The role of FDG PET/CT in detection of distant metastasis in theinitial staging of breast cancer.

BACKGROUND/AIM: We aimed to evaluate the role of FDG PET/CT in the detection of extraaxillary regional nodal/distant metastasis in breast cancer patients and to assess the value of FDG PET/CT for detecting distant metastases in patient subgroups. MATERIALS AND METHODS: A total of 254 patients with breast cancer (248 female, 6 male) who underwent PET/CT for initial staging were enrolled. Patients were divided into four groups: Group 1 consisted of 154 patients diagnosed by tru-cut/core/FNAB, Group 2 comprised 32 patients diagnosed by excisional biopsy, Group 3 included 62 patients who had mastectomy-axillary lymph node dissection, and Group 4 consisted of 6 patients who had axillary lymph node metastasis diagnosed by excisional biopsy. RESULTS: PET/CT detected distant metastasis in 76 of the 254 patients. Of these patients, 21.7% had bone/bone marrow metastasis, 7.1% had lung metastasis, 13% had mediastinal lymph node metastasis, 4.8% had liver metastasis, 9.8% had other organ/system metastasis, and 6% had other lymphadenopathies. According to T staging, the percentages of distant metastasis were as follows: 13.6% of the 66 T1 stage patients, 35.7% of the 129 T2 stage patients, 40% of the 20 T3 stage patients, and 33.3% of the 39 T4 stage patients. CONCLUSION: FDG-PET/CT led to a change in the stage of disease and the treatment approach in newly diagnosed breast cancer patients due to its superiority in detecting extraaxillary regional lymph node metastases and distant metastases.

The role of FDG-PET/CT in detecting unsuspected and unknown distant metastasis in the initial staging of NSCLC.

BACKGROUND/AIM: Our purpose in this retrospective study was to determine the ratio of unexpected [metastases within the coverage area of thorax computed tomography (CT)] and unknown (metastases out of the coverage area of thorax CT) metastases by positron emission tomography/CT (PET/CT) in patients with newly diagnosed non-small cell lung cancer (NSCLC) who had no defined metastatic lesion, and to investigate the contribution of fludeoxyglucose (FDG)-PET/CT in metastasis staging. MATERIALS AND METHODS: A total of 567 patients (489 males and 78 females, mean age 60.9 ± 10.7 years) were enrolled in this study. Among the 567 patients, a total of 156 patients who underwent PET/CT for metabolic characterization (group 1) and had solitary pulmonary nodules (group la, n = 39) or solitary pulmonary masses (group lb, n = 117) and the remaining 411 patients (group 2) with NSCLC who had PET/CT performed for staging formed the basis of this study RESULTS: In group 1, 5/39 (12.8%) patients with a solitary pulmonary nodule and 29/117 (24.8%) patients with a solitary pulmonary mass had distant metastases. In group 2, 129 patients of 411 (31.4%) had distant metastasis. CONCLUSION: FDG-PET/CT is proven to be an effective method in detection of unsuspected-unknown metastasis, either in patients with solitary pulmonary lesion or in the initial staging of patients with NSCLC.