Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New objective criteria improve PET scan reliability in detecting breast cancer metastasis

23.08.2006
To begin to standardize PET scanning techniques to detect the spread of breast cancer to the lymph nodes, researchers at the Saul and Joyce Brandman Breast Center at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center have developed objective criteria that can be used to complement clinical observations. The group's findings and recommendations appear in the August issue of Archives of Surgery.

The spread of breast cancer cells to lymph nodes under the arm is a significant indication of the stage of the disease and the patient's prognosis, and lymph node biopsies or even surgical removal often are needed to determine whether metastasis has occurred.

In an effort to develop noninvasive options to assess lymph node involvement, PET scans (positron emission tomography) and other technologies are being refined and studied for their ability to detect breast cancer cells in lymph nodes. But while noninvasive imaging procedures offer reduced discomfort and risk, scans may be open to interpretation when analyzed visually.

PET scans for invasive breast cancers and their metastases are performed after injection of a glucose-like substance called fludeoxyglucose F 18 (FDG) and a radioactive tracer. Because malignant cells use more glucose than normal cells, FDG accumulates in them and the tracer makes them visible on the PET scan.

The key to accurate diagnosis, according to the article, is the amount of tracer uptake – a "standardized uptake value" (SUV). At Cedars-Sinai, axillary nodes with SUVs of 2.3 or greater were 15 times more likely to contain metastasis than nodes with SUVs less than 2.3. In fact, with the SUV threshold set at 2.3, 60 percent of those with axillary metastases were identified (60 percent sensitivity), there were no false positive readings (100 percent specificity) and all those with a positive result were accurately diagnosed (100 percent positive predictive value). Accuracy was 72 percent.

"The purpose of the article is not to advocate using PET scans to detect axillary node metastasis but to suggest that if physicians are going to perform a PET scan before surgery for systemic staging, an SUV should be calculated. PET should be performed and interpreted in the proper clinical context, and SUVs should be used as an adjunct to clinical judgment," said Edward H. Phillips, MD, the paper's senior author who is executive vice chairman of Cedars-Sinai's Department of Surgery, chief of the Division of General Surgery, and director of the Saul and Joyce Brandman Breast Center.

Although Cedars-Sinai's threshold was 2.3, that number is expected to vary from one institution to another because of technical and calibration factors. Therefore, each PET center is advised to develop it own reference values.

"FDG-PET is not a perfect test, but by quantifying the cancer-cell activity in the axillary lymph nodes, it can become a more accurate test," said Phillips. "As we continue to see advances in technologies, I believe we will be able to identify smaller and smaller tumors with greater accuracy."

In their study, the researchers reviewed the medical records of 462 women with invasive breast cancer who underwent FDG-PET for staging at the Saul and Joyce Brandman Breast Center between Nov. 1, 2001 and Aug. 31, 2005. The study focused on the cases of 51 women (with 54 invasive cancers) who had PET scanning performed before undergoing axillary lymph node surgery or chemotherapy.

It was determined an SUV greater than 2.3 was sufficient to diagnose lymph node involvement, and that there would be no need for sentinel lymph node biopsy or needle biopsy. The study suggests that with SUV validation of metastasis, chemotherapy can be initiated or the surgeon can proceed directly to axillary lymph node dissection to control the spread of the disease.

Sandy Van | EurekAlert!
Further information:
http://www.csmc.edu/
http://www.cedars-sinai.edu

More articles from Health and Medicine:

nachricht Team discovers how bacteria exploit a chink in the body's armor
20.01.2017 | University of Illinois at Urbana-Champaign

nachricht Rabies viruses reveal wiring in transparent brains
19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

Helmholtz International Fellow Award for Sarah Amalia Teichmann

20.01.2017 | Awards Funding

An innovative high-performance material: biofibers made from green lacewing silk

20.01.2017 | Materials Sciences

Ion treatments for cardiac arrhythmia — Non-invasive alternative to catheter-based surgery

20.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>