Positron Emission Mammography: Initial Clinical Results
- 172 Downloads
Background: Evaluation of high-risk mammograms represents an enormous clinical challenge. Functional breast imaging coupled with mammography (positron emission mammography [PEM]) could improve imaging of such lesions. A prospective study was performed using PEM in women scheduled for stereotactic breast biopsy.
Methods: Patients were recruited from the surgical clinic. Patients were injected with 10 mCi of 2-[18F] fluorodeoxyglucose. One hour later, patients were positioned on the stereotactic biopsy table, imaged with a PEM scanner, and a stereotactic biopsy was performed. Imaging was reviewed and compared with pathologic results.
Results: There were 18 lesions in 16 patients. PEM images were analyzed by drawing a region of interest at the biopsy site and comparing the count density in the region of interest with the background. A lesion-to-background ratio >2.5 appeared to be a robust indicator of malignancy and yielded a sensitivity of 86%, specificity of 91%, and overall diagnostic accuracy of 89%. No adverse events were associated with the PEM imaging.
Conclusions: The data show that PEM is safe, feasible, and has an encouraging accuracy rate in this initial experience. Lesion-to-background ratios >2.5 were found to be a useful threshold value for identifying positive (malignant) results. This study supports the further development of PEM.
Key WordsMammography Breast Imaging PET Cancer Diagnosis
Unable to display preview. Download preview PDF.
- 2.Weinberg IN, Majewski S, Weisenberger AG, et al. Preliminary results for positron emission mammography: real-time functional breast imaging in a conventional mammography gantry. Eur J Nucl Med 1996; 23: 804–6.Google Scholar
- 3.IN Weinberg, V Zawarzin, R Pani. Implementing PET-guided biopsy. Integrating functional imaging data with digital x-ray mammography cameras. In: Mun SK ed. Medical Imaging 2001: Visualization, Display, and Image-Guided Procedures. Vol. 4319. Proc. Bellingham: SPIE, 82 7.Google Scholar
- 4.Adler LP, Crowe JP, Al-Kaisi NK, Sunshine JL. Evaluation of breast masses and axillary lymph nodes with [F-18] 2-deoxy-2-fluoro-D-glucose PET. Radiology 1993; 187: 743–50.Google Scholar
- 5.Avril N, Schelling RM, Dose J, et al. Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: use and limitations. J Clin Oncol 2000; 18: 3495–3502.Google Scholar
- 7.Smith IC, Ogston KN, Whitford P, et al. Staging of the axilla in breast cancer accurate in vivo assessment using positron emission tomography with 2-(fluorine-18)-fluoro-2-deoxy-D-glucose. Ann Surg 1998; 228: 220–7.Google Scholar
- 8.Greco M, Crippa F, Agresti R, et al. Axillary lymph node staging in breast cancer by 2-fluoro-2-deoxy-D-glucose-positron emission tomography: clinical evaluation and alternative management. J Natl Cancer Inst 2001; 93: 630–5.Google Scholar
- 9.Council on Scientific Affairs. Positron emission tomography in oncology. JAMA 1988; 259: 2126–31.Google Scholar