PET/CT in breast cancer.

Area of Science:

• Oncology
• Nuclear Medicine
• Radiopharmaceutical Chemistry

Background:

• Breast cancer is a leading global neoplasm with diverse molecular subtypes impacting patient outcomes.
• Positron Emission Tomography/Computed Tomography (PET/CT) is crucial for breast cancer management, offering insights into diagnosis, staging, and treatment response.
• Standard radiotracers like [¹⁸F]-Fluorodeoxyglucose have limitations, particularly in specific subtypes such as invasive lobular carcinoma.

Purpose of the Study:

• To review the evolving role of PET/CT and novel radiopharmaceuticals in breast cancer management.
• To highlight advancements in molecular imaging for personalized diagnosis, staging, and therapy monitoring.
• To discuss emerging radiotracers and their specific applications in breast cancer subtypes and metastasis detection.

Main Methods:

• Review of current literature on PET/CT applications in breast cancer.
• Discussion of established and novel radiopharmaceuticals, including [¹⁸F]-Fluorodeoxyglucose, 16α-[¹⁸F] fluoro-17β-estradiol, [⁶⁸Ga]-FAPI, [⁸⁹Zr]-trastuzumab, and [¹⁸F]-NaF.
• Exploration of imaging targets such as HER2, fibroblast activation protein, PSMA, and GRPR.

Main Results:

• 16α-[¹⁸F] fluoro-17β-estradiol and [⁶⁸Ga]-FAPI show improved utility in invasive lobular carcinoma compared to [¹⁸F]-Fluorodeoxyglucose.
• HER2-targeted agents like [⁸⁹Zr]-trastuzumab enable precise assessment of tumor heterogeneity.
• [¹⁸F]-NaF is effective for detecting bone metastases, and novel targets like PSMA and GRPR are being identified.

Conclusions:

• Molecular imaging with PET/CT is indispensable for personalizing breast cancer treatment strategies.
• Advanced radiopharmaceuticals enhance diagnostic accuracy and optimize clinical decision-making across various breast cancer scenarios.
• Ongoing research into new imaging targets promises further improvements in patient care and therapeutic efficacy.