18F-Fluorodeoxyglucose versus 18F-Fluoromethylcholine Positron Emission Tomography in The Detection of Ductal Carcinoma in situ of The Breast
*Kerryn Butler Henderson Department Of Medicine, University Of Tasmania, Australia
*Corresponding Author: Kerryn Butler Henderson
Department Of Medicine, University Of Tasmania, Australia Email:Kerryn.Butlerhenderson@utas.edu.au
Published on: 2015-04-23
Purpose: Poor sensitivity and accuracy have been reported using 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the detection of ductal carcinoma in situ (DCIS), yet no reference to the use of 18F-fluoromethylcholine (FCH) PET can be identified in the in situ breast cancer literature. This study determined the tumour to background ratio for cases where both FDG and FCH-PET were used to detect DCIS. Methods: Patients with newly diagnosed DCIS were recruited from the Breast Assessment Centre at a Western Australian teaching hospital. During the 16 month recruitment period, two patients consented to participate in the study. Each underwent a FDG-PET and a FCH-PET scan. The activity within the tumour was measured against the activity in the contralateral breast to obtain the tumour-to-background ratio. Results: The DCIS lesions were visualised on the FDG and FCH-PET scans in both patients. The tumour to background ratios were 1.49:1 and 1.47:1 for the FDG-PET scan, compared to 1.49:1 and 1.20:1 for the FCH-PET scan. Both patients had comedo/ solid unifocal DCIS, with intermediate and high nuclear grade. Conclusions: FDG-PET gave a higher tumour to background ratio than FCH-PET in the detection of DCIS and hence appeared to be the preferred radiopharmaceutical for imaging and hand-held PET technology in in situ breast cancer management.
18F-Fluorodeoxyglucose; 18F-Fluoromethylcholine; Positron Emission Tomograph; Ductal Carcinoma in situ;Breast Cancer
Ductal carcinoma in situ (DCIS) is defined as neoplastic cells confined to the mammary duct system of the breast. When these neoplastic cells spread outside the ducts into the tissue, the lesion becomes invasive ductal carcinoma. The reported sensitivity of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in breast cancer varies from 25% to 96%, but is generally at the lower end for in situ and small size tumours. Several other radiopharmaceuticals that target other tissue characteristics also demonstrate poor sensitivity and low accuracy. However, the use of 18F-fluoromethylcholine (FCH) for DCIS has never been investigated although its potential has been referenced in other literature and merited exploration . This study aims to determine the tumour- to-background (TTB) ratio of FDG-PET and FCH-PET in detecting newly diagnosed DCIS.