•To compare the diagnostic accuracy of whole body 18FDG PET/low dose non enhanced CT to the combination of enhanced CT of the chest and abdomen plus bone scan.

•Seventy seven consecutive PET-CT scans were performed in thirty nine breast cancer patients with suspected local recurrence or distant metastasis. •Whole body PET-CT was performed using an 8 slice system (Discovery LS: GE) utilizing 120 KVP , with 100 mA , slice thickness of 3.75 mm, and Pitch of 1.675:1 (Fig.1)•Histology (n=11) or follow-up clinically and radiologically ( n= 28) for at least 6 months were employed as the standard of reference for imaging findings.•Conventional modalities (CM) including enhanced CT of the chest , abdomen...

•PET-CT was true negative in 10 patients in excluding local recurrence and distant metastasis without false negative reading : a sensitivity and negative predictive value of 100 % .•CM was true negative in also 10 patients with two false negative reading : a sensitivity of 92% and a negative predictive value of 83%.•PET-CT was true positive in twenty sex and false positive in three patients in whom the histopathological examination revealed granulomatous disease : a specificity and positive predictive value of 76.9% and 89 %...

•Hybrid FDG PET/CT outperformed CM in restaging breast cancer patients.•Combined FDG–PET/CT could potentially replace the array of conventional imaging procedures to detect distant metastases and local recurrence in breast cancer patients with sufficient accuracy.•Prospective studies on new FDG–PET/CT-based imaging algorithm in breast cancer patients is highly desirable.

1. American Cancer Society.Breast Cancer Facts & Figures 2009-2010.Available at http://www.cancer.org 2. AvrilN, RoseCA, SchellingM, etal.Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: use and limitations. J Clin Oncol. 2000;18:3495–3502 3.Wahl RL, Siegel BA, Coleman RE, et al. Prospective multi-center study of axillary nodal staging with FDG positron emission tomography in breast cancer. J Clin Oncol 2004;22:277–85 4. Cermik TF, Mavi A, Basu S, et al. Impact of FDG PET on the preoperative staging of newly diagnosed breast cancer. Eur J Nucl Med Mol...

Corresponding Author: Mohei M. Abouzied, MD, FACP King faisal Specialist Hospital and Research Center Department of radiology MBC#28 Riyadh 11211 Kingdom of Saudi Arabia Email: [email protected]