Mehdi Taghipour1, Sara Sheikhbahaei, Tyler J Trahan, Rathan M Subramaniam. 1. aRussell H Morgan Department of Radiology and Radiological SciencesbDepartment of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of MedicinecDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Abstract
OBJECTIVE: To evaluate the accuracy and value of the fourth and subsequent post-therapy follow-up fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) scans in the clinical assessment of breast cancer patients. MATERIALS AND METHODS: Ninety-two female patients, with a total of 426 fourth and subsequent follow-up PET/CT scans, were retrospectively included. Patients were followed for a median of 23.7 months (range, 0.7-124.4) from the fourth follow-up PET/CT. The diagnostic accuracy of PET/CT, its impact on clinical assessment, patients' management, and survival outcome were established. RESULT: Of the 426 follow-up PET/CT scans, 264 (62%) were interpreted as positive and 162 (38%) were interpreted as negative. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the fourth and subsequent follow-up PET/CT scans were 97.7, 98.1, 98.8, 96.3, and 97.9%, respectively. Fourth and subsequent follow-up PET/CT were useful in excluding a tumor in 13.4% (39/292) of patients with a clinical suspicion of recurrence and identifying suspected recurrence in 10.5% (14/134) of patients without previous clinical suspicion. A change in management was noted in 6.7% (9/134) of scan times when the scans were performed without previous clinical suspicion of recurrence or therapy response and was 27.7% (81/292) when the scans were performed with clinical suspicion. Overall survival differed significantly between patients with all negative follow-up scans (n=23) and those who had at least one positive follow-up scan (n=69) (hazard ratio of 4.65, P<0.001). CONCLUSION: The fourth and subsequent PET/CT scans performed after the completion of primary treatment led to a change in management in 27.7% of patients when the scans were performed with clinical suspicion and only in 6.7% of patients when performed without clinical suspicion or context.
OBJECTIVE: To evaluate the accuracy and value of the fourth and subsequent post-therapy follow-up fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) scans in the clinical assessment of breast cancerpatients. MATERIALS AND METHODS: Ninety-two female patients, with a total of 426 fourth and subsequent follow-up PET/CT scans, were retrospectively included. Patients were followed for a median of 23.7 months (range, 0.7-124.4) from the fourth follow-up PET/CT. The diagnostic accuracy of PET/CT, its impact on clinical assessment, patients' management, and survival outcome were established. RESULT: Of the 426 follow-up PET/CT scans, 264 (62%) were interpreted as positive and 162 (38%) were interpreted as negative. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the fourth and subsequent follow-up PET/CT scans were 97.7, 98.1, 98.8, 96.3, and 97.9%, respectively. Fourth and subsequent follow-up PET/CT were useful in excluding a tumor in 13.4% (39/292) of patients with a clinical suspicion of recurrence and identifying suspected recurrence in 10.5% (14/134) of patients without previous clinical suspicion. A change in management was noted in 6.7% (9/134) of scan times when the scans were performed without previous clinical suspicion of recurrence or therapy response and was 27.7% (81/292) when the scans were performed with clinical suspicion. Overall survival differed significantly between patients with all negative follow-up scans (n=23) and those who had at least one positive follow-up scan (n=69) (hazard ratio of 4.65, P<0.001). CONCLUSION: The fourth and subsequent PET/CT scans performed after the completion of primary treatment led to a change in management in 27.7% of patients when the scans were performed with clinical suspicion and only in 6.7% of patients when performed without clinical suspicion or context.
Authors: David Groheux; Elif Hindié; Sylvie Giacchetti; Anne-Sophie Hamy; Frederique Berger; Pascal Merlet; Anne de Roquancourt; Patricia de Cremoux; Michel Marty; Mathieu Hatt; Marc Espié Journal: Eur J Cancer Date: 2014-05-16 Impact factor: 9.162
Authors: William B Eubank; David A Mankoff; Hubert J Vesselle; Janet F Eary; Erin K Schubert; Lisa K Dunnwald; Skyler K Lindsley; Julie R Gralow; Mary M Austin-Seymour; Georgianna K Ellis; Robert B Livingston Journal: Radiographics Date: 2002 Jan-Feb Impact factor: 5.333
Authors: Alexander J Antoniou; Charles Marcus; Abdel K Tahari; Richard L Wahl; Rathan M Subramaniam Journal: J Nucl Med Date: 2014-04-28 Impact factor: 10.057
Authors: S Mahner; S Schirrmacher; W Brenner; L Jenicke; C R Habermann; N Avril; J Dose-Schwarz Journal: Ann Oncol Date: 2008-03-19 Impact factor: 32.976
Authors: Shaheenah Dawood; Kristine Broglio; Ana M Gonzalez-Angulo; Aman U Buzdar; Gabriel N Hortobagyi; Sharon H Giordano Journal: J Clin Oncol Date: 2008-08-25 Impact factor: 44.544
Authors: Mehdi Taghipour; Charles Marcus; Sara Sheikhbahaei; Esther Mena; Shwetha Prasad; Abhinav K Jha; Lilja Solnes; Rathan M Subramaniam Journal: J Nucl Med Date: 2016-11-03 Impact factor: 10.057