Introduction

There is much literature about the role of 2-[¹⁸F]FDG PET/CT in patients with breast cancer (BC). However, there exists no international guideline with involvement of the nuclear medicine societies about this subject.

Purpose

To provide an organized, international, state-of-the-art, and multidisciplinary guideline, led by experts of two nuclear medicine societies (EANM and SNMMI) and representation of important societies in the field of BC (ACR, ESSO, ESTRO, EUSOBI/ESR, and EUSOMA).

Methods

Literature review and expert discussion were performed with the aim of collecting updated information regarding the role of 2-[¹⁸F]FDG PET/CT in patients with no special type (NST) BC and summarizing its indications according to scientific evidence. Recommendations were scored according to the National Institute for Health and Care Excellence (NICE) criteria.

Results

Quantitative PET features (SUV, MTV, TLG) are valuable prognostic parameters. In baseline staging, 2-[¹⁸F]FDG PET/CT plays a role from stage IIB through stage IV. When assessing response to therapy, 2-[¹⁸F]FDG PET/CT should be performed on certified scanners, and reported either according to PERCIST, EORTC PET, or EANM immunotherapy response criteria, as appropriate. 2-[¹⁸F]FDG PET/CT may be useful to assess early metabolic response, particularly in non-metastatic triple-negative and HER2+ tumours. 2-[¹⁸F]FDG PET/CT is useful to detect the site and extent of recurrence when conventional imaging methods are equivocal and when there is clinical and/or laboratorial suspicion of relapse. Recent developments are promising.

Conclusion

2-[¹⁸F]FDG PET/CT is extremely useful in BC management, as supported by extensive evidence of its utility compared to other imaging modalities in several clinical scenarios.

中文翻译：

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EANM-SNMMI 联合指南关于 2-[18F]FDG PET/CT 在非特殊类型乳腺癌中的作用

介绍

有很多关于 2-[ ¹⁸ F]FDG PET/CT 在乳腺癌 (BC) 患者中的作用的文献。然而，目前尚无核医学会参与的有关该主题的国际指南。

目的

由两个核医学学会（EANM 和 SNMMI）的专家以及 BC 领域重要学会的代表（ACR、ESSO、ESTRO、EUSOBI）领导，提供有组织的、国际性的、最先进的多学科指南/ESR 和 EUSOMA）。

方法

我们进行了文献综述和专家讨论，旨在收集有关 2-[ ¹⁸ F]FDG PET/CT 在非特殊型 (NST) BC 患者中的作用的最新信息，并根据科学证据总结其适应症。建议根据国家健康与护理卓越研究所 (NICE) 标准进行评分。

结果

定量 PET 特征（SUV、MTV、TLG）是有价值的预后参数。在基线分期中，2-[ ¹⁸ F]FDG PET/CT 在 IIB 期到 IV 期发挥作用。在评估治疗反应时，应在经过认证的扫描仪上进行 2-[ ¹⁸ F]FDG PET/CT，并根据情况根据 PERCIST、EORTC PET 或 EANM 免疫治疗反应标准进行报告。 2-[ ¹⁸ F]FDG PET/CT 可用于评估早期代谢反应，特别是在非转移性三阴性和 HER2+ 肿瘤中。当传统成像方法模棱两可以及临床和/或实验室怀疑复发时，2-[ ¹⁸ F]FDG PET/CT 可用于检测复发部位和程度。最近的发展是有希望的。

结论

2-[ ¹⁸ F]FDG PET/CT 在 BC 管理中非常有用，与多种临床情况中的其他成像方式相比，其实用性得到了广泛证据的支持。