title: Can 18F-FDG PET improve the evaluation of suspicious breast lesions on MRI?
abstract: OBJECTIVE
  To evaluate the impact of adding 18F-fluorine-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the evaluation of suspicious breast lesions on magnetic resonance imaging (MRI).
  
  
  METHODS
  Sixty patients with suspicious breast lesions on MRI were selected to perform a PET-CT in prone position, dedicated to the evaluation of the breasts. The areas with increased 18F-FDG concentration relative to normal parenchyma were considered positive on PET-CT. Fusion of PET and MRI images (PET-MRI) was performed on a dedicated workstation to better locate corresponding lesions, and its findings were compared with histological results.
  
  
  RESULTS
  76 lesions were evaluated, including 64 mass lesions (84.2%) and 12 non-mass lesions (15.8%). Lesions' mean diameter on MRI was 29.6 ± 19.2 mm (range 6-94 mm). PET-CT showed increased metabolically activity on 57 lesions (75.0%), with mean maximum SUV of 5.7 ± 5.0 (range 0.8-23.1). On histopathology, there were 17 (22.4%) benign and 59 (79.7%) malignant lesions. Considering all lesions, PET-MRI fusion provided 89.8% sensitivity, 76.5% specificity and 86.8% accuracy. Considering only mass lesions higher than 10mm, PET-MRI fusion provided 95.8% sensitivity, 83.3% specificity and 93.3% accuracy.
  
  
  CONCLUSIONS
  The inclusion of 18F-FDG PET on the evaluation of suspicious breast lesions on MRI helped to differentiate benign from malignant breast lesions, especially for mass lesions with a diameter higher than 10 mm.
authors.affiliation: Department of Diagnostic Imaging, Hospital A.C. Camargo, Fundação Antônio Prudente, R. Professor Antônio Prudente, 211, CEP: 01509-010 São Paulo, Brazil. Electronic address: almirgvb@yahoo.com.br.
authors.forename: Almir G V
authors.initials: AG
authors.lastname: Bitencourt
authors.affiliation: Department of Diagnostic Imaging, Hospital A.C. Camargo, Fundação Antônio Prudente, R. Professor Antônio Prudente, 211, CEP: 01509-010 São Paulo, Brazil. Electronic address: e.lima-nuclear2@uol.com.br.
authors.forename: Eduardo N P
authors.initials: EN
authors.lastname: Lima
authors.affiliation: Department of Diagnostic Imaging, Hospital A.C. Camargo, Fundação Antônio Prudente, R. Professor Antônio Prudente, 211, CEP: 01509-010 São Paulo, Brazil. Electronic address: chojniak@uol.com.br.
authors.forename: Rubens
authors.initials: R
authors.lastname: Chojniak
authors.affiliation: Department of Diagnostic Imaging, Hospital A.C. Camargo, Fundação Antônio Prudente, R. Professor Antônio Prudente, 211, CEP: 01509-010 São Paulo, Brazil. Electronic address: elvira.marques@ig.com.br.
authors.forename: Elvira F
authors.initials: EF
authors.lastname: Marques
authors.affiliation: Department of Diagnostic Imaging, Hospital A.C. Camargo, Fundação Antônio Prudente, R. Professor Antônio Prudente, 211, CEP: 01509-010 São Paulo, Brazil. Electronic address: julianaalves79@hotmail.com.
authors.forename: Juliana A
authors.initials: JA
authors.lastname: Souza
authors.affiliation: Department of Mastology, Hospital A.C. Camargo, Fundação Antônio Prudente, R. Professor Antônio Prudente, 211, CEP: 01509-010 São Paulo, Brazil. Electronic address: wesley.andrade@hotmail.com.
authors.forename: Wesley P
authors.initials: WP
authors.lastname: Andrade
authors.affiliation: Department of Diagnostic Imaging, Hospital A.C. Camargo, Fundação Antônio Prudente, R. Professor Antônio Prudente, 211, CEP: 01509-010 São Paulo, Brazil. Electronic address: marcosduarte500@gmail.com.
authors.forename: Marcos D
authors.initials: MD
authors.lastname: Guimarães
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Breast cancer; Fluorodeoxyglucose F18; Magnetic resonance imaging; Positron-emission tomography; Prone position