Case Author(s): Jayson R. St. Jacques,M.D. and Farrokh Dehdashti,M.D. , . Rating: #D2, #Q3
Diagnosis: Recurrent breast carcinoma
Brief history:
50 year old woman with history of breast cancer
Images:
PET imaging of neck to proximal thigh - coronal sections.
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View second image(ct).
Axial CT images of the chest.
Full history/Diagnosis is available below
Diagnosis: Recurrent breast carcinoma
Full history:
50 year old woman with history of breast carcinoma originally diagnosed in 1993 by right-sided lumpectomy followed by chemotherapy and radiation. The patient then underwent mastectomy in 2000 for recurrent disease in the right breast. Chest CT recently showed multiple pulmonary nodules. PET study was requested to evaluate extent of disease.
Radiopharmaceutical:
14.9 mCi F-18 Fluorodeoxyglucose i.v.
Findings:
Multiple pulmonary nodules, lymph nodes, and areas of osseous involvement, all showing increased activity consistent with metastatic disease from patient's known metastatic breast carcinoma.
Discussion:
PET imaging is extremely useful for management of breast cancer. PET imaging is excellent for detection of distant metastatic disease at initial staging, evaluation of therapy, and evaluation of recurrence. PET has been shown to be very useful in assessing the extent of metastatic/recurrent disease and particularly helpful in detection of disease in patients with elevation of tumor markers and negative/equivocal imaging studies (sensitivity of 86% and accuracy of 90%, Liu et al. 2002). PET also has been shown to be superior to MRI in differentiating recurrent local disease from posttherapeutic changes (Hathaway et al. 1999).
References:
1. Liu et al., Jpn J Clin Oncol; 2002; 32:244-7.
2. Hathaway et al., Radiologt\y 1999; 210:807-14.
3. Kim et al., 2001; 25:829-34.
ACR Codes and Keywords:
References and General Discussion of PET Tumor Imaging Studies (Anatomic field:Breast, Category:Neoplasm, Neoplastic-like condition)
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Case number: pt080
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