The study compared the diagnostic performance of PEM,
(High - Resolution - PET,
with an intrinsic resolution of 1.6 mm,
similar diagnostic sensitivity and higher specificity than MRI for satellite lesion detection) to breast MRI for detection of breast cancer.(1).
Methods and Materials
PEM was performed (2) on 68 women with suspicious breast lesions 90 min after i.v.
application of 3.5 MBq F-18-FDG per KG body weight.
The technique is shown on Fig.
70 lesions were identified,
because 2 women showed 2 maligne lesions at once as displayed on Fig.
A ROI around the target lesion,
measured the maximum PEM uptake value (PUVmax) and was correlated with a corresponding non-target ROI in the contra lateral healthy breast determining the target / non-target ratio.
Two independentreaders analyzed...
14 of 70 lesions were malignant with a mean PUVmax of 4.6±3,4 while the contra - lateral healthy glandular tissue showed a PUVmax of 1.1±0.4 (p=0.004).
The mean target / non-target ratio in patients with breast cancer of 3.4±1.6,
which was significantly higher compared to that found for benign lesions 1.1±0.02 (p=0.001).
Using the recommended PUVmax >2.0 as highly suspicious for malignancy,
PEM was true - positive in all 14 cancers and false positive in 3 cases,
resulting in sensitivity of 100%,
specificity of 94%,...
The study showed that PEM can discriminate breast cancer from benign lesions with high accuracy by using PUVmax combined with the target/non-target ratio.
Further investigation with a larger sample size is needed to comfirm our findings.
(1) Berg W.,
Comparative Effectiveness of PEM and MRI for Presurgical Planning of the Ipsilateral Breast in Women with Breast Cancer.
Radiology 1:258 (2011)
Am J Roentgenol.
JE et al,
The period of time between the dianostic PEM and the PEM guided biopsy reduces the contrast to noice ratio.
Four to five hours delay is easily been tolerated.
Out Patient Unit,
Radiologie and Nuklearmedizin Ludwigshafen