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Dual-Time-Point ¹⁸F-FDG PET/CT Versus Dynamic Breast MRI of Suspicious Breast Lesions

¹ Dipartimento di Scienze Biomorfologiche e Funzionali, Università degli Studi di Napoli Federico II, Via Posillipo 196, 80123, Naples, Italy.
² National Research Council Napoli, Institute of Bio-structure and Bio-imaging, SDN Foundation, Naples, Italy.
³ Dipartimento di Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy.

OBJECTIVE. The purpose of our study was to compare dual-time-point ¹⁸F-FDG PET/CT, performed with the patient in the prone position, and contrast-enhanced MRI in patients with suspected breast malignancy.

SUBJECTS AND METHODS. Forty-four patients with 55 breast lesions underwent two PET/CT scans (dual-time-point imaging) in the prone position and breast MRI. Sensitivity, specificity, and overall accuracy were calculated. In addition, the average percentage of change in standard uptake values (%SUV_max) between time point 1 and time point 2 was calculated for PET/CT. A final histopathologic diagnosis was available for all patients.

RESULTS. MRI showed an overall accuracy of 95%, with sensitivity and specificity of 98% and 80%. Conversely, dual-time-point PET/CT showed an accuracy of 84% for lesions with an SUV_max 2.5 or with a positive %SUV_max, with sensitivity and specificity of 80% and 100% versus 69% accuracy, 62% sensitivity (both, p < 0.001), and 100% specificity (p not significant) for single-time-point PET/CT. On PET/CT, malignant lesions showed an increase in FDG between time points 1 and 2, with a %SUV_max of 11 ± 24. Benign lesions showed either no change or a decrease in SUV_max between time points 1 and 2, with a %SUV_max of –21 ± 7.

CONCLUSION. A dual time point improves PET/CT accuracy in patients with a suspected breast malignancy over single-time-point PET/CT. On PET/CT, FDG is increasingly taken up over time in breast tumors; conversely, benign lesions show a decrease in FDG uptake over time. These changes in SUV might represent a reliable parameter that can be used to differentiate benign from malignant lesions of the breast on PET/CT examination.

Keywords: breast carcinoma • FDG PET • MRI • PET/CT

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This article has been cited by other articles:

				G. Q. Maguire Jr., M. E. Noz, and F. Ponzo Prone Breast Dual-Time-Point PET/CT Compared With MRI for Determining Breast Cancer Am. J. Roentgenol., July 1, 2009; 193(1): W77 - W77. [Full Text] [PDF]

				M. Imbriaco, F. Soscia, and G. Avitabile Reply Am. J. Roentgenol., July 1, 2009; 193(1): W78 - W78. [Full Text] [PDF]