ArticleEuropean journal of nuclear medicine and molecular imaging2026
Stage-dependent performance and molecular subtype-specific relapse patterns on same-session [18F]FDG PET/contrast-enhanced CT in breast cancer.
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate stage-dependent performance of same-session [18F]FDG PET/contrast-enhanced CT (PET/ceCT) for initial breast cancer staging and PET/ceCT-detected relapse patterns during follow-up.
methodsThis retrospective single-centre study included a primary staging cohort with one index PET/ceCT per patient and a longitudinal cohort of follow-up/restaging examinations. PET/ceCT-derived endpoints were assessed against clinically adjudicated reference standards established through multidisciplinary team review, pathology when available and follow-up imaging. SUVmax and ceCT lesion diameter were analysed as exploratory biomarkers.
resultsThe staging cohort included 116 patients. Baseline stage was evaluable in 106 patients: 65 had cN-positive disease, 9 had cT3-4 cN0 disease and 32 had cT1-2 cN0 disease. Overall nodal staging performance showed sensitivity 64.8%, specificity 88.9%, PPV 92.0%, NPV 56.1% and accuracy 72.9%. In cT3-4 and/or cN-positive disease, PET-positive nodal findings had a PPV of 100%. Baseline M-stage assessment was limited by the low number of clinically confirmed M1 cases. SUVmax correlated with Ki-67 (rho = 0.322, p = 0.003, q = 0.022). The longitudinal cohort included 176 patients and 429 examinations. In 311 adjudicated examinations, restaging performance for disease progression showed sensitivity 100%, specificity 93.5%, PPV 97.3%, NPV 100% and accuracy 98.1%. First confirmed relapse was multiorgan/multisystem in 48/82 patients and visceral-only in 15/82; visceral conversion occurred in 5/16 patients with initial bone-only or nodal/locoregional relapse.
conclusionSame-session [18F]FDG PET/ceCT showed greatest baseline utility in higher-risk breast cancer and was useful for longitudinal characterization of relapse phenotype and metastatic evolution.
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