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Keywords:
Neoplasia, Image verification, Cancer, Diagnostic procedure, Contrast agent-intravenous, Ultrasound, PET-CT, Mammography, Oncology, Nuclear medicine, Breast
Authors:
R. Battista1, S. Panareo2, V. Marchesi1, A. Pecchi1, B. Canossi1, P. Torricelli1; 1Modena/IT, 2Ferrara/IT
DOI:
10.1594/ecr2015/C-2453
Conclusion
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% [4],
67,8% [1] and 83% [5].
According to the literature [7] 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,
the age of patients and the histologically.
Also Chung et al [8] have not shown a correlation of SUV value with the incidence of breast malignancy.
Backwards Litmanovich et al [4] demonstrated a statistically significant difference between the SUVmax of malignant breast lesion and that of benign breast lesion.
Therefore we believe that SUV value is not a sufficiently reliable parameter to orient towards malignancy or benignity [9].
In 8 cases (26.6%) PET/CT evidence has not been confirmed by radiological imaging due to movement artifacts during PET/CT acquisition and/or due to physiological distribution of 18F-FDG in the breast.
Limitations of our study include small sample size and the retrospective design.
In addition,
not all breast abnormalities detected on 18F-FDG PET/CT had histopathological correlation,
this was because of benign appearances on breast imaging not requiring biopsy.
In conclusion incidental breast lesions detected at 18F-FDG PET/CT are uncommon [1].
However,
when detected they may represent malignancy in up to 68,2% of cases [10].
Therefore we believe that incidental mammary 18F-FDG uptake need mammoghapy and ultrasound evaluation,
with biopsy if necessary.