Saturday, August 7, 2010

Practical tips for the week: PETCT in breast cancer

1.       PETCT is very useful for detecting bone involvement and obviate the need for additional bone scans (Czernin).

2.       PET/CT demonstration of osseous metastases usually precludes need for bone scan but may miss osteoblastic lesions (Blodgett)

3.       Watch out for internal mammary node. Hypermetabolic foci in this region can be erroneously assigned to bony structures or chest wall. PETCT should correctly differentiate internal mammary node from bone involvement (Czernin).

4.       How to monitor treatment: 6 week rules
6 weeks after end of radiation
6 weeks after end of surgery
6 weeks after start of chemotherapy  (UCLA Martin)

5.       SUV depends upon proliferative tumour cell activity. Lobular carcinoma exhibits lower SUV than infiltrating ductal carcinoma. PET cannot detect carcinoma in situ (UCLA Martin)

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