Diagnostic value of full-dose FDG PET/CT for axillary lymph node staging in breast cancer patients
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Published on: January 22, 2018
Till A Heusner1, Sherko Kuemmel, Steffen Hahn
1Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany. till.heusner@uni-due.de
Purpose:
The aims of this study were (1) to evaluate FDG PET/CT and CT for the detection of axillary lymph node metastases in breast cancer (BC) patients and (2) to evaluate FDG PET/CT as a pre-test for the triage to sentinel lymph node biopsy (SLNB) versus axillary lymph node dissection (ALND).
Methods:
The sensitivity, specificity, positive and negative predictive value (PPV, NPV), and accuracy of FDG PET/CT and CT for axillary lymph node metastases were determined in 61 patients (gold standard: histopathology). According to the equation "NPV = specificity (1-prevalence) / [specificity (1-prevalence) + (1-sensitivity) prevalence]" FDG PET/CT was evaluated as a triage tool for SLNB versus ALND.
Results:
The sensitivity, specificity, PPV, NPV and accuracy of FDG PET/CT was 58, 92, 82, 77 and 79% and of CT 46, 89, 72, 71 and 72%, respectively. Patients with an up to approximately 60% risk for axillary lymph node metastases appear to be candidates for SLNB provided that the axilla is unremarkable on FDG PET/CT.
Conclusion:
FDG PET/CT cannot replace invasive approaches for axillary staging but may extend the indication for SLNB.
