Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Nuclear Medicine

Guidelines from the NCCN recommend a systematic loco-regional work-up including physical examination, bilateral mammogram, sonography, or breast MR imaging. Systematic distant staging including chest diagnostic CT, abdominal or pelvic diagnostic CT or MR imaging, and bone scanning is also recommended for LABC [3].18F-Fluorodeoxyglucose (18F-FDG) PET is a functional imaging method aimed at detecting increased glucose metabolism in tumor cells. As anatomical changes are preceded by functional changes, it has the potential to detect lesions earlier than anatomic imaging methods. Unlike 99mTc-MDP (Methylene Diphosphonate ) or fluorine-18 skeletal scintigraphy, which detects reactive bone formation, 18F-FDG PET targets the tumor cells and hence has the potential to detect skeletal lesions/marrow metastases earlier than skeletal scintigraphy [4]. Experts of the NCCN consider that 2FDG PET/CT is most helpful in situations where standard staging studies are equivocal or suspicious.3 It is, however, stated that 2FDG PET/CT may also be helpful in identifying unsuspected regional nodal disease and/or distant metastases in LABC when used in addition to standard staging studies

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