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Figures
- FIGURE 1.
A 62-y-old woman with initial stage III ILC upstaged to IV by 18F-FDG PET and CT. (A) Axial fused 18F-FDG PET/CT image demonstrates previously unknown right humeral head metastases as 18F-FDG–avid osseous lesion (arrow). (B) Metastatic lesion is apparent as sclerotic osseous lesion on CT (arrow). Biopsy confirmed osseous metastasis.
- FIGURE 2.
A 56-y-old woman with initial stage III ILC upstaged to IV on CT component of 18F-FDG PET/CT. (A) Axial 18F-FDG PET does not demonstrate suggestive foci. (B) Axial CT component of PET/CT demonstrates multiple osseous sclerotic lesions suggestive of metastases (arrow). (C) Axial fused 18F-FDG PET/CT image confirms that osseous sclerotic lesions demonstrate background 18F-FDG avidity. Biopsy confirmed osseous metastasis.
- FIGURE 3.
A 52-y-old woman with initial stage III left breast ILC upstaged to IV by 18F-FDG PET and CT. (A) Axial fused 18F-FDG PET/CT image demonstrates previously known ipsilateral left axillary nodal metastasis as 18F-FDG–avid lesion (solid arrow), as well as previously unknown contralateral right axillary node (dashed arrow). (B) Both ipsilateral and contralateral axillary nodal lesions are apparent as enlarged and rounded nodes on CT. Biopsy of contralateral right axillary node demonstrated nodal metastasis. Contralateral axillary nodal metastases are distant metastases (M1 disease) as classified by American Joint Committee on Cancer (18).
- FIGURE 4.
A 64-y-old woman with initial stage III ILC false-positive for distant metastasis on 18F-FDG PET/CT. (A) Axial 18F-FDG PET demonstrates 18F-FDG–avid (SUV, 2.9) focus in left abdomen (arrow). (B) Axial CT component of PET/CT demonstrates 2.1-cm adrenal nodule with average Hounsfield units of 29 (arrow). Biopsy resulted in diagnosis of benign adrenal adenoma.
- FIGURE 5.
A 42-y-old woman with initial stage III IDC upstaged to IV by 18F-FDG PET. (A) Axial fused 18F-FDG PET/CT image demonstrates previously unknown right ilium metastases as 18F-FDG–avid osseous lesion (arrow). (B) No definite corresponding lesion is seen on axial CT component of PET/CT. (C) Axial fused 18F-FDG PET/CT image confirms osseous localization of 18F-FDG–avid focus (arrow). (D) No corresponding focus is seen on 99mTc-MDP bone scan (anterior [left] and posterior [right] spot views of pelvis shown). Biopsy confirmed osseous metastasis.
- FIGURE 6.
A 46-y-old woman with initial stage III IDC false-positive for distant metastasis on CT component of 18F-FDG PET/CT. (A) Axial 18F-FDG PET does not demonstrate suggestive foci. (B) Axial CT component of PET/CT demonstrates osseous sclerotic lesion (arrow) in T1 vertebra. (C) Axial fused 18F-FDG PET/CT image confirms that osseous sclerotic lesion (arrow) demonstrates background 18F-FDG avidity. Biopsy of sclerotic lesion yielded dense cortical bone without evidence of malignancy, consistent with bone island.
Tables
Characteristic ILC cohort Comparison IDC cohort Age (y) Median 57 59 Range 34–92 33–90 Number of patients 146 (100%) 89 (100%) AJCC stage before PET/CT* (n) I 8 (5%) 0 (0%) II 50 (35%) 0 (0%) III 88 (60%) 89 (100%) Race (n) Caucasian 129 (88.4%) 69 (77.5%) African American 9 (6.2%) 13 (14.6%) Asian 8 (5.5%) 6 (6.7%) Other 0 (0.0%) 1 (1.1%) Receptor phenotype (n) ER+/HER2− 132 (90.4%) 46 (51.7%) HER2+ 8 (5.5%) 19 (21.3%) Triple-negative 5 (3.4%) 23 (25.8%) Other/unspecified 1 (0.7%) 1 (1.1%) ↵* Clinical classification is according to seventh edition of AJCC Cancer Staging Manual (18). Inclusion criteria for IDC cohort specified initial stage III disease, to allow comparison to stage III ILC patients.
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