Joint EANM-SNMMI Guideline on the Role of 2-[F]FDG PET/CT in No Special Type Breast Cancer : (endorsed by the ACR, ESSO, ESTRO, EUSOBI/ESR, and EUSOMA)

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2024 May 13

PMID 38740576

Authors

Sofia C Vaz

John Patrick Pilkington Woll

Fatima Cardoso

David Groheux

Gary J R Cook

Gary A Ulaner

Heather Jacene

Isabel T Rubio

Jan W Schoones

Marie-Jeanne Vrancken Peeters

Philip Poortmans

Ritse M Mann

Stephanie L Graff

Elizabeth H Dibble

Lioe-Fee de Geus-Oei

Affiliations

Soon will be listed here.

Abstract

Introduction: There is much literature about the role of 2-[F]FDG PET/CT in patients with breast cancer (BC). However, there exists no international guideline with involvement of the nuclear medicine societies about this subject.

Purpose: To provide an organized, international, state-of-the-art, and multidisciplinary guideline, led by experts of two nuclear medicine societies (EANM and SNMMI) and representation of important societies in the field of BC (ACR, ESSO, ESTRO, EUSOBI/ESR, and EUSOMA).

Methods: Literature review and expert discussion were performed with the aim of collecting updated information regarding the role of 2-[F]FDG PET/CT in patients with no special type (NST) BC and summarizing its indications according to scientific evidence. Recommendations were scored according to the National Institute for Health and Care Excellence (NICE) criteria.

Results: Quantitative PET features (SUV, MTV, TLG) are valuable prognostic parameters. In baseline staging, 2-[F]FDG PET/CT plays a role from stage IIB through stage IV. When assessing response to therapy, 2-[F]FDG PET/CT should be performed on certified scanners, and reported either according to PERCIST, EORTC PET, or EANM immunotherapy response criteria, as appropriate. 2-[F]FDG PET/CT may be useful to assess early metabolic response, particularly in non-metastatic triple-negative and HER2+ tumours. 2-[F]FDG PET/CT is useful to detect the site and extent of recurrence when conventional imaging methods are equivocal and when there is clinical and/or laboratorial suspicion of relapse. Recent developments are promising.

Conclusion: 2-[F]FDG PET/CT is extremely useful in BC management, as supported by extensive evidence of its utility compared to other imaging modalities in several clinical scenarios.

Citing Articles

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PMID: 39900666 DOI: 10.1007/s00117-024-01403-z.

F-FDG PET/CT radiomic analysis and artificial intelligence to predict pathological complete response after neoadjuvant chemotherapy in breast cancer patients.

Urso L, Manco L, Cittanti C, Adamantiadis S, Szilagyi K, Scribano G Radiol Med. 2025; .

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Editorial Commentary: Should "heterogeneous response" be considered as new category for assessing treatment response in patients with breast cancer?.

Vaz S, Groheux D, van Nijnatten T, Antunovic L, Cardoso F, Mottaghy F Eur J Nucl Med Mol Imaging. 2024; 52(3):801-805.

PMID: 39706898 DOI: 10.1007/s00259-024-07042-9.

Predictive value of F-fluorodeoxyglucose uptake for axillary lymph node metastasis in operable breast cancer: impact of molecular subtypes.

Lim C, Lee J, Lee J, Park S Ann Nucl Med. 2024; .

PMID: 39623100 DOI: 10.1007/s12149-024-02002-7.

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