Enhancing precision in bone metastasis diagnosis for lobular breast cancer: reassessing the role of 18F-FDG PET/CT.

IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Nuclear Medicine Communications Pub Date : 2024-07-22 DOI:10.1097/MNM.0000000000001880
Sharjeel Usmani, Khulood Al Riyami, Anjali Jain, Adil Aljarrah Alajmi, Khalid AlBaimani, Paul Dumasig, Asiya Al Busaidi, Rashid Al Sukati
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Abstract

Purpose: Detection of osseous metastases by imaging can be challenging in patients with invasive lobular breast cancer (ILC). ILC may demonstrate low metabolic rate due to lower tumor cell density, decreased proliferation rate, diffuse infiltration of surrounding tissue, and low level of GLUT-1 expression. The aim of this study is to assess the diagnostic accuracy of 18F-FDG PET/CT in identifying bone metastases in ILC patients.

Material and methods: Out of 52 individuals diagnosed with lobular breast cancer and underwent 18F-FDG PET/CT for evaluation of metastases, 21 patients were included in our study population after applying inclusion and exclusion criteria. The radiological and clinical follow-up of at least 6 months served as the reference standard comparator.

Results: Bone metastases were confirmed in six patients. 18F-FDG PET/CT was true positive in two and false negative in four patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18F-FDG PET/CT were 33.33, 93.33, 66.67, 77.78, and 76.19%, respectively (95% confidence interval). The tendency of ILC osseous metastases to be more sclerotic explains the low diagnostic accuracy of 18F-FDG PET/CT in detection of bone metastases, making it a less suited method of evaluation.

Conclusion: The results of the present study indicate that 18F-FDG PET/CT has a low diagnostic accuracy in detecting bone metastases in lobular breast cancer and, by inference, new functional modalities can be explored in these patients. The findings contribute valuable insights to optimize the integration of molecular imaging into the diagnostic algorithm for this specific breast cancer subtype.

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提高小叶乳腺癌骨转移诊断的精确度:重新评估 18F-FDG PET/CT 的作用。
目的:对于浸润性小叶乳腺癌(ILC)患者来说,通过成像检测骨转移是一项挑战。由于肿瘤细胞密度较低、增殖率下降、周围组织弥漫浸润以及 GLUT-1 表达水平较低,浸润性小叶乳腺癌可能表现出低代谢率。本研究旨在评估 18F-FDG PET/CT 在鉴别 ILC 患者骨转移方面的诊断准确性:在 52 例确诊为小叶乳腺癌并接受 18F-FDG PET/CT 评估骨转移的患者中,21 例患者在应用纳入和排除标准后被纳入我们的研究人群。至少 6 个月的放射学和临床随访作为参照标准:结果:6 例患者确诊为骨转移。18F-FDG PET/CT 在两名患者中为真阳性,在四名患者中为假阴性。18F-FDG PET/CT 的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 33.33%、93.33%、66.67%、77.78% 和 76.19%(95% 置信区间)。ILC 骨转移灶更倾向于硬化,这解释了 18F-FDG PET/CT 在检测骨转移灶方面诊断准确率较低的原因,使其成为一种不太适合的评估方法:本研究结果表明,18F-FDG PET/CT 在检测小叶乳腺癌骨转移方面的诊断准确率较低,由此推断,可以在这些患者中探索新的功能模式。这些研究结果为将分子成像优化整合到这一特殊乳腺癌亚型的诊断算法中提供了有价值的见解。
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来源期刊
CiteScore
2.20
自引率
6.70%
发文量
212
审稿时长
3-8 weeks
期刊介绍: Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.
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