Positron emission tomography (PET) is a nuclear-imaging technology used in the staging, evaluation, and medical management in patients with many cancers, including the breast. PET enables the noninvasive visualization and quantitative assessment of tumor status during and after treatment. Compared with anatomic imaging, PET offers a far more detailed picture of functional changes in tumor behavior. The metabolic changes captured via PET often precede those shown via anatomic imaging, allowing for an earlier assessment of treatment response. Using the best studied radiotracer, 18F-flurodeoxyglucose (FDG), PET has begun to provide much valuable information regarding tumor status in patients with locally advanced breast cancer, metastatic disease, and the evaluation of response to new cell-targeted drugs. Other novel radiopharmaceuticals now under investigation have the potential to assess the key molecular pathways implicated in cancer onset and progression. Together with new integrated imaging platforms such as PET and computed tomography, these tracers may allow oncologists to better understand the natural history of breast cancer and create more effective individualized treatments for patients with breast cancer.
This activity will explore the role of PET imaging in patients with breast cancer and describe the primary radiotracer and its target for molecular PET imaging. It will also evaluate PET's limitations and advantages, relative to standard imaging and surgical techniques, in the initial diagnosis and staging of patients, as well as in treatment monitoring. It will also address how PET is being used in neoadjuvant chemotherapy and in evaluating response in patients with metastatic disease as well as the research in potential targets for PET using new radioisotopes and possible future directions for molecular imaging with PET.
After reading this article, the participant should be able to:
- Compare the relative advantages and disadvantages of functional metabolic imaging and anatomic imaging.
- Describe the different radiotracers used in PET imaging and their appropriate uses.
- Evaluate the role of PET and PET-CT in the initial diagnosis and staging, as well as in the settings of locally advanced breast cancer, distant disease, and metastatic breast cancer.
- Explain the particular utility of PET in the setting of neoadjuvant chemotherapy.
- Summarize the anticipated developments in new PET platforms, tracers, and potential metabolic targets.
Categories: Nuclear medicine, radiation therapy/dosimetry