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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 4/2009

01-06-2009 | Original Article

Differentiation of FDG-avid loco-regional recurrent and compromised benign lesions after surgery for breast cancer with dual-time point F-18-fluorodeoxy-glucose PET/CT scan

Authors: Kazuyoshi Suga, Yasuhiko Kawakami, Atsuto Hiyama, Naofumi Matsunaga

Published in: Annals of Nuclear Medicine | Issue 4/2009

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Abstract

Objective

To evaluate the ability of dual-time point F-18-fluorodeoxy-glucose (FDG) PET/CT scans to differentiate FDG-avid loco-regional recurrent and compromised benign lesions after surgery for breast cancer.

Methods

A total of 64 FDG-avid recurrent lesions (local tumor recurrence or lymph node metastases) in 52 patients and 38 FDG-avid compromised benign lesions after surgery in 37 patients were included in the study. FDG PET/CT study was performed at 60 and 120 min after intravenous injection of 3.5 MBq/kg FDG. The maximum SUV (SUVmax) on the early and delayed scans and the percent change of SUVmax (%ΔSUVmax) between the two time points were measured. The optimal differential parameter was determined by receiver-operating characteristic curve analysis.

Results

The average early SUVmax, delayed SUVmax and ΔSUVmax% were 4.9 ± 2.6, 6.0 ± 3.6 and 18.2% ± 18.8 in FDG-avid recurrent lesions, and 2.1 ± 0.8, 1.8 ± 1.0 and −17.8% ± 21.3 in FDG-avid benign lesions, respectively. Delayed SUVmax was significantly increased compared with early SUVmax in recurrent lesions (P < 0.0001), while it was decreased in benign lesions (P < 0.0001). All the three parameters in recurrent lesions were significantly higher than those in benign lesions (P < 0.0001). The highest diagnostic accuracy of the differentiation was achieved by the combined use of the optimal parameter of delayed SUVmax > 2.5 and %ΔSUVmax > 0%, with a sensitivity of 90.6%, specificity of 81.5%, accuracy of 87.2%, NPV of 89.2%, and PPV of 83.7%, which were better than the respective values obtained with the use of delayed SUVmax > 2.5 alone or %ΔSUVmax > 0% alone (P < 0.005 and P < 0.05, respectively), and the use of the traditional parameter of early SUVmax > 2.5 (P < 0.005).

Conclusions

This approach with SUVmax estimation appears to improve the differentiation between FDG-avid loco-regional recurrent of breast cancer and compromised benign lesions after surgery, since delayed scanning significantly enhances the difference in FDG uptake between these lesions.
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Metadata
Title
Differentiation of FDG-avid loco-regional recurrent and compromised benign lesions after surgery for breast cancer with dual-time point F-18-fluorodeoxy-glucose PET/CT scan
Authors
Kazuyoshi Suga
Yasuhiko Kawakami
Atsuto Hiyama
Naofumi Matsunaga
Publication date
01-06-2009
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 4/2009
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-009-0261-5

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