الفهرس | Only 14 pages are availabe for public view |
Abstract Breast cancer is the most commonly diagnosed form of cancer and leading cause of death in women. The incidence rate is increasing and woman with 1 in 8 chances of women developing breast cancer in their lifetime. Mortality for patients with breast cancer decreased significantly, largely because of early detection or screening for breast cancer and advances in medical care and treatments. Conventional imaging modalities such as mammography and ultrasound rely primarily on changes in anatomic structure for disease detection. FDG PET can help detect accelerated metabolic activity that occurs before anatomic structural changes occur. However, the expense of the examination and radiation exposure involved is not generally suitable for routine screening purposes. A major advantage of FDG PET imaging as compared to conventional imaging is the ability to screen the entire patient for local recurrence, lymph node metastases and distant metastases during a single whole body examination. The main drawback of PET in tumor imaging is the complete absence of anatomic landmarks, which impedes precise localization of lesions. Furthermore, there are issues regarding specificity as FDG is not only taken up by many malignant tumors but also by sites of active inflammation. PET/CT is a unique combination of the cross sectional anatomy provided by CT and the metabolic information provided by PET which are acquired during a single examination. Limitations of FDG PET in the follow-up of breast cancer patients include the relatively low detection rate of bone metastases, especially in case of the sclerotic subtype, and the relatively high rate of false positive results. The major limitation of PET or PET/CT for breast imaging is its poor detection rate for small breast carcinomas and non-invasive breast cancers. PET/CT has a role to play in : (1) patients with dense breasts, (2) patients with breast implants, (3) localizing primary tumor in those patients with metastases of a breast origin, (4) in patients when the mammography is indeterminate, and (5) for those patients whom biopsy is not a desirable option. |