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Reproducibility assessment of uptake on dedicated breast PET for noise discrimination

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Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objectives

Dedicated breast PET (dbPET) systems have improved the detection of small breast cancers but have increased false-positive diagnoses due to an increased chance of noise detection. This study examined whether reproducibility assessment using paired images helped to improve noise discrimination and diagnostic performance in dbPET.

Methods

This study included 21 patients with newly diagnosed breast cancer who underwent [18F]FDG-dbPET and contrast-enhanced breast MRI. A 10-min dbPET data scan was acquired per breast, and two sets of reconstructed images were generated (named dbPET-1 and dbPET-2, respectively), each of which consisted of randomly allocated 5-min data from the 10-min data. Uptake spots higher than the background were indexed for the study with visual assessment. All indexed uptakes on dbPET-1 were evaluated using dbPET-2 for reproducibility. MRI findings based on the Breast Imaging-Reporting and Data System (BI-RADS) 2013 were used as the gold standard. Uptake spots that corresponded to BI-RADS 1 on MRI were considered noise, while those with BI-RADS 4b–6 were considered malignancies. The diagnostic performance of dbPET for malignancy was evaluated using four different criteria: any uptake on dbPET-1 regarded as positive (criterion A), a subjective visual assessment of dbPET-1 (criterion B), reproducibility assessment between dbPET-1 and dbPET-2 (criterion C), and a combination of B and C (criterion D).

Results

A total of 213 indexed uptake spots were identified on dbPET-1, including 152, 15, 6, 6, and 34 lesions classified as BI-RADS MRI categories 1, 2, 4b, 4c, and 5, respectively. Overall, 31.9% of the index uptake values were reproducible. All malignant lesions were reproducible, whereas 93.4% of noise was not reproducible. The sensitivities for malignancy for criteria A, B, C, and D were 100%, 91.3%, 100%, and 91.3%, respectively, with positive predictive values (PPVs) of 21.4%, 68.9%, 67.6%, and 82.4%, respectively.

Conclusions

Our results demonstrated that reproducibility assessment helped reduce false-positive findings caused by noise on dbPET without lowering the sensitivity for malignancy. While subjective visual assessment was also efficient in increasing PPV, it occasionally missed malignant uptake.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Tae Oishi‬, RT, for her contribution to dbPET image acquisition, and Yoshiyuki Yamakawa from Shimadzu Cooperation for his technical support in the dbPET image reconstruction. We also thank Editage for the English language editing.‬‬‬‬‬

Funding

This work was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (19K17196).

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Authors and Affiliations

  1. Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan

    Shunsuke Yuge, Takayoshi Ishimori, Masako Kataoka & Yuji Nakamoto

  2. Department of Advanced Medical Imaging Research, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto City, Kyoto, Japan, 606-8507

    Kanae K. Miyake

  3. Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan

    Yoshiaki Matsumoto & Masakazu Toi

  4. Department of Real World Data Research and Development, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto, Japan

    Koji Fujimoto

  5. Department of Breast Surgery, Kansai Medical University Hospital, Hirakata City, Osaka, Japan

    Tomoharu Sugie

Authors
  1. Shunsuke Yuge
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  2. Kanae K. Miyake
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  3. Takayoshi Ishimori
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  4. Masako Kataoka
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  5. Yoshiaki Matsumoto
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  6. Koji Fujimoto
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  7. Tomoharu Sugie
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  8. Masakazu Toi
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  9. Yuji Nakamoto
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Corresponding author

Correspondence to Kanae K. Miyake.

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Conflict of interest

Author Masakazu Toi has received research support from Shimadzu Corporation.

Ethical approval

This study was conducted in accordance with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Kyoto University Graduate School and Faculty of Medicine. (Approval number, R1213).

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The requirement for informed consent was waived by the Ethics Committee of Kyoto University Graduate School and Faculty of Medicine owing to the retrospective design.

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Yuge, S., Miyake, K.K., Ishimori, T. et al. Reproducibility assessment of uptake on dedicated breast PET for noise discrimination. Ann Nucl Med 37, 121–130 (2023). https://doi.org/10.1007/s12149-022-01809-6

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  • DOI: https://doi.org/10.1007/s12149-022-01809-6

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