Influence of [<sup>18</sup>F]FDG-PET/CT on Clinical Management Decisions in Breast Cancer Patients—A PET/CT Registry Study
There is a lack of evidence regarding the clinical impact of [<sup>18</sup>F]fluorodeoxyglucose positron emission tomography/computed tomography ([<sup>18</sup>F]FDG-PET/CT, hereinafter referred to as PET/CT), especially regarding management changes and their link to overall...
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MDPI AG
2023-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/14/2420 |
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| author | Sebastian Werner Julia Sekler Brigitte Gückel Christian la Fougère Konstantin Nikolaou Christina Pfannenberg Heike Preibsch Tobias Engler Susann-Cathrin Olthof |
| author_facet | Sebastian Werner Julia Sekler Brigitte Gückel Christian la Fougère Konstantin Nikolaou Christina Pfannenberg Heike Preibsch Tobias Engler Susann-Cathrin Olthof |
| author_sort | Sebastian Werner |
| collection | DOAJ |
| description | There is a lack of evidence regarding the clinical impact of [<sup>18</sup>F]fluorodeoxyglucose positron emission tomography/computed tomography ([<sup>18</sup>F]FDG-PET/CT, hereinafter referred to as PET/CT), especially regarding management changes and their link to overall survival. We analyzed 52 PET/CTs in 47 stage I-IV breast cancer patients, selected from a prospective oncological PET/CT registry. Indications for PET/CT were primary staging (<i>n</i> = 15), restaging (<i>n</i> = 17), and suspected recurrence (<i>n</i> = 20). PET/CT-induced management changes were categorized as major or minor. PET/CT-induced management changes in 41 of 52 scans (78.8%; 38 of 47 patients (80.9%)), of which major changes were suggested in 18 of 52 scans (34.6%, 17 of 47 patients, 36.2%). PET/CT downstaged 6 of 15 primary staging patients, excluding distant metastases. Major management changes were documented in 3 of 17 restaging exams. PET/CT ruled out clinically suspected recurrence in 6 of 20 cases and confirmed it in 11 of 20. In three cases, locoregional recurrence had already been diagnosed via biopsy. In 30 of 52 exams, additional diagnostic tests were avoided, of which 13 were invasive. PET/CT-based management changes resulted in a 5-year survival rate of 72.3% for the whole study group, 93.3% for the staging group, 53.8% for the restaging group, and 68.4% for the recurrence group. This study shows that PET/CT significantly impacts clinical management decisions in breast cancer patients in different clinical scenarios, potentially determining the patient’s tumor stage as the basis for further therapy more reliably and by avoiding unnecessary diagnostic tests. |
| first_indexed | 2024-03-11T01:10:17Z |
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| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T01:10:17Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-f68fc02bb2c24c48829d86cb16fff3652023-11-18T18:58:35ZengMDPI AGDiagnostics2075-44182023-07-011314242010.3390/diagnostics13142420Influence of [<sup>18</sup>F]FDG-PET/CT on Clinical Management Decisions in Breast Cancer Patients—A PET/CT Registry StudySebastian Werner0Julia Sekler1Brigitte Gückel2Christian la Fougère3Konstantin Nikolaou4Christina Pfannenberg5Heike Preibsch6Tobias Engler7Susann-Cathrin Olthof8Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, GermanyDepartment of Nuclear Medicine and Clinical Molecular Imaging, University Hospital of Tuebingen, Otfried-Mueller-Straße 14, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, GermanyCluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, Faculty of Medicine, Eberhard Karls University, 72076 Tuebingen, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, GermanyThere is a lack of evidence regarding the clinical impact of [<sup>18</sup>F]fluorodeoxyglucose positron emission tomography/computed tomography ([<sup>18</sup>F]FDG-PET/CT, hereinafter referred to as PET/CT), especially regarding management changes and their link to overall survival. We analyzed 52 PET/CTs in 47 stage I-IV breast cancer patients, selected from a prospective oncological PET/CT registry. Indications for PET/CT were primary staging (<i>n</i> = 15), restaging (<i>n</i> = 17), and suspected recurrence (<i>n</i> = 20). PET/CT-induced management changes were categorized as major or minor. PET/CT-induced management changes in 41 of 52 scans (78.8%; 38 of 47 patients (80.9%)), of which major changes were suggested in 18 of 52 scans (34.6%, 17 of 47 patients, 36.2%). PET/CT downstaged 6 of 15 primary staging patients, excluding distant metastases. Major management changes were documented in 3 of 17 restaging exams. PET/CT ruled out clinically suspected recurrence in 6 of 20 cases and confirmed it in 11 of 20. In three cases, locoregional recurrence had already been diagnosed via biopsy. In 30 of 52 exams, additional diagnostic tests were avoided, of which 13 were invasive. PET/CT-based management changes resulted in a 5-year survival rate of 72.3% for the whole study group, 93.3% for the staging group, 53.8% for the restaging group, and 68.4% for the recurrence group. This study shows that PET/CT significantly impacts clinical management decisions in breast cancer patients in different clinical scenarios, potentially determining the patient’s tumor stage as the basis for further therapy more reliably and by avoiding unnecessary diagnostic tests.https://www.mdpi.com/2075-4418/13/14/2420breast neoplasmspositron emission tomography computed tomographyfluorodeoxyglucose F18survival rateregistries |
| spellingShingle | Sebastian Werner Julia Sekler Brigitte Gückel Christian la Fougère Konstantin Nikolaou Christina Pfannenberg Heike Preibsch Tobias Engler Susann-Cathrin Olthof Influence of [<sup>18</sup>F]FDG-PET/CT on Clinical Management Decisions in Breast Cancer Patients—A PET/CT Registry Study Diagnostics breast neoplasms positron emission tomography computed tomography fluorodeoxyglucose F18 survival rate registries |
| title | Influence of [<sup>18</sup>F]FDG-PET/CT on Clinical Management Decisions in Breast Cancer Patients—A PET/CT Registry Study |
| title_full | Influence of [<sup>18</sup>F]FDG-PET/CT on Clinical Management Decisions in Breast Cancer Patients—A PET/CT Registry Study |
| title_fullStr | Influence of [<sup>18</sup>F]FDG-PET/CT on Clinical Management Decisions in Breast Cancer Patients—A PET/CT Registry Study |
| title_full_unstemmed | Influence of [<sup>18</sup>F]FDG-PET/CT on Clinical Management Decisions in Breast Cancer Patients—A PET/CT Registry Study |
| title_short | Influence of [<sup>18</sup>F]FDG-PET/CT on Clinical Management Decisions in Breast Cancer Patients—A PET/CT Registry Study |
| title_sort | influence of sup 18 sup f fdg pet ct on clinical management decisions in breast cancer patients a pet ct registry study |
| topic | breast neoplasms positron emission tomography computed tomography fluorodeoxyglucose F18 survival rate registries |
| url | https://www.mdpi.com/2075-4418/13/14/2420 |
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