Performance of dedicated breast positron emission tomography in the detection of small and low-grade breast cancer

Abstract

Purpose

This study compares the sensitivity of dedicated breast positron emission tomography (DbPET) and whole body positron emission tomography (WBPET) in detecting invasive breast cancer based on tumor size and biology. Further, we explored the relationship between maximum standardized uptake value (SUVmax) of DbPET and biological features of the tumor.

Methods

A total of 639 invasive breast cancer lesions subjected to both DbPET and WBPET before surgery, between January 2016 and May 2019, were included in the study. The sensitivity of DbPET and WBPET in detection and the biology of the tumor according to the clinicopathological features were retrospectively evaluated.

Results

The overall sensitivity of DbPET was higher than that of WBPET (91.4% vs. 80.3%, p < 0.001). Subcentimetric tumors were significant (80.9% vs. 54.3%, p < 0.001). Regardless of the nuclear grade, DbPET could detect more lesions than WBPET. The SUVmax was positively correlated with tumor size (R = 0.395, p < 0.001) and the nuclear grade (p < 0.001). Luminal A-like breast cancer had significantly lower SUVmax values than the other subtypes (p < 0.001).

Conclusions

DbPET is superior to WBPET in the detection of subcentimetric, low-grade breast cancers. Further, by using SUVmax, DbPET can distinguish luminal A-like breast cancer from the other subtypes.

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Data availability

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

Abbreviations

CT:

Computed tomography

DbPET:

Dedicated breast positron emission tomography

ER:

Estrogen receptor

FDG:

18F-fluorodeoxyglucose

FOV:

Field of view

HER2:

Human epidermal growth factor receptor type 2

LBR:

Lesion-to-background ratio

MRI:

Magnetic resonance imaging

PEM:

Positron emission mammography

PET:

Positron emission tomography

ROI:

Region of interest

SUVmax:

Maximum standardized uptake value

WBPET:

Whole body positron emission tomography

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Acknowledgements

We thank Kazushi Marukawa and Masatsugu Tsujimura of Chuden Hospital for providing data regarding PET examinations.

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Correspondence to Satoshi Sueoka.

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The authors declare that they have no conflict of interest.

Ethical approval

The Institutional Review Board approved this study. All procedures performed involving human participants were in accordance with the ethical standards of the institutional research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this retrospective study, the need for formal consent was waived.

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Sueoka, S., Sasada, S., Masumoto, N. et al. Performance of dedicated breast positron emission tomography in the detection of small and low-grade breast cancer. Breast Cancer Res Treat (2021). https://doi.org/10.1007/s10549-020-06088-1

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Keywords

  • Breast cancer
  • Positron emission tomography
  • Dedicated breast PET
  • Whole body PET
  • Sensitivity