Aims and objectives
Whole body positron emission tomography/computed tomography (PET/CT) with fluorine 18 fluorodeoxyglucose (18F-FDG) has been used successfully and with increasing frequency in the evaluation and clinical management of an expanding number of neoplasms.
As widespread clinical application increases,
unexpected radiographic findings are occasionally identified.
These incidental findings are often suspicious for a second primary malignancy.
in patients with a known or suspected primary malignancy,
additional primary cancer has been found in 1,7-31,0% of cases .
Although the sensitivity of 18F-FDG PET/CT in identifying primary...
Methods and materials
We performed a retrospective analysis of all whole body 18F-FDG PET/CT done at Department of Nuclear Medicine of Ferrara University between 2004 and 2014 in which was found an incidental mammary uptake of 18F-FDG,
successively examined with clinical examination,
ultrasound and MRI if necessary.
Cases suggestive for breast cancer were investigated with biopsy (Tru-cut).
Forty-three patients (7 male,
mean age 66.28±14.7y/o) were selected.
Table 1 shows the data relating to the cases examined.
PET/CT images were acquired with an integrated PET/CT device...
Among 43 patients studied: 19 (44.2%) underwent ultrasound plus mammography to examine mammary finding; 11 (25.58%) underwent ultrasound only; 13 (27.9%) have not continued follow-up.
Among 19 patients who underwent both procedures: in 8 (42.1%) both mammography and ultrasound were negative; in 10 (57.9%) both mammography and ultrasound were positive; in 1 (11.1%) case it is observed only the positive of ultrasound.
Among 11 patients who underwent ultrasound only: 6 have not underwent biopsy because the ultrasound alone showed a benign finding; the remaining 5...
In the 73.3% of cases (30 of 43 patients) the incidental PET/CT finding has been confirmed by conventional radiology.
The frequency of malignancy in incidental breast lesions was 68,2%.
This correlates with previous studies that reported rates of malignancy of incidental 18F-FDG-avid breast foci of 37.5% ,
67,8%  and 83% .
According to the literature  60% of malignant identified lesion were CDI.
In our study,
there wasn’t a statistically significance difference in the mean SUVmax between the benign and the malignant lesions,
Wilson G et al.
The role of the breast radiologist in evaluation of breast incidentalomas detected on 18-fludeoxyglucose positron emission tomography/CT.
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Detection of unexpected additional primary malignancies with PET/CT.
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PET /CT detection of unexpected gastrointestinal foci of 18F-FDG uptake: incidence ,
localization patterns and clinical significance.
J Nucl Med 2005; 46:758-762