Lee, Hwee Meng, Joanne (2023) The Role Of 18f-fdg Pet/CT In Comparison With Computed Tomography In The Restaging Of Breast Cancer In Malaysia. Masters thesis, Universiti Sains Malaysia.
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Abstract
Title: The role of 18F-FDG PET/CT in comparison with computed tomography (CT) in the restaging of breast cancer in Malaysia. Introduction: Breast cancer is the leading cancer among women detected in Malaysia and worldwide. While limited investigation is needed for patients with early-stage breast cancer, those afflicted with stages III and IV breast cancer are recommended to undergo more imaging for staging since this is directly vital for their survival. The reasons for further evaluation or restaging include suspicion of disease recurrence, appraisal of disease progression, or restaging following completion of treatment, all these which require further radiological confirmation. Computed tomography (CT) is commonly used as first line imaging for restaging, whereas fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) is not frequently utilised. The imaging results directly affect further patient management. Objective: To determine the role of 18F-FDG PET/CT as a routine procedure in restaging breast cancer, especially in the detection of distant metastases. Methods: This research involved histopathology-confirmed breast cancer patients whose ages ranged from 18 years to 90, and who had undergone CT in their respective hospitals; they were then sent for restaging using 18F-FDG PET/CT from 2017 to 2021 at Hospital Pulau Pinang. A data collection sheet (proforma) was devised to obtain information from the patients’ case records. The number and the locations of lesions on both CT and 18F-FDG PET/CT were recorded. The outcomes were categorised for each organ into no evidence of metastasis, suspicious of metastasis or definite metastasis. The clinical data obtained were evaluated using IBM SPSS version 26.0.0. Results: One hundred and eleven breast cancer patients with a mean age of 51.95 years were enrolled. Most were female (99.1%), with Malays comprising a slight majority (52.3%). Invasive carcinoma of no special type (NST) was the largest pathology subtype at 84.7%. The largest group (43.2%) in this study was in stage II, followed by stage III (36.9%), stage I (13.5%), with the fewest in stage IV (6.3%). Sixty-two patients’ classification changed from detection of lesion(s) to no evidence of disease, and in one patient from no evidence of disease to detection of lesions. Detection status of CT and 18F-FDG PET/CT remained the same in 44 patients for lesions detected, while 4 patients had no evidence of disease. A statistically significant change was found using the McNemar Test in the detection of lesions between conventional CT and 18F-FDG PET/CT, as the p value was < 0.050. By the supplementation of 18F-FDG PET/CT, 32.4% were upstaged, 3.6% of the patients were downstaged, while 64% of the patients remained in the same stage. Conclusion: There is an added advantage of 18F-FDG PET/CT in restaging breast cancer, especially in the detection of distant metastases. This would lead to appropriate changes in patient management.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Institut Perubatan & Pergigian Termaju (Advanced Medical & Dental Institute (AMDI)) > Thesis |
| Depositing User: | MUHAMAD AMIN BIN AZMI |
| Date Deposited: | 16 Jul 2026 01:02 |
| Last Modified: | 16 Jul 2026 01:02 |
| URI: | http://eprints.usm.my/id/eprint/64651 |
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