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Clinical Significance of Focal Breast Lesions Incidentally Identified by $^{18}F-FDG$ PET/CT  

Cho, Young-Seok (Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Choi, Joon-Young (Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Lee, Su-Jin (Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Hyun, Seung-Hyup (Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Lee, Ji-Young (Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Choi, Yong (Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Choe, Yearn-Seong (Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Lee, Kyung-Han (Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Byung-Tae (Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Publication Information
Nuclear Medicine and Molecular Imaging / v.42, no.6, 2008 , pp. 456-463 More about this Journal
Abstract
Purpose: We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by $^{18}F-FDG$ PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. Materials & Methods: The subjects were 3,768 consecutive $^{18}F-FDG$ PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal $^{18}F-FDG$ uptake or a focal nodular lesion on CT image irrespective of $^{18}F-FDG$ uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. Results: The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value>75 HU or <30HU; standard deviation of mean attenuation > 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone ($0.680{\pm}0.093$ vs. $0.786{\pm}0.076$, p<0.05). Conclusion: The malignant risk of focal breast lesions incidentally found on $^{18}F-FDG$ PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both $^{18}F-FDG$ uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion.
Keywords
PET/CT; $^{18}F-FDG$; breast; cancer screening;
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