Research ArticleCLINICAL INVESTIGATIONS

Dual Time Point 18F-FDG PET Imaging Detects Breast Cancer with High Sensitivity and Correlates Well with Histologic Subtypes

Ayse Mavi, Muammer Urhan, Jian Q. Yu, Hongming Zhuang, Mohamed Houseni, Tevfik F. Cermik, Dhurairaj Thiruvenkatasamy, Brian Czerniecki, Mitchell Schnall and Abass Alavi
Journal of Nuclear Medicine September 2006, 47 (9) 1440-1446;

Article Figures & Data

Figures

  • FIGURE 1. 
    FIGURE 1. 

    Patient with history of invasive ductal cancer of right breast had dual time point PET. (A) Coronal slices in top row were obtained at first time point. (B) Corresponding scans in bottom row were acquired at second time point. Measured SUVmax1 of lesion in first image set was 4.3 (thin arrow), whereas that of second set was 4.8 (thick arrow). Percent increase in SUV of the lesion was 11.6%. Measured SUVmax1 of normal contralateral glandular breast tissue was 1.1 in first image set, whereas that of second set was 0.9. Therefore, increase in T/B ratios between first image set and second image set was 36.4%. Surgical pathology confirmed 2-cm invasive ductal cancer.

  • FIGURE 2. 
    FIGURE 2. 

    Patient with invasive ductal carcinoma of right breast was examined with dual time point PET. (A) Coronal slices in top row were obtained at first time point. (B) Corresponding images in bottom row were acquired at second time point. Images in both sets clearly show primary lesion. However, intensity of uptake was substantially higher on delayed images. In addition, axillary lymph node metastasis was faintly visualized on first set but was clearly demonstrated on second set. Measured SUVmax1 of lesion in first image set was 2.2 (thin black arrow), whereas that of second set was 2.6 (thick black arrow). Percent increase in SUV of the lesion was 18.2%. SUVmax1 of metastatic right axillary lymph node was 1.0 in first set (open arrow in A) and increased to 1.1 in second set (open arrow in B). Surgical pathology confirmed 2.5-cm invasive ductal carcinoma with axillary metastasis.

  • FIGURE 3. 
    FIGURE 3. 

    Patient with history of noninvasive carcinoma of right breast underwent dual time point 18F-FDG PET for preoperative staging. (A) Coronal slices in top row were obtained at first time point. (B) Corresponding scans in bottom row were acquired at second time point. Lesion is questionable in first set, whereas it is clearly visualized in second set. Measured SUVmax1 of lesion in first image set (thin arrow) was 1.4, whereas that of second set was 1.9 (thick arrow). Percent change from first to second time point of this measurement was 35.7%. Surgical pathology confirmed noninvasive breast tumor.

Tables

  • TABLE 1

    SUVmax Measurements and Changes over Time in Normal Breast, Invasive Cancer, Noninvasive Cancer, and T/B Ratios

    HistopathologySUVmax1SUVmax2Δ%SUVmaxΔ% in ratio 1 and ratio 2 (T/B ratio)
    Group A (n = 82)3.9 ± 3.74.3 ± 4.08.3 ± 11.522.0 ± 26.8
    Group B (n = 24)2.0 ± 0.62.1 ± 0.63.4 ± 13.015.7 ± 18.6
    Group C (n = 120)1.2 ± 0.31.1 ± 0.2−10.0 ± 10.8

    • Group A = invasive cancer; group B = noninvasive cancer; group C = contralateral breast; ratio 1 = T/B ratios of SUVmax at first time point; ratio 2 = T/B ratios of SUVmax at second time point; Δ% = percent change.

    • Data are presented as mean ± SD.

  • TABLE 2

    SUVmax Measurements and Changes over Time in Invasive Cancers According to Subtypes

    Group A (n = 82)SUVmax1SUVmax2Δ% SUVmax
    Invasive ductal (n = 66)4.3 ± 3.9*4.7 ± 4.3*8.1 ± 10.6*
    Invasive lobular (n = 7)2.7 ± 1.8*3.1 ± 2.3*10.5 ± 14.0*
    Invasive mixed (n = 7)2.0 ± 0.9*2.2 ± 1.1*9.3 ± 14.6*
    Medullary (n = 1)7.28.619.4
    Mucinous (n = 1)1.01.00

    • ↵* Data are presented as mean ± SD.

    • Group A = invasive cancers; Δ% = percent change.

  • TABLE 3

    SUVmax Measurements and Changes over Time According to Tumor Size in Invasive Cancers with Increase in T/B Ratios

    Group A (n = 82)SUVmax1SUVmax2Δ%SUVmaxΔ% in ratio 1 and ratio 2 (T/B ratio)
    Tumors >10 mm (n = 57)4.8 ± 4.15.3 ± 4.48.6 ± 12.223.1 ± 28.5
    Tumors 4−10 mm (n = 25)1.9 ± 0.82.0 ± 0.76.5 ± 9.918.8 ± 23.5

    • Group A = invasive cancer; ratio 1 = T/B ratios of SUVmax at first time point; ratio 2 = T/B ratios of SUVmax at second time point; Δ% = percent change.

    • Data are presented as mean ± SD.

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