title: Evaluation of a Hanging-Breast PET System for Primary Tumor Visualization in Patients With Stage I-III Breast Cancer: Comparison With Standard PET/CT.
abstract: OBJECTIVE
  The purposes of this study were to evaluate the performance of a mammography with molecular imaging PET (MAMMI-PET) system for breast imaging in the hanging-breast position for the visualization of primary breast cancer lesions and to compare this method with whole-body PET/CT.
  
  
  METHODS
  Between March 2011 and March 2014, a prospective evaluation included women with one or more histologically confirmed primary breast cancer lesions (index lesions). After injection of 180-240 MBq of (18)F-FDG, whole-body PET/CT and MAMMI-PET acquisitions were performed, index lesions were scored 0, 1, or 2 for FDG uptake relative to background. Detection and FDG uptake were compared by breast length, maximal tumor diameter, affected breast quadrants, tumor grade, and histologic and immunologic sub-types. Finally, the two PET modalities were compared for detection of index lesions.
  
  
  RESULTS
  For 234 index lesions (diameter, 5-170 mm), the overall sensitivity was 88.9% for MAMMI-PET and 91% for PET/CT (p = 0.61). Twenty-three (9.8%) index lesions located too close to the pectoral muscle were missed with MAMMI-PET, and 20 index lesions were missed with PET/CT. Lesion visibility on MAMMI-PET images was influenced by tumor grade (p = 0.034) but not by cancer subtype (p = 0.65).
  
  
  CONCLUSIONS
  Although in an overall evaluation MAMMI-PET was not superior to PET/CT, MAMMI-PET does have higher sensitivity for primary breast cancer lesions within the scanning range of the device. Optimization of the positioning device may increase visualization of the most dorsal lesions.
authors.affiliation: 1 Nuclear Medicine Department, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.|2 Surgery Department, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Suzana C
authors.initials: SC
authors.lastname: Teixeira
authors.affiliation: 3 Nuclear Medicien Service, ERESA General University Hospital of Valencia, Valencia, Spain.
authors.forename: José Ferrér
authors.initials: JF
authors.lastname: Rebolleda
authors.affiliation: 1 Nuclear Medicine Department, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.|2 Surgery Department, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Bas B
authors.initials: BB
authors.lastname: Koolen
authors.affiliation: 4 Pathology Department, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Jelle
authors.initials: J
authors.lastname: Wesseling
authors.affiliation: 3 Nuclear Medicien Service, ERESA General University Hospital of Valencia, Valencia, Spain.
authors.forename: Raúl Sánchez
authors.initials: RS
authors.lastname: Jurado
authors.affiliation: 1 Nuclear Medicine Department, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
authors.forename: Marcel P M
authors.initials: MP
authors.lastname: Stokkel
authors.affiliation: 3 Nuclear Medicien Service, ERESA General University Hospital of Valencia, Valencia, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Del Puig Cózar Santiago
authors.affiliation: 5 Biometrics Department, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Vincent
authors.initials: V
authors.lastname: van der Noort
authors.affiliation: 2 Surgery Department, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Emiel J Th
authors.initials: EJ
authors.lastname: Rutgers
authors.affiliation: 1 Nuclear Medicine Department, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
authors.forename: Renato A
authors.initials: RA
authors.lastname: Valdés Olmos
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; D008327:Mammography; D008875:Middle Aged; D057054:Molecular Imaging; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals; D051598:Whole Body Imaging; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: PET/CT; breast cancer; dedicated PET; molecular imaging; oncology