Authors' objectives:

The aim of this report was to assess the diagnostic accuracy of FDG-PET in the detection of breast and ovarian recurrence in comparison to other imaging techniques and to determine the clinical value of this method in the management of patients.

Authors' results and conclusions: Fourteen studies met the inclusion criteria previously established for breast cancer. Ten were retrospective. The sensitivity of FDG-PET in detecting overall recurrences in these studies varied from 84% to 97,1% and the specificity from 0% to 84,2%. Inflammations and artefacts in muscle and lymphatic nodes were the main causes of false positive results. Three studies agreed on that available conventional imaging methods had a lower sensitivity but showed discordance on specificity results. Studies that assessed loco-regional recurrences concluded that this technique identified a greater number of lesions in lymphatic nodes and three out out of four studies that evaluated distant recurrences found that the sensibility and PPV was 100%. Eleven studies were included for ovarian cancer. Eight were prospective but included less than 35 subjects. The only study that included a consecutive group of patients to evaluate the overall efficacy of FDG-PET to detect ovary recurrences concluded that the sensitivity and specificity was above 80% but found no significant differences when this method was compared to computerized tomography. Most studies agreed on that FDG-PET was more sensitive than other conventional methods (TC, RMN, CA-125) when evaluating patients suspected of having recurrence, even though there were no differences in specificity.

Authors' recommendations: We consider that due to the limitations in the design of the studies, this technique still needs to be validated for its use in breast and ovarian cancer recurrences. We recommend the elaboration of a standardized protocol and adequately designed studies to assess the efficacy and evaluate the real impact of its incorporation on the health outcomes and mortality of patients.

Authors' methods: Systematic review

Project Status: Completed

Year Published: 2004

URL for published report: http://www.sergas.es/gal/Servicios/docs/AvaliacionTecnoloxias/PET-INF2004_01.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Scientific Advice Unit, avalia-t; The Galician Health Knowledge Agency (ACIS)

Contact Address: Conselleria de Sanidade, Xunta de Galicia, San Lazaro s/n 15781 Santiago de Compostela, Spain. Tel: 34 981 541831; Fax: 34 981 542854;

Contact Name: avalia-t@sergas.es

Contact Email: avalia-t@sergas.es

Copyright: <p>Galician Agency for Health Technology Assessment (AVALIA-T)</p>