最近发布的 EANM/SNMMI 指南得到了乳腺癌 (BC) 护理领域几个重要临床和影像学会（ACR、ESSO、ESTRO、EUSOBI/ESR、EUSOMA）的认可，强调了 [18F]FDG PET/ CT 治疗非特殊类型 (NST) BC 患者。本综述识别并总结了 EANM/SNMMI 指南与 NCCN、ESMO 和 ABC 建议相比的相似点、差异和新颖之处。EANM/SNMMI 指南基于系统文献检索和 AGREE 工具。证据水平根据 NICE 标准确定，每项陈述均达到 85% 或更高的一致性。与 NCCN、ESMO 和 ABC 指南进行比较，检查早期阶段至晚期和转移性 BC 患者的具体临床情况。关于 NST BC 患者的初始分期，[18F]FDG PET/CT 是 EANM-SNMMI 中的首选模式指南显示，在头对头比较和随机研究中，单一模式优于胸部-腹部-骨盆增强 CT 加骨扫描的组合。建议临床 IIB 期或更高阶段的患者使用它，并且可能对某些 IIA 期 NST BC 病例有用。在 NCCN、ESMO 和 ABC 指南中，建议 [18F]FDG PET/CT 作为传统成像的补充，以解决不确定的结果，尽管 ESMO 和 ABC 也建议 [18F]FDG PET/CT 可以替代传统成像对患有以下疾病的患者进行分期：高风险和转移性 NST BC。在随访过程中，NCCN 和 ESMO 仅在怀疑复发时才推荐诊断性影像学检查。同样，EANM-SNMMI 指出，仅当临床或实验室怀疑复发或传统成像方法模棱两可时，[18F]FDG PET/CT 才可用于检测复发部位和程度。 EANM-SNMMI 指南首次强调 [18F]FDG PET/CT 在评估主要全身治疗的早期代谢反应中的作用，特别是 HER2 BC 和 TNBC。在转移情况下，EANM-SNMMI 指出，[18F]FDG PET/CT 可能有助于评估骨转移并确定早期治疗反应，与 ESMO 的指南一致。最近发布的 EANM/SNMMI 指南强化了 [18F] 的作用FDG PET/CT 在 NST BC 患者的管理中得到了其在多种临床场景中实用性的广泛证据的支持。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

The recently released EANM/SNMMI guideline, endorsed by several important clinical and imaging societies in the field of breast cancer (BC) care (ACR, ESSO, ESTRO, EUSOBI/ESR, EUSOMA), emphasized the role of [18F]FDG PET/CT in management of patients with no special type (NST) BC. This review identifies and summarizes similarities, discrepancies and novelties of the EANM/SNMMI guideline compared to NCCN, ESMO and ABC recommendations.The EANM/SNMMI guideline was based on a systematic literature search and the AGREE tool. The level of evidence was determined according to NICE criteria, and 85 % agreement or higher was reached regarding each statement. Comparisons with NCCN, ESMO and ABC guidelines were examined for specific clinical scenarios in patients with early stage through advanced and metastatic BC.Regarding initial staging of patients with NST BC, [18F]FDG PET/CT is the preferred modality in the EANM-SNMMI guideline, showing superiority as a single modality to a combination of contrast-enhanced CT of thorax-abdomen-pelvis plus bone scan in head-to-head comparisons and a randomized study. Its use is recommended in patients with clinical stage IIB or higher and may be useful in certain stage IIA cases of NST BC. In NCCN, ESMO, and ABC guidelines, [18F]FDG PET/CT is instead recommended as complementary to conventional imaging to solve inconclusive findings, although ESMO and ABC also suggest [18F]FDG PET/CT can replace conventional imaging for staging patients with high-risk and metastatic NST BC. During follow up, NCCN and ESMO only recommend diagnostic imaging if there is suspicion of recurrence. Similarly, EANM-SNMMI states that [18F]FDG PET/CT is useful to detect the site and extent of recurrence only when there is clinical or laboratory suspicion of recurrence, or when conventional imaging methods are equivocal. The EANM-SNMMI guideline is the first to emphasize a role of [18F]FDG PET/CT for assessing early metabolic response to primary systemic therapy, particularly for HER2+ BC and TNBC. In the metastatic setting, EANM-SNMMI state that [18F]FDG PET/CT may help evaluate bone metastases and determine early response to treatment, in agreement with guidelines from ESMO.The recently released EANM/SNMMI guideline reinforces the role of [18F]FDG PET/CT in the management of patients with NST BC supported by extensive evidence of its utility in several clinical scenarios.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.