title: Positron emission mammography: initial clinical results.
abstract: BACKGROUND
  Evaluation of high-risk mammograms represents an enormous clinical challenge. Functional breast imaging coupled with mammography (positron emission mammography [PEM]) could improve imaging of such lesions. A prospective study was performed using PEM in women scheduled for stereotactic breast biopsy.
  
  
  METHODS
  Patients were recruited from the surgical clinic. Patients were injected with 10 mCi of 2-[18F] fluorodeoxyglucose. One hour later, patients were positioned on the stereotactic biopsy table, imaged with a PEM scanner, and a stereotactic biopsy was performed. Imaging was reviewed and compared with pathologic results.
  
  
  RESULTS
  There were 18 lesions in 16 patients. PEM images were analyzed by drawing a region of interest at the biopsy site and comparing the count density in the region of interest with the background. A lesion-to-background ratio >2.5 appeared to be a robust indicator of malignancy and yielded a sensitivity of 86%, specificity of 91%, and overall diagnostic accuracy of 89%. No adverse events were associated with the PEM imaging.
  
  
  CONCLUSIONS
  The data show that PEM is safe, feasible, and has an encouraging accuracy rate in this initial experience. Lesion-to-background ratios >2.5 were found to be a useful threshold value for identifying positive (malignant) results. This study supports the further development of PEM.
authors.affiliation: Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. elevine@wfubcm.ed
authors.forename: Edward A
authors.initials: EA
authors.lastname: Levine
authors.forename: Rita I
authors.initials: RI
authors.lastname: Freimanis
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Perrier
authors.forename: Kathryn
authors.initials: K
authors.lastname: Morton
authors.forename: Nadia M
authors.initials: NM
authors.lastname: Lesko
authors.forename: Simon
authors.initials: S
authors.lastname: Bergman
authors.forename: Kim R
authors.initials: KR
authors.lastname: Geisinger
authors.forename: Rodney C
authors.initials: RC
authors.lastname: Williams
authors.forename: Connie
authors.initials: C
authors.lastname: Sharpe
authors.forename: Valera
authors.initials: V
authors.lastname: Zavarzin
authors.forename: Irving N
authors.initials: IN
authors.lastname: Weinberg
authors.forename: Pavel Y
authors.initials: PY
authors.lastname: Stepanov
authors.forename: David
authors.initials: D
authors.lastname: Beylin
authors.forename: Kathryn
authors.initials: K
authors.lastname: Lauckner
authors.forename: Mohan
authors.initials: M
authors.lastname: Doss
authors.forename: Judy
authors.initials: J
authors.lastname: Lovelace
authors.forename: Lee P
authors.initials: LP
authors.lastname: Adler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D014055:Tomography, Emission-Computed