Comparison of FDG-PET with MIBI-SPECT in the detection of breast cancer and axillary lymph node metastasis.
OBJECTIVE
The purpose of this work was to compare [18F]2-deoxy-2-fluoro-D-glucose (FDG) PET and 99mTc-methoxyisobutylisonitrile (MIBI) SPECT in the detection of breast cancer and axillary lymph node metastasis in the same patients.


METHODS
FDG-PET and MIBI-SPECT were performed within 3 days for 40 women (age range 25-86 years old) with suspected breast cancer, in whom biopsies and/or mastectomies were performed. Both images were visually assessed, and the count ratio between tumor and normal tissue (T/N ratio) was calculated.


RESULTS
Thirty-eight patients had breast cancer, and the remaining two had benign breast lesions. The sensitivities of FDG-PET and MIBI-SPECT were 78.9 and 76.3% for breast cancer and 50.0 and 37.5% for axillary lymph node metastasis, respectively. The T/N ratio of breast cancer was significantly higher in FDG-PET (6.01 +/- 3.08 mean +/- SD) than that in MIBI-SPECT (3.48 +/- 1.21) (p = 0.01). Nonmalignant diffuse uptake of FDG in the breasts and the accumulation of MIBI in heart and liver occasionally obscured tumor uptake.


CONCLUSIONS
These results indicate that MIBI-SPECT is comparable with FDG-PET in detecting breast cancer. Neither FDG-PET nor MIBI-SPECT is sufficiently sensitive to rule out axillary lymph node metastasis.
Yutani
K
K
Department of Radiology, Kaizuka City Hospital, Osaka, Japan. yutani@tracer.med.osaka-u.ac.jp
Shiba
E
E
Kusuoka
H
H
Tatsumi
M
M
Uehara
T
T
Taguchi
T
T
Takai
S I
SI
Nishimura
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D003937:Diagnosis, Differential; D005260:Female; D018226:Fibroadenoma / Q000000981:diagnostic imaging; D005348:Fibrocystic Breast Disease / Q000000981:diagnostic imaging; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008099:Liver / Q000378:metabolism; D008207:Lymphatic Metastasis; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics; D014055:Tomography, Emission-Computed / Q000379:methods; D015899:Tomography, Emission-Computed, Single-Photon
D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi