Abstract
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Objectives We evaluated the utility and diagnostic accuracy of an integrated PET/CT-mammography (mammo-PET/CT) compared with conventional whole body PET/CT (supine-PET/CT) and MR-mammography for initial assessment of breast cancer patients.
Methods Forty women (52±12 yrs) with breast cancer who underwent supine-PET/CT, mammo-PET/CT and MR-mammography were included. We compared the tumor size, tumor to thoracic wall distance, tumor to skin distance, volume of axillary fossa, number of metastatic lymph nodes in supine-PET/CT and mammo-PET/CT. Next, we evaluated the difference of focality of primary tumor and tumor size in mammo-PET/CT and MR-mammography. Histopathologic findings served as the standard of reference.
Results In the comparison with supine-PET/CT and mammo-PET/CT, significant differences were found in tumor size (supine-PET/CT: 1.3±0.6 cm, mammo-PET/CT: 1.5±0.6 cm, p<0.001), tumor to thoracic wall distance (1.8±0.9 cm, 2.2±2.1 cm, p<0.001) and tumor to skin distance (1.5±0.8 cm, 2.1±1.4 cm, p<0.001). The volume of axillary fossa was significantly wider in mammo-PET/CT than supine-PET/CT (21.7±8.7 cm3 vs 23.4±10.4 cm3, p=0.03). Mammo-PET/CT correctly defined the T-stage of primary tumor more than did supine-PET/CT (72.5% vs 67.5%). No significant difference was found in the number of metastatic lymph nodes. In the comparison with MR-mammography and mammo-PET/CT, Mammo-PET/CT correctly classified the focality of lesion more than did MR-mammography (95% vs 90%). In T-stage, 72.5% of mammo-PET/CT and 70% of MR-mammography were corresponded with pathologic staging.
Conclusions We suggest that mammo-PET/CT correctly defined the T-stage more than supine-PET/CT. The evaluation of axillary fossa may be delineated more clearly in mammo-PET/CT. The initial assessment of the mammo-PET/CT indicated similar accuracy to MR-mammography for detection of focality and T-stage of primary tumor lesion of breast
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