Preoperative [18]fluorodeoxyglucose-positron emission tomography/computed tomography in early stage breast cancer: Rates of distant metastases

AIM To investigate rates of distant metastases(DM) detected with [18]fluorodeoxyglucose-positron emissiontomography/computed tomography(^(18)FDG-PET/CT) in early stage invasive breast cancer.METHODS We searched the English language literature databases of PubM ed, EMBASE, ISI Web of Knowledge, Web of Science and Google Scholar, for publications on DM detected in patients who had ^(18)FDG-PET/CT scans as part of the staging for early stages of breast cancer(stage Ⅰ?and Ⅱ), prior to or immediately following surgery. Reports published between 2011 and 2017 were considered. The systematic review was conducted according to the PRISMA guidelines.RESULTS Among the 18 total studies included in the analysis, the risk of DM ranged from 0% to 8.3% and 0% to 12.9% for stage Ⅰ?and Ⅱ invasive breast cancer, respectively. Among the patients with clinical stage Ⅱ, the rate of occult metastases diagnosed by ^(18)FDG-PET/CT was 7.2%(range, 0%-19.6%) for stage ⅡA and 15.8%(range, 0%-40.8%) for stage ⅡB. In young patients(< 40-yearold), ^(18)FDG-PET/CT demonstrated a higher prevalence of DM at the time of diagnosis for those with aggressive histology(i.e., triple-negative receptors and poorly differentiated grade).CONCLUSION Young patients with poorly differentiated tumors and stage ⅡB triple-negative breast cancer may benefit from ^(18)FDG-PET/CT at initial staging to detect occult DM prior to surgery.

^(18)F-FDG-PET glucose hypometabolism pattern in patients with epileptogenic hypothalamic hamartoma

Epileptogenic hypothalamic hamartoma is characterized by intractable gelastic seizures.A systematic analysis of the overall brain metabolic pattern in patients with hypothalamic hamartoma(HH)could facilitate the understanding of the epileptic brain network and the associated brain damage effects of HH.In this study,we retrospectively evaluated 27 patients with epileptogenic HH(8 female patients;age,2–33 years)by using ^(18)F-fluorodeoxyglucose-positron emission tomography.The correlations among tomography result,seizure type,sex,and structural magnetic resonance imaging were assessed.Whole metabolic patterns and voxel-based morphometry findings were assessed by group analysis with healthy controls.Assessment of the whole metabolic pattern in patients with HH revealed several regional metabolic reductions in the cerebrum and an overall metabolic reduction in the cerebellum.In addition,areas showing hypometabolism in the neocortex were more widely distributed ipsilaterally than contralaterally to the HH.Reductions in glucose metabolism and gray matter volume in the neocortex were predominant ipsilateral to the HH.In conclusion,the glucose hypometabolism pattern in patients with epileptogenic HH involved the neocortex,subcortical regions,and cerebellum.The characteristics of glucose hypometabolism differed across seizure type and sex.Reductions in glucose metabolism and structural changes may be based on different mechanisms,but both are likely to occur ipsilateral to the HH in the neocortex.We hypothesized that the dentato-rubro-thalamic tract and cerebro-ponto-cerebellar tract,which are responsible for intercommunication between the cerebral cortex,subcortical regions,and cerebellar regions,may be involved in a pathway related to seizure propagation,particularly gelastic seizures,in patients with HH.