Skip to main content
SpringerLink
Log in

The role of Positron Emission Tomography/Computer Tomography (PET/CT) in the diagnosis, staging, characterization, and therapy of breast cancer

  • short review
  • Published:
memo - Magazine of European Medical Oncology Aims and scope Submit manuscript

Abstract

PET or PET/CT mostly utilizing the tracer [18F]fluorodeoxyglucose (18FDG) are unique imaging methods for the detection of breast cancers with increased glucolytic activity. PET/CT simultaneously provides anatomic and metabolic information by detecting increased glucose uptake. PET/CT may provide extra information on stage that can be utilized in certain cases during treatment decision making. PET/CT is a very sensitive imaging option to detect lymph node involvement or distant metastasis for which information is needed in selected cases. In the neoadjuvant or metastatic setting, PET or PET/CT may serve as a valuable noninvasive option for investigating chemosensitivity and monitoring the effectiveness of systemic therapy. Its use, however, should be reserved for particular cases with diagnostic uncertainty in the routine management of breast cancer.

Molecular imaging with non-FDG PET tracers developed using advanced molecular and cell biology techniques widens the possibility to study the pathological molecular events and processes in breast cancer, and may be used for the detection of key molecules to be targeted by pharmaceutical interventions; the method provides new possibility to evaluate novel drugs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Makhoul I, Kiwan E. Neoadjuvant systemic treatment of breast cancer. J Surg Oncol. 2011 Mar 15;103(4):348–57.

    Article  PubMed  Google Scholar 

  2. Robertson IJ, Hard F, Kell MR. FDG-PET/CT in the staging of local/regional metastases in breast cancer. Breast. 2011 Jul 30. Epub ahead of print.

  3. Monzawa S, Adachi S, Suzuki K, et al. Diagnostic performance of fluorodeoxyglucose-positron emission tomography/computed tomography of breast cancer in detecting axillary lymph node metastases: comparison with ultrasonography and contrast-enhanced CT. Ann Nucl MED. 2009;23(10):855–61.

    Article  PubMed  Google Scholar 

  4. Ueda S, Tsuda H, Asakawa H, et al. Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer. BMC Cancer. 2008;8:165

    Article  PubMed  Google Scholar 

  5. Fuster D, Duch J, Paredes P, et al. Preoperative staging of large primary breast cancer with [18F]fluorodeoxyglucose positron emission tomography/computed tomography compared with conventional imaging procedures. J Clin Oncol. 2008;26:4746–51.

    Article  PubMed  Google Scholar 

  6. Carkaci S, Macapinlac HA, Cristofanilli M, et al. Retrospective study of 18F-FDG PET/CT in the diagnosis of inflammatory breast cancer: preliminary data. J Nucl Med. 2009;50(2):231–8.

    Article  PubMed  Google Scholar 

  7. Alberini JL, Lerebours F, Wartski M, et al. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging in the staging and prognosis of inflammatory breast cancer. Cancer. 2009 Nov 1;115(21):5038–47.

    Article  PubMed  Google Scholar 

  8. Groheux D, Moretti JL, Baillet G, et al. Effect of (18)F-FDG PET/CT imaging in patients with clinical Stage II and III breast cancer. Int J Radiat Oncol Biol Phys. 2008 Jul 1;71(3):695–704.

    Article  PubMed  Google Scholar 

  9. Groheux D, Giacchetti S, Espié M, et al. The yield of 18F-FDG PET/CT in patients with clinical stage IIA, IIB, or IIIA breast cancer: a prospective study. J Nucl Med. 2011;52:1526–34.

    Article  CAS  PubMed  Google Scholar 

  10. Koolen BB, Vegt E, Rutgers EJ, Vogel WV, et al. FDG-avid sclerotic bone metastases in breast cancer patients: a PET/CT case series. Ann Nucl Med. 2011 Sept 28. Epub ahead of print.

  11. Hahn S, Heusner T, Kümmel S, et al. Comparison of FDG-PET/CT and bone scintigraphy for detection of bone metastases in breast cancer. Acta Radiol. 2011 Nov 1;52(9):1009–14.

    Article  PubMed  Google Scholar 

  12. Niikiura N, Costelloe CM, Madewell JE, et al. FDG-PET/CT compered with conventional imaging in the detection of distant metastases of primary breast cancer. Oncologist. 2011;16(8):1111–9.

    Article  Google Scholar 

  13. Ohsumi S, Inoue T, Kiyoto S, et al. Detection of isolated ipsilateral regional lymph node recurrences by F18-fluorodeoxyglucose positron emission tomography-CT in follow up of postoperatve brast cancer patients. Breast Cancer Res Treat. 2011. Epub ahead of print.

  14. Ueda S, Tsuda H, Asakawa H, et al. Clinicopathological and prognostic relevance of uptake level using 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG-PET/CT) in primary breast cancer. J Clin Oncol. 2008;38(4):250–8.

    Google Scholar 

  15. Ueda S, Tsuda H, Saeki T, et al. Early reduction in standardized uptake value after one cycle of neoadjuvant chemotherapy measured by sequential FDG PET/CT is an independent predictor of pathological response of primary breast cancer. Breast J. 2010;16(6):660–2.

    Article  PubMed  Google Scholar 

  16. Ueda S, Tsuda H, Saeki T, et al. Early metabolic response to neoadjuvant letrozole, measured by FDG PET/CT, is correlated with a decrease in the Ki67 labeling index in patients with hormone receptor-positive primary breast cancer: a pilot study. Breast Cancer. 2011;18(4):299–308.

    Article  PubMed  Google Scholar 

  17. Wang CL, MacDonald LR, Rogers JV, et al. Positron emission mammography: correlation of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status and 18F-FDG. AJR Am J Roentgenol. 2011;197(2):W247–55.

    Article  PubMed  Google Scholar 

  18. Ueda S, Saeki T, Shigekawa T, et al. (18)F-Fluorodeoxyglucose positron emission tomography optimizes neoadjuvant chemotherapy for primary breast cancer to achieve pathological complete response. Int J Clin Oncol. 2011 Aug 10. Epub ahead of print.

  19. Keam B, Im SA, Koh Y, et al. Early metabolic response using FDG PET/CT and molecular phenotypes of breast cancer treated with neoadjuvant chemotherapy. BMC Cancer. 2011 Oct 20;11:452.

    Article  CAS  PubMed  Google Scholar 

  20. Kumar A, Kumar R, Seenu V, et al. The role of (18)F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer. Eur Radiol. 2009;19:1347–57.

    Article  PubMed  Google Scholar 

  21. Berriolo-Riedinger A, Touzery C, Riedinger JM, et al. [18F]FDG-PET predicts complete pathological response of breast cancer to neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging. 2007,34:1915–24.

    Article  CAS  PubMed  Google Scholar 

  22. Duch J, Fuster D, Munoz M, et al. (18)F-FDG PET/CT for early prediction of response to neoadjuvant chemotherapy in breast cancer. Eur J Nucl Med Mol Imaging. 2009;36:1551–7.

    Article  CAS  PubMed  Google Scholar 

  23. Dunnwald LK, Gralow JR, Ellis GK, et al. Tumor metabolism and blood flow changes by positron emission tomography: relation to survival in patients treated with neoadjuvant chemotherapy for locally advanced breast cancer. J Clin Oncol. 2008;26:4449–57.

    Article  CAS  PubMed  Google Scholar 

  24. Jung SY, Kim SK, Nam BH, et al. Prognostic impact of [(18)F] FDG-PET in operable breast cancer treated with neoadjuvant chemotherapy. Ann Surg Oncol. 2009;17:247–53.

    Article  PubMed  Google Scholar 

  25. Rousseau C, Devillers A, Sagan C, et al. Monitoring of early response to neoadjuvant chemotherapy in stage ii and iii breast cancer by [18F]fluorodeoxyglucose positron emission tomography. J Clin Oncol. 2006;24:5366–72.

    Article  PubMed  Google Scholar 

  26. Schwarz-Dose J, Untch M, Tiling R, et al. Monitoring primary systemic therapy of large and locally advanced breast cancer by using sequential positron emission tomography imaging with [18F]fluorodeoxyglucose. J Clin Oncol. 2009;27:535–41.

    Article  PubMed  Google Scholar 

  27. Padmanabhan P, Goggi J, Bejot R, et al. Molecular targeting of breast cancer: imaging and therapy. Curr Pharm Biotechnol. 2011;12(4):528–38.

    Article  CAS  PubMed  Google Scholar 

  28. Sekar TV, Dhanabalan A, Paulmurugan R, et al. Imaging cellular receptors in breast cancers: an overview. Curr Pharm Biotechnol. 2011;12(4):508–27.

