title: Dual time point 18F-FDG PET imaging detects breast cancer with high sensitivity and correlates well with histologic subtypes.
abstract: This prospective study was designed to assess the utility of the dual time point imaging technique by (18)F-FDG PET in detecting primary breast cancer and to determine whether there is a relationship between (18)F-FDG uptake and its change over time and the histopathologic subtypes.
  
  
  METHODS
  One hundred fifty-two patients with newly diagnosed breast cancer underwent 2 sequential PET scans (dual time point imaging) for preoperative staging. The maximum standardized uptake value (SUVmax) of (18)F-FDG was measured from both time points. The percent change in SUVmax (Delta%SUVmax) between time points 1 (SUVmax1) and 2 (SUVmax2) was calculated. Patients were divided into 2 groups according to histopathology as invasive and noninvasive. Invasive tumors were also divided into 2 groups (>10 mm and 4-10 mm). The tumor-to-contralateral normal breast (background) ratios of SUVmax at both time points for groups were measured and the Delta%SUVmax values were calculated.
  
  
  RESULTS
  The mean +/- SD of the SUVmax1, the SUVmax2, and the Delta%SUVmax were 3.9 +/- 3.7, 4.3 +/- 4.0, and 8.3% +/- 11.5% for invasive; 2.0 +/- 0.6, 2.1 +/- 0.6, and 3.4% +/- 13.0% for noninvasive; and were 1.2 +/- 0.3, 1.1 +/- 0.2, and -10.0% +/- 10.8% for the contralateral normal breast groups, respectively. In the comparison of SUVmax1, Delta%SUVmax, and the tumor-to-background ratios among groups, all results were significant (P < 0.001). Visual assessment revealed that the sensitivity of dual time point imaging was 90.1% for invasive cancer >10 mm, 82.7% for invasive breast cancers 4-10 mm, and 76.9% for noninvasive breast cancers.
  
  
  CONCLUSIONS
  Dual time point imaging is a simple and noninvasive method that may improve the sensitivity and accuracy of (18)F-FDG PET in assessing patients with primary breast cancer. The changes that are noted in SUVs in dual time point imaging vary depending on the histopathologic type of primary breast cancer.
authors.affiliation: Department of Radiology, Division of Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia, 19104, USA.
authors.forename: Ayse
authors.initials: A
authors.lastname: Mavi
authors.forename: Muammer
authors.initials: M
authors.lastname: Urhan
authors.forename: Jian Q
authors.initials: JQ
authors.lastname: Yu
authors.forename: Hongming
authors.initials: H
authors.lastname: Zhuang
authors.forename: Mohamed
authors.initials: M
authors.lastname: Houseni
authors.forename: Tevfik F
authors.initials: TF
authors.lastname: Cermik
authors.forename: Dhurairaj
authors.initials: D
authors.lastname: Thiruvenkatasamy
authors.forename: Brian
authors.initials: B
authors.lastname: Czerniecki
authors.forename: Mitchell
authors.initials: M
authors.lastname: Schnall
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013382:Subtraction Technique
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18