[Imaging bone metastases in breast cancer]

Area of Science:

• Oncology
• Radiology
• Nuclear Medicine

Background:

• Breast cancer frequently metastasizes to bone, necessitating accurate assessment for optimal patient management.
• Early detection of bone involvement is key to preventing skeletal-related events and improving outcomes.

Purpose of the Study:

• To review and compare various bone imaging modalities for detecting breast cancer bone metastases.
• To evaluate the role of nuclear medicine techniques, including SPECT/CT and PET/CT, in diagnosing and monitoring bone metastases.

Main Methods:

• Discussion of whole-body bone scintigraphy (BS) and its limitations.
• Evaluation of hybrid imaging techniques like SPECT/CT for enhanced accuracy.
• Assessment of 2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography (PET) and PET/CT for detecting and monitoring bone metastases.
• Consideration of whole-body magnetic resonance imaging (MRI) as a potential tool.

Main Results:

• Whole-body bone scintigraphy is recommended for high-risk patients.
• SPECT/CT improves the diagnostic accuracy of bone scintigraphy.
• FDG PET/CT demonstrates high specificity and accuracy for detecting breast cancer bone metastases and monitoring treatment response.
• Whole-body MRI is emerging as a supplementary tool.

Conclusions:

• No single imaging modality is universally superior for diagnosing breast cancer bone metastases or assessing treatment response.
• A combination of imaging techniques, leveraging their individual strengths and weaknesses, likely represents the optimal diagnostic approach.
• Continued research is needed to establish consensus on the best imaging strategies.