Positron emission mammography: initial clinical results.
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.
Levine
Edward A
EA
Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. elevine@wfubcm.ed
Freimanis
Rita I
RI
Perrier
Nancy D
ND
Morton
Kathryn
K
Lesko
Nadia M
NM
Bergman
Simon
S
Geisinger
Kim R
KR
Williams
Rodney C
RC
Sharpe
Connie
C
Zavarzin
Valera
V
Weinberg
Irving N
IN
Stepanov
Pavel Y
PY
Beylin
David
D
Lauckner
Kathryn
K
Doss
Mohan
M
Lovelace
Judy
J
Adler
Lee P
LP
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