Method for Combined FDG-PET and Radiographic Imaging of Primary Breast Cancers

Abstract

The purpose of the study was to demonstrate the feasibility of a hybrid functional/anatomic breast imaging platform with biopsy capability for facilitating lesion detection and diagnosis. This platform consists of an investigative dedicated positron emission mammography (PEM) device mounted on a stereotactic X-ray mammography system, permitting sequential acquisition of mammographic and emission images during a single breast compression. There is automatic coregistration of images from both modalities, and these results can be successfully correlated with histopathologic findings. The potential utility of functional images correlated to anatomic images would include noninvasively detecting clinically and radiographically occult cancers, assessing response to therapy, discriminating between benign and malignant breast masses, and ultimately reducing the number of invasive and costly surgical interventions. A spot-digital mammogram and subsequent PEM image, collected over a 4-minute period, were obtained in a single patient with the breast in compression after intravenous injection of (F-18)-2-deoxy-2-fluoro-D-glucose (FDG) at the time of stereotactic biopsy. The authors conclude that FDG-based lesion localization information may be combined with the lesion X-ray attenuation characteristics using this common imaging platform.

Nuclear imaging of the breast: Translating achievements in instrumentation into clinical use

“…This was the case for the initial PEM designs 61,[98][99][100] and for the original Gamma Medica LumaGem MBI detector. 101 In the breast, coregistration of anatomy and function may be more important than in other organs because breast tissue is so deformable, with few anatomical landmarks.…”

Positron Emission Tomography-Magnetic Resonance Imaging: Technical Review

“…MR has exquisite sensitivity for staging breast cancer and is, perhaps, too sensitive as to have false positives and lead to unnecessary biopsies 63 ; up to 75% turn out to be benign 64 . Will combining the specificity of PET and the sensitivity and spatial resolution of MR produce a winner?…”

State-of-the-art of PET scanners for small animal and breast cancer imaging

“…Clinical trials have been performed with the dual planar configuration