Positron emission tomography for the evaluation of gastrointestinal tumors

La TEP au 18FDG présente de nombreuses indications dans l’évaluation des tumeurs digestives. Son rôle principal concerne le bilan d’extension des récidives tumorales démontrées ou suspectées mais des indications plus ponctuelles concernent également le diagnostic différentiel des masses pancréatiques et le bilan initial du cancer de l’oesophage. Le principal avantage de la TEP résulte de la nature métabolique du signal, indépendant et complémentaire des modifications anatomiques visibles en imagerie classique. Un autre avantage est lié à l’examen du corps entier aujourd’hui pratiqué systématiquement. La TEP trouve dès lors sa place en première ligne dans ses différentes indications

Étude des performances de la TEP-TDM au 18F-FDG dans les premières suspicions de récidive chez les femmes atteintes d’un adénocarcinome lobulaire du sein

International audienc

Performances de la TEP-FDG numérique avec acquisition dédiée sur les artères céphaliques pour le diagnostic d’artérite à cellules géantes

International audienc

Intérêt de la TEP céphalique pour le diagnostic d’artérite à cellules géantes

International audienc

Diagnostic effectiveness of [18F]Fluoroestradiol PET/CT in oestrogen receptor-positive breast cancer: the key role of histopathology. Evidence from an international multicentre prospective study.

[ <sup>18</sup> F]Fluoroestradiol ([ <sup>18</sup> F]FES) PET/CT has been proposed as a tool for detecting the oestrogen receptor density in patients with metastatic breast cancer (BC) non-invasively across all disease localizations. However, its diagnostic potential in terms of the detection rate (DR) of metastases is unclear. In this study, we pitted this method against [ <sup>18</sup> F]FDG PET/CT and tried to identify predictors of the diagnostic superiority of the [ <sup>18</sup> F] FES-based method. From a multicentre database, we enrolled all patients with metastatic BC who had undergone both [ <sup>18</sup> F]FES PET/CT and [ <sup>18</sup> F]FDG PET/CT. Two readers assessed both images independently and used a patient-based (PBA) and lesion-based analysis (LBA) to calculate the DR. Pathology-related and clinical factors were tested as predictors of [ <sup>18</sup> F]FES PET/CT superiority using a multivariate model. 92 patients, bearing a total of 2678 metastases, were enrolled. On PBA, the DR of [ <sup>18</sup> F]FDG and [ <sup>18</sup> F]FES PET/CT was 97% and 86%, respectively (p = 0.018). On LBA, the [ <sup>18</sup> F]FES method proved more sensitive than [ <sup>18</sup> F]FDG PET/CT in lymph nodes, bone, lung and soft tissue (p < 0.01). This greater sensitivity was associated with lobular histology, both on PBA (Odds Ratio (OR) 3.4, 95%CI 1.0-12.3) and on LBA (OR 4.4, 95%CI 1.2-16.1 for lymph node metastases and OR 3.29, 95%CI 1.1-10.2 for bone localizations). The overall DR of [ <sup>18</sup> F]FES PET/CT appears to be lower than that of [ <sup>18</sup> F]FDG PET/CT on PBA. However, the [ <sup>18</sup> F]FES method, if positive, can identify more lesions than [ <sup>18</sup> F]FDG at most sites. The higher sensitivity of [ <sup>18</sup> F]FES PET/CT was associated with lobular histology