Breast Incidental Lesions at 18 F FDG PET/CT: Diagnostic Performance of PET-derived Metabolic Parameters
Novelty in Biomedicine,
Vol. 5 No. 4 (2017),
22 October 2017
,
Page 158-165
https://doi.org/10.22037/nbm.v5i4.17989
Abstract
Background: Breast incidental lesion at 18 F FDG PET/CT are occasionally encountered in cancer patients, which may represent a second primary malignancy. The aim of the present study was to investigate the diagnostic performance of PET metabolic parameters to characterize breast incidentaloma.Materials and Methods: All the images of patients with cancers other than breast with breast incidental lesion underwent PET/CT scan at Masih Daneshvari Hospital between May 2012 and May 2016 were retrieved and reviewed. SUVmax, SUVmean, MTV and TLG in addition to associated morphologic features on CT and demographics were recorded and correlated with final diagnosis defined by histophatologic confirmation or an at least 1-year clinical formal follow up.
Results: Of a total 58 from 51 patients (51/5029, 1.01%), 10 (19.60%) were histopathologically verified as second primary breast cancers. There was a statistically significant difference in SUVmax, SUVmean, MTV and TLG between benign and malignant group (1.64 vs. 5.32 (p=0.009), 1.34 vs. 3.69 (p=0.027), 0.96 vs. 2.62 (p=0.035), 1.54 vs 8.89 (p=0.006). Using cut off 2, 1.35, 1.16 and 1.75, sensitivity and specificity of SUVmax, SUVmean, MTV and TLG were calculated as 77% and 62%, 92% and 66.5%, 77% and 75% 77% and 67%, respectively.
Conclusion: Despite a significantly higher value in malignant breast incidental lesion, PET-derivative metabolic parameters provided only modest sensitivity and specificity and hence may not be considered as the sole criteria for risk stratification in this clinical setting.
- diagnostic performance
- metabolic parameters
- 18 F FDG PET/CT
- breast incidental lesion
How to Cite
References
Litmanovich, D., Gourevich, K., Israel, O., et al. (2009). Unexpected foci of 18F-FDG uptake in the breast detected by PET/CT: incidence and clinical significance. European journal of nuclear medicine and molecular imaging, 36(10), 1558-1564.
Kim SK, Allen-Auerbach M, Goldin J, Fueger BJ, Dahlbom M, Brown M, Czernin J, Schiepers C. Accuracy of PET/CT in characterization of solitary pulmonary lesions. Journal of Nuclear Medicine. 2007;48(2):214-20.
Kim YI, Cheon GJ, Paeng JC, Cho JY, Kang KW, Chung JK, Kim EE, Lee DS. Total lesion glycolysis as the best 18F-FDG PET/CT parameter in differentiating intermediate–high risk adrenal incidentaloma. Nuclear medicine communications. 2014;35(6):606-12.
Morita T, Tatsumi M, Ishibashi M, Isohashi K, Kato H, Honda O, Shimosegawa E, Tomiyama N, Hatazawa J. Assessment of mediastinal tumors using SUVmax and volumetric parameters on FDG PET/CT. Asia Oceania Journal of Nuclear Medicine and Biology. 2017;5(1):22-9
Park T, Lee S, Park S, Lee E, Pahk K, Rhee S, Cho J, Kim C, Eo JS, Choe JG, Kim S. Value of 18F-FDG PET/CT in the Detection of Ovarian Malignancy. Nuclear medicine and molecular imaging. 2015;49(1):42-51.
Chae EY, Cha JH, Kim HH, Shin HJ, Kim HJ, Oh HY, Koh YH, Moon DH. Analysis of incidental focal hypermetabolic uptake in the breast as detected by 18F-FDG PET/CT: clinical significance and differential diagnosis. Acta Radiologica. 2012 Jun 1;53(5):530-5.
Kang BJ, Lee JH, Yoo IR, Kim SH, Choi JJ, Jeong SH, Yim HW. Clinical significance of incidental finding of focal activity in the breast at 18F-FDG PET/CT. American Journal of Roentgenology. 2011;197(2):341-7.
Shin KM, Kim HJ, Jung SJ, Lim HS, Lee SW, Cho SH, Jang YJ, Lee HJ, Kim GC, Jung JH, Park JY. Incidental Breast Lesions Identified by 18F-FDG PET/CT: Which Clinical Variables Differentiate between Benign and Malignant Breast Lesions?. Journal of breast cancer. 2015;18(1):73-9.
Chung HW, Lee KY, Kim HJ, Kim WS, So Y. FDG PET/CT metabolic tumor volume and total lesion glycolysis predict prognosis in patients with advanced lung adenocarcinoma. Journal of cancer research and clinical oncology. 2014;140(1):89-98.
Lee JW, Kang CM, Choi HJ, Lee WJ, Song SY, Lee JH, Lee JD. Prognostic value of metabolic tumor volume and total lesion glycolysis on preoperative 18F-FDG PET/CT in patients with pancreatic cancer. Journal of Nuclear Medicine. 2014 Jun 1;55(6):898-904.
Satoh Y, Onishi H, Nambu A, Araki T. Volume-based parameters measured by using FDG PET/CT in patients with stage I NSCLC treated with stereotactic body radiation therapy: prognostic value. Radiology. 2014;270(1):275-81.
Pak K, Cheon GJ, Nam HY, Kim SJ, Kang KW, Chung JK, Kim EE, Lee DS. Prognostic value of metabolic tumor volume and total lesion glycolysis in head and neck cancer: a systematic review and meta-analysis. Journal of Nuclear Medicine. 2014;55(6):884-90.
Maffione AM, Chondrogiannis S, Capirci C, Galeotti F, Fornasiero A, Crepaldi G, Grassetto G, Rampin L, Marzola MC, Rubello D. Early prediction of response by 18 F-FDG PET/CT during preoperative therapy in locally advanced rectal cancer: A systematic review. European Journal of Surgical Oncology (EJSO). 2014;40(10):1186-94.
Kim C, Chung HH, Oh SW, Kang KW, Chung JK, Lee DS. Differential diagnosis of borderline ovarian tumors from stage I malignant ovarian tumors using FDG PET/CT. Nuclear medicine and molecular imaging. 2013;47(2):81-8.
Adejolu M, Huo L, Rohren E, Santiago L, Yang WT. False-positive lesions mimicking breast cancer on FDG PET and PET/CT. American Journal of Roentgenology. 2012;198(3):W304-14.
Avril N, Rose CA, Schelling M, Dose J, Kuhn W, Bense S, Weber W, Ziegler S, Graeff H, Schwaiger M. Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: use and limitations. Journal of Clinical Oncology. 2000;18(20):3495-502.
- Abstract Viewed: 690 times
- PDF Downloaded: 429 times