الفهرس 
Anatomy of the Female BreastOnly 14 pages are availabe for public view
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Abstract
Cancer breast is a leading cause of death and the most common cancer
in women, its prevention remains a challenge, thus early and accurate
diagnosis are mandatory to achieve this target.
PET-CT provides the needed information about both the metabolic
activity as well the anatomical location of the neoplasm combining the
advantages of both conventional methods, CT and PET.
The present study evaluated 30 female patients with breast cancer who
were previously operated by PET/CT for post-operative follow up.
The patients were subdivided into 3 groups according to the referring
cause for PET-CT post-operative follow up. Group-1 presented with nonconclusive
CT findings, group-2 presented with elevated tumor markers
and group-3 presented for follow up after chemotherapy and/or
radiotherapy
For group-1, the sensitivity of CT alone was 90%, the added
functional imaging of PET in combined PET-CT raised it to 100%, while
the specificity of CT alone was 12.5%, and in combined PET-CT reached
100%.
The sensitivity of CT alone in group-2 was calculated to be 57%, and
PET in combined PET-CT raised this percentage to reach 100%, while
the overall specificity for CT alone and for combined PET-CT was the
same100%.
In the 3rd group, the sensitivity of CT alone and of combined PET-CT
was the same 83.3%, while the overall specificity of CT alone was
84.21%, and that of combined PET-CT reached 100%. The overall
relatively low combined PET/CT sensitivity for this group was caused by
one false negative osteogenic bone metastasis that was neither detected
by CT nor combined PET/CT, and was only detected by bone
scintigraphy.
FDG-PET-CT is generally more sensitive in the detection of distant
metastases than conventional imaging, and is therefore a more accurate
method of determining recurrence of the disease. One exception is the
detection of sclerotic bone metastases as these lesions are often not
metabolically active enough to be detected by FDG-PET. Bone
scintigraphy could help in such cases.
FDG-PET-CT is highly useful for monitoring response to therapeutic
interventions. This technique can identify response to therapy earlier than
any other imaging method currently available which greatly improves
patient management by allowing termination of ineffective and toxic
therapies.
PET-CT proved to be helpful in the evaluation of anatomic regions
that have been previously treated by surgery or radiation in which the
discrimination between post-treatment scar and recurrent tumor can be
problematic
Finally, we recommend combined FDG-PET-CT as the investigation
of choice for post-operative follow up of breast cancer patients, as it has
superior results over equivocal findings of the conventional imaging,
greatest role in detection of newly developed lesions in patients with
rising tumor markers and for its greatest impact on detection of the
disease progression.