FDG-PET/CT in Breast Cancer

Breast cancer is the most common cancer in women worldwide and it is still one of the leading causes of morbi-mortality, therefore being a major concern. 2-[18F]FDG PET/CT is commonly used in the clinical management of patients with breast cancer, with significant impact on clinical management. Currently, there is robust evidence supporting the usefulness of 2-[18F]FDG PET/CT in the initial staging of patients with locally advanced and metastatic breast cancer, in the early assessment of treatment response and in the early detection of recurrence. The first presentation of this webinar will summarize the recently published “Joint EANM-SNMMI guideline on the role of 2-[18F]FDG PET/CT in no special type breast cancer” which was endorsed by other relevant societies in the subject of breast cancer (ACR, ESSO, ESTRO, EUSOBI/ESR, and EUSOMA). Updated information to support the recommendations to perform 2-[18F]FDG PET/CT in no special type breast cancer in different clinical settings will be provided. Despite no special type breast cancer presenting high 2-[18F]FDG avidity, other breast cancer subtypes seem to be better evaluated with other PET radiopharmaceuticals. Therefore, the second presentation will address the potential role of [18F]FES, [89Zr]Trastuzumab, [18F]Sodium fluoride (NaF), [18F]Fluciclovine (FACBC), [89Zr]Pembrolizumab and FAPI-ligands in breast cancer. During this webinar we want to brainstorm about the role of PET/CT in the different subtypes and clinical scenarios of patients with breast cancer. The webinar will be enriched by interactive clinical case discussion, aiming to resemble the challenges found in daily clinical practice.

Learning Objectives:

1. General aspects to avoid false positive and false negative findings on 2-[18F]FDG PET/CT.
2. Diagnostic accuracy of 2-[18F]FDG PET/CT compared to conventional imaging modalities.
3. Recommendations for performing 2-[18F]FDG PET/CT in the initial staging, in assessing response to therapy and in assessing recurrence.
4. Appropriate PET radiopharmaceuticals to better address each breast cancer subtype.
5. Specific characteristics, physiological biodistribution, advantages and disadvantages of PET radiopharmaceuticals used in breast cancer beyond 2-[18F]FDG.
6. General interpretation criteria to optimize the information provided in the final PET/CT report.