BREAST IMAGING WITH FLUORINE-18-FDG PET - QUANTITATIVE IMAGE-ANALYSIS

This study evaluated various quantitative criteria for analysis of bre ast imaging with PET using the radiolabeled glucose analog F-18-fluoro deoxyglucose (FDG), Methods: In a prospective study, 73 patients with abnormal mammography or palpable breast masses scheduled for biopsy we re investigated with PET, A total of 97 breast tumors were evaluated b y histology, including 46 benign and 51 malignant tumors. Using a whol e-body PET scanner, attenuation-corrected images were acquired between 40 and 60 min after tracer injection, For Patlak analysis, dynamic da ta acquisition was obtained in 24 patients, To differentiate between b enign and malignant breast tumors, receiver operating characteristic c urves were calculated using incrementally increasing threshold values for tumor/nontumor ratios based on average and maximum activity values per region of interest, standardized uptake values (corrected for par tial volume effect, normalized to blood glucose, partial volume effect and blood glucose, using the lean body mass as well as the body surfa ce area) and calculating the FDG influx rate (K) assessed by Patlak an alysis, Results: Quantification of FDG uptake in breast tumors provide d objective criteria for differentiation between benign and malignant tissue with similar diagnostic accuracy as compared with visual analys is, Applying correction for partial volume effect and normalization by blood glucose yielded the highest diagnostic accuracy. Conclusions: T hese quantitative methods provided accurate evaluation of PET data for differentiating benign from malignant breast tumors. Quantitative ass essment is recommended to complement visual image interpretation with the potential benefit of reduced interobserver variability.