Metabolic characterization of breast tumors with positron emission tomography using F-18 fluorodeoxyglucose

J Clin Oncol. 1996 Jun;14(6):1848-57. doi: 10.1200/JCO.1996.14.6.1848.

Abstract

Purpose: To evaluate the diagnostic value of position emission tomographic (PET) imaging with F-18 fluorodeoxyglucose (FDG) in differentiating between benign and malignant breast tumors.

Patients and methods: Fifty-one patients, with suspicious breast lesions newly discovered either by physical examination or by mammography, underwent PET imaging before exploratory surgery. FDG-PET images of the breast were analyzed visually and quantitatively for objective assessment of regional tracer uptake.

Results: Primary breast cancer was identified visually with a sensitivity of 68% to 94% and a specificity of 84% to 97% depending on criteria used for image interpretation. Quantitative analysis of FDG uptake in tumors using standardized uptake values (SUV) showed a significant difference between benign (1.4 +/- 0.5) and malignant (3.3 +/- 1.8) breast tumors (P < .01). Receiver operating characteristic (ROC) curve analysis exhibited a sensitivity of 75% and a specificity of 100% at a threshold SUV value of 2.5. Sensitivity increased to 92% with a corresponding specificity of 97% when partial volume correction of FDG uptake was performed based on independent anatomic information.

Conclusion: PET imaging allowed accurate differentiation between benign and malignant breast tumors providing a high specificity. Sensitivity for detection of small breast cancer ( < 1 cm) was limited due to partial volume effects. Quantitative image analysis combined with partial volume correction may be necessary to exploit fully the diagnostic accuracy. PET imaging may be helpful as a complimentary method in a subgroup of patients with indeterminate results of conventional breast imaging.

MeSH terms

  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology
  • Deoxyglucose / analogs & derivatives*
  • Female
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Humans
  • Middle Aged
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Tomography, Emission-Computed*

Substances

  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Deoxyglucose