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Clinical Investigation |
1 Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; 2 Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; and 3 Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Correspondence: For correspondence or reprints contact: Abass Alavi, MD, Division of Nuclear Medicine, Hospital of the University of Pennsylvania, 3400 Spruce St., 110 Donner Bldg., Philadelphia, PA, 19104. E-mail: alavi{at}rad.upenn.edu
This prospective study was designed to assess the utility of the dual time point imaging technique by 18F-FDG PET in detecting primary breast cancer and to determine whether there is a relationship between 18F-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 18F-FDG was measured from both time points. The percent change in SUVmax (
%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 %SUVmax values were calculated. Results: The mean ± SD of the SUVmax1, the SUVmax2, and the %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, %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. Conclusion: Dual time point imaging is a simple and noninvasive method that may improve the sensitivity and accuracy of 18F-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.
Key Words: 18F-FDG PET • dual time point imaging • breast cancer • histopathology
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