    Article  CAS  PubMed  Google Scholar 

  29. Tomasi G, Kenny L, Mauri F, et al. Quantification of receptor-ligand binding with [(18)F]fluciclatide in metastatic breast cancer patients. Eur J Nucl Med Mol Imaging. 2011;38(12):2186–97.

    Article  CAS  PubMed  Google Scholar 

  30. Hatt M, Cheze-Le Rest C, Aboagye EO, et al. Reproducibility of 18F-FDG and 3′-deoxy-3′-18F-fluorothymidine PET tumor volume measurements. J Nucl Med. 2010;51(9):1368–76.

    Article  CAS  PubMed  Google Scholar 

  31. Krause BJ, Schwarzenböck S, Schwaiger M. Tracers in oncology—preclinical and clinical evaluation. Nuklearmedizin. 2010;49(Suppl 1):S41–5.

    PubMed  Google Scholar 

  32. Nanni C, Fantini L, Nicolini S, Fanti S. Non FDG PET. Clin Radiol. 2010;65(7):536–48.

    Article  CAS  PubMed  Google Scholar 

  33. Contractor KB, Kenny LM, Stebbing J, et al. [11C]choline positron emission tomography in estrogen receptor-positive breast cancer. Clin Cancer Res. 2009 Sept 1;15(17):5503–10.

    Article  CAS  PubMed  Google Scholar 

  34. Contractor KB, Kenny LM, Stebbing J, et al. Biological basis of (11C)choline-positron emission tomography in patients with breastcancer: comparison with (18F)fluorothymidine positron emission tomography. Nucl Med Commun. 2011;32(11):997–1004.

    Article  CAS  PubMed  Google Scholar 

  35. Oude Munnink TH, Nagengast WB, Brouwers AH, et al. Molecular imaging of breast cancer. Breast. 2009;18(Suppl 3):S66–73.

    Article  PubMed  Google Scholar 

  36. Linden HM, Kurland BF, Peterson LM, et al. Fluoroestradiol positron emission tomography reveals differences in pharmacodynamics of aromatase inhibitors, tamoxifen, and fulvestrant in patients with metastatic breast cancer. Clin Cancer Res. 2011 Jul 15;17(14):4799–805.

    Article  CAS  PubMed  Google Scholar 

  37. Kurland BF, Peterson LM, Lee JH, et al. Between-patient and within-patient (site-to-site) variability in estrogen receptor binding, measured in vivo by 18F-fluoroestradiol PET. J Nucl Med. 2011;52(10):1541–9.

    Article  CAS  PubMed  Google Scholar 

  38. Tinianow JN, Gill HS, Ogasawara A, et al. Site-specifically 89Zr-labeled monoclonal antibodies for ImmunoPET. Nucl Med Biol. 2010;37(3):289–97.

    Article  CAS  PubMed  Google Scholar 

  39. Dijkers EC, Oude Munnink TH, Kosterink JG, et al. Biodistribution of 89Zr-trastuzumab and PET imaging of HER2-positive lesions in patients with metastaticbreast cancer. Clin Pharmacol Ther. 2010;87(5):586–92.

    Article  CAS  PubMed  Google Scholar 

  40. Manning K, Tepfer B, Goldklang G, et al. Clinical practice guidelines for the utilization of positron emission tomography/computed tomography imaging in selected oncologic applications: suggestions from a provider group. Mol Imaging Biol. 2007;9(6):324–32.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.

Author information

Authors and Affiliations

  1. Department of Oncotherapy, University of Szeged, Korányi fasor 12, 6720, Szeged, Hungary

    Katalin Hideghéty MD, PhD &  Zsuzsanna Kahán MD, PhD

  2. Institute of Oncotherapy, Clinical Center, University of Pécs, Édesanyák útja 17, 7624, Pécs, Hungary

    Zoltán Lőcsei MD

Authors
  1. Zoltán Lőcsei MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katalin Hideghéty MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zsuzsanna Kahán MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zsuzsanna Kahán MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lőcsei, Z., Hideghéty, K. & Kahán, Z. The role of Positron Emission Tomography/Computer Tomography (PET/CT) in the diagnosis, staging, characterization, and therapy of breast cancer. memo 5, 119–124 (2012). https://doi.org/10.1007/s12254-012-0007-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12254-012-0007-2

Keywords

Search

Navigation