Diagnostic Performance of 18F-FDG PET/CT in Detecting Distant Metastases in Breast Cancer

Официальное название

Diagnostic Performance of F18-FDG PET/CT in Detecting Distant Metastases in Breast Cancer

Обзор

compare the accuracy and sensitivity of 18F FDG-PET/CT and CE-CT in detecting distant metastases in breast cancer

Подробное описание

Breast cancer is the most common cancer type and the most common cause of death in women worldwide.

Breast cancer patients with large tumours (T3) have a 8.3%-15.1% risk for distant metastasis. Metastatic breast cancer (MBC) is considered an incurable disease with a 5-year overall survival of only 25%.

Effective management of breast cancer requires accurate diagnosis and determination of the extent of the disease to select the most effective treatment approach. Breast cancer is very heterogenous and is characterized by different pathological features, with distinct responses to treatment and differences in long-term patient survival.

Various imaging modalities have been suggested for diagnosing MBC; however, contrast-enhanced computed tomography (CE-CT) and bone scintigraphy are often used in clinical practice. However, CE-CT has low sensitivity for bone metastases and low specificity for liver metastases.

CE-CT and the corresponding response evaluation criteria in solid tumours (RECIST) are methods that assess changes in structural lesions, making it challenging to differentiate between active tumour tissue and scar lesions \[18F\]-fluorodeoxyglucose-positron emission tomography/computed tomography (\[18F\] FDG-PET/CT) is a glucose analog transported via glucose transporters into the cells and phosphorylated by hexokinase .FDG follows the same pathway as glucose during the first enzymatic reactions in the cells, but because FDG lacks a hydroxyl group at the C-2 position, it is not metabolized further and is physically trapped in tumor cells at a rate proportional to glucose utilization.

Malignant cells show higher glucose metabolism and increased glycolytic activity compared to non-malignant cells (10). This high glycolytic activity eases the detection of malignant cells using \[18F\] FDG-PET/CT) imaging. so, \[18F\] FDG-PET/CT can detect changes in metabolic activity before morphologic changes can be seen.

However, the exact clinical stage at which PET/CT can be performed with well-balanced cost-effectiveness is uncertain till now .

Первичные конечные точки

• Comparison between 18F-FDG PET/CT and CT in detecting distant metastases. [Срок оценки: 12 months]

Вторичные конечные точки (1)

• Early staging and clinical management of breast cancer in attempt to improve survival and quality of life [Срок оценки: 12 months]

Критерии участия

• Inclusion criteria:

• Patients with pathologically proven breast cancer
• Metastatic breast cancer proved by pathology or radiological modalities.
• Interval between 18F-FDG PET/CT and CE-CT from one to three weeks.
• Exclusion criteria:

• Patients with known concomitant malignancy
• Patients receive systemic treatment chemotherapy or radiotherapy between 18F-FDG PET/CT and CE-CT.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Публикации

• Niikura N, Costelloe CM, Madewell JE, Hayashi N, Yu TK, Liu J, Palla SL, Tokuda Y, Theriault RL, Hortobagyi GN, Ueno NT. FDG-PET/CT compared with conventional imaging in the detection of distant metastases of primary breast cancer. Oncologist. 2011;16(8):1111-9. doi: 10.1634/theoncologist.2011-0089. Epub 2011 Jul 17. PMID 21765193
• Paydary K, Seraj SM, Zadeh MZ, Emamzadehfard S, Shamchi SP, Gholami S, Werner TJ, Alavi A. The Evolving Role of FDG-PET/CT in the Diagnosis, Staging, and Treatment of Breast Cancer. Mol Imaging Biol. 2019 Feb;21(1):1-10. doi: 10.1007/s11307-018-1181-3. PMID 29516387
• Vercher-Conejero JL, Pelegri-Martinez L, Lopez-Aznar D, Cozar-Santiago Mdel P. Positron Emission Tomography in Breast Cancer. Diagnostics (Basel). 2015 Mar 16;5(1):61-83. doi: 10.3390/diagnostics5010061. PMID 26854143
• Zangheri B, Messa C, Picchio M, Gianolli L, Landoni C, Fazio F. PET/CT and breast cancer. Eur J Nucl Med Mol Imaging. 2004 Jun;31 Suppl 1:S135-42. doi: 10.1007/s00259-004-1536-7. Epub 2004 May 5. PMID 15133636
• Vogsen M, Harbo F, Jakobsen NM, Nissen HJ, Dahlsgaard-Wallenius SE, Gerke O, Jensen JD, Asmussen JT, Jylling AMB, Braad PE, Vach W, Ewertz M, Hildebrandt MG. Response Monitoring in Metastatic Breast Cancer: A Prospective Study Comparing 18F-FDG PET/CT with Conventional CT. J Nucl Med. 2023 Mar;64(3):355-361. doi: 10.2967/jnumed.121.263358. Epub 2022 Oct 7. PMID 36207136
• Loibl S, Poortmans P, Morrow M, Denkert C, Curigliano G. Breast cancer. Lancet. 2021 May 8;397(10286):1750-1769. doi: 10.1016/S0140-6736(20)32381-3. Epub 2021 Apr 1. PMID 33812473
• Hadebe B, Harry L, Ebrahim T, Pillay V, Vorster M. The Role of PET/CT in Breast Cancer. Diagnostics (Basel). 2023 Feb 6;13(4):597. doi: 10.3390/diagnostics13040597. PMID 36832085
• Cardoso F, Paluch-Shimon S, Senkus E, Curigliano G, Aapro MS, Andre F, Barrios CH, Bergh J, Bhattacharyya GS, Biganzoli L, Boyle F, Cardoso MJ, Carey LA, Cortes J, El Saghir NS, Elzayat M, Eniu A, Fallowfield L, Francis PA, Gelmon K, Gligorov J, Haidinger R, Harbeck N, Hu X, Kaufman B, Kaur R, Kiely BE, Kim SB, Lin NU, Mertz SA, Neciosup S, Offersen BV, Ohno S, Pagani O, Prat A, Penault-Llorca F, PMID 32979513

Идентификаторы

NCT: NCT07523516 · AssuitUfacultyProtocol19962026

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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