The impact of PET/BT on clinical management of breast cancer patients


Thesis Type: Expertise In Medicine

Institution Of The Thesis: Uludağ Üniversitesi, Turkey

Approval Date: 2008

Thesis Language: Turkish

Student: FAİK ERSOY

Supervisor: ERAY ALPER

Abstract:

Positron Emission Tomography with 18-Fluorodeoxyglucose (FDGPET) is an imaging technique that has a great importance and is becoming more widespread in oncology. In our study, we aimed to evaluate the role of FDG-PET in follow-up of the breast cancer patients and to assess the findings of PET/CT with the findings of Tc99m-methylene diphosphonate (MDP) bone scintigraphy, tumor markers, clinical parameters and existing radiologic imaging modalities. 50 breast cancer patients referred to Uludag University Faculty of Medicine Nuclear Medicine Department for FDG-PET/CT imaging between June 2006 and September 2007 who had Tc99m-methylene diphosphonate (MDP) bone scintigraphy and tumor markers examination in the last 3 months were included in our study. The PET/CT scanning of all patients were done with the present PET scanner integrated with multislice CT (Siemens Biograph 6 LSO) in our department. In 31 patients (62%), bone scintigraphy was performed in our center but in 19 patients (38%) it was performed in other centers. In the 16 patients (%32 of all patients) progression was determined with PET/CT scanning. In 14 of these patients with progression, the tumor markers were elevated. In the remaining 2 patients, tumor markers were normal. The stage of the cancer was altered in 9 cases (18%) after PET/CT scanning. In all nine cases, PET/CT scanning increased the stage of the disease. As a result; when FDG-PET/CT scanning is compared with the conventional imaging modalities and laboratory parameters, FDG-PET/CT has advantages in follow-up of breast cancer patients. In the follow-up of breast cancer patients, FDG-PET/CT is more reliable method than the parameters like tumor markers and bone scintigraphy. One of the advantages of the FDG-PET/CT scanning is its ability in the assesment of lymph nodes, soft tissues and organs as well as in skeleton. But due to the accessibility and cost of FDG-PET/CT and common agreement about the superiority of bone scintigraphy in the detection of osteosclerotic metastasis, it is suggested to use both imaging procedures as complemantary to each other, instead of using only one of them.