 18FDG-PET/CT for predicting the outcome in ER+/HER2- breast cancer patients: comparison of clinicopathological parameters and PET image-derived indices including tumor texture analysis. Breast Cancer Res. 19(1):3, 2017
- Melsaether A et al: Breast PET/MR imaging. Radiol Clin North Am. 55(3):579-89, 2017
- Song BI et al: Predictive value of 18F-FDG PET/CT for axillary lymph node metastasis in invasive ductal breast cancer. Ann Surg Oncol. 24(8):2174-81, 2017
- Ulaner GA et al: 89Zr-Trastuzumab PET/CT for Detection of Human Epidermal Growth Factor Receptor 2-Positive Metastases in Patients With Human Epidermal Growth Factor Receptor 2-Negative Primary Breast Cancer. Clin Nucl Med. 42(12):912-17, 2017
- Groheux D et al: ¹⁸F-FDG PET/CT for Staging and Restaging of Breast Cancer. J Nucl Med. 57 Suppl 1:17S-26S, 2016
- Groheux D et al: Prognostic impact of 18F-FDG PET/CT staging and of pathological response to neoadjuvant chemotherapy in triple-negative breast cancer. Eur J Nucl Med Mol Imaging. 42(3):377-85, 2015
- Hogan MP et al: Comparison of 18F-FDG PET/CT for Systemic Staging of Newly Diagnosed Invasive Lobular Carcinoma Versus Invasive Ductal Carcinoma. J Nucl Med. 56(11):1674-80, 2015
- Kaushik A et al: Estimation of radiation dose to patients from (18) FDG whole body PET/CT investigations using dynamic PET scan protocol. Indian J Med Res. 142(6):721-31, 2015
- Shin KM et al: Incidental Breast Lesions Identified by (18)F-FDG PET/CT: Which Clinical Variables Differentiate between Benign and Malignant Breast Lesions? J Breast Cancer. 18(1):73-9, 2015
- Kalinyak JE et al: Breast cancer detection using high-resolution breast PET compared to whole-body PET or PET/CT. Eur J Nucl Med Mol Imaging. 41(2):260-75, 2014
- Carkaci S et al: (18)F-FDG PET/CT predicts survival in patients with inflammatory breast cancer undergoing neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging. Epub ahead of print, 2013
- Groheux D et al: 18F-FDG PET/CT in staging patients with locally advanced or inflammatory breast cancer: comparison to conventional staging. J Nucl Med. 54(1):5-11, 2013
- Groheux D et al: Performance of FDG PET/CT in the clinical management of breast cancer. Radiology. 266(2):388-405, 2013
- Kaushik A et al: Estimation of patient dose in (18)F-FDG and (18)F-FDOPA PET/CT examinations. J Cancer Res Ther. 9(3):477-83, 2013
- Rong J et al: Comparison of (18)FDG PET-CT and bone scintigraphy for detection of bone metastases in breast cancer patients. A meta-analysis. Surg Oncol. 22(2):86-91, 2013
- Adejolu M et al: False-positive lesions mimicking breast cancer on FDG PET and PET/CT. AJR Am J Roentgenol. 198(3):W304-14, 2012
- Cooper KL et al: Positron emission tomography (PET) for assessment of axillary lymph node status in early breast cancer: A systematic review and meta-analysis. Eur J Surg Oncol. 37(3):187-98, 2011
- Long NM et al: Causes and imaging features of false positives and false negatives on F-PET/CT in oncologic imaging. Insights Imaging. 2(6):679-698, 2011
- Tateishi U et al: Neoadjuvant chemotherapy in breast cancer: prediction of pathologic response with PET/CT and dynamic contrast-enhanced MR imaging--prospective assessment. Radiology. 263(1):53-63, 2012
- Adams MC et al: A systematic review of the factors affecting accuracy of SUV measurements. AJR Am J Roentgenol. 195(2):310-20, 2010
- Carkaci S et al: Retrospective study of 18F-FDG PET/CT in the diagnosis of inflammatory breast cancer: preliminary data. J Nucl Med. 50(2):231-8, 2009
- Lavayssière R et al: Positron Emission Tomography (PET) and breast cancer in clinical practice. Eur J Radiol. 69(1):50-8, 2009
- Avril N et al: F-18 fluorodeoxyglucose-positron emission tomography imaging for primary breast cancer and loco-regional staging. Radiol Clin North Am. 45(4):645-57, vi, 2007
- Rosen EL et al: FDG PET, PET/CT, and breast cancer imaging. Radiographics. 27 Suppl 1:S215-29, 2007
- Avril N et al: Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: use and limitations. J Clin Oncol. 18(20):3495-502, 2000
- Smith RF et al: Characterization of anaerobic diphtheroids. Health Lab Sci. 5(2):95-9, 1968
