Breast Cancer Research

, 21:15 | Cite as

Letter to the Editor: A response to Hruska’s case study on molecular breast imaging and the need for true tissue quantification

  • Richard M. FlemingEmail author
  • Matthew R. Fleming
  • Tapan K. Chaudhuri
  • William C. Dooley
  • Andrew McKusick
Open Access


FMTVDM©℗; B.E.S.T. Imaging©℗ Breast cancer Breast inflammation Theranostics Quantification AI Nuclear camera quantitative calibration Patent protected 

We applaud the efforts by Hruska et al. [1] to quantify differences in tissue using molecular breast imaging (MBI) and background parenchymal uptake (BPU); we have discussed the use of such previously [2]. The approach while commendable did not provide diagnostically useful information to differentiate tissue types. This approach, like the utilization of standardized uptake value (SUV), compares differences in background with tissue [3]. As we have already discussed [2, 4, 5] in the literature, this approach is an incorrect model, due to (1) the critical lack of standardization and calibration of nuclear cameras including both SPECT/Planar and PET; (2) the utilization of ratios which are not absolute values and therefore cannot be used to differentiate tissue based upon those issues, issues which are critical to the understanding of tissue differences; and (3) the inability to truly “measure” transitional changes in tissue, which would allow for the determination of actual treatment response on a per patient basis, saving time, money, and lives.



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  1. 1.
    Hruska CB, Geske JR, Swanson TN, et al. Quantitative background parenchymal uptake on molecular breast imaging and breast cancer risk: a case-control study. Breast Cancer Res. 2018;20:46. Scholar
  2. 2.
    Fleming RM, Dooley WC. Breast enhanced scintigraphy testing (B.E.S.T.) distinguishes between normal, inflammatory breast changes and breast cancer. A prospective analysis and comparison with mammography. Integr Cancer Ther. 2002;1(3):238–45.CrossRefGoogle Scholar
  3. 3.
    Keys JW Jr. SUV: standard uptake or silly useless value? J Nucl Med. 1995;36:1836–9.Google Scholar
  4. 4.
    Fleming RM, Fleming MR, McKusick A, Chaudhuri TK. Semiquantification limitations: FMTVDM©℗ demonstrates quantified tumor response to treatment with both regional blood flow and metabolic changes. J Nucl Med. 2018;59(10):1643–4. published ahead of print. PMID: 30030345.CrossRefPubMedGoogle Scholar
  5. 5.
    Fleming RM, Fleming MR, Chaudhuri TK, Dooley WC, McKusick A. FMTVDM; B.E.S.T.©℗ imaging theranostically used to guide treatment response in a woman with recalcitrant breast cancer. Biomed J Sci Tech Res. 2018 ISSN: 2574-1241. DOI:

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© The Author(s). 2019

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Authors and Affiliations

  1. 1.FHHI-Omnific Imaging-CamelotLos AngelesUSA
  2. 2.Eastern Virginia Medical SchoolNorfolkUSA
  3. 3.Oklahoma University Health Science CenterOklahoma CityUSA
  4. 4.Sebec Consulting & MediaCharlotteUSA

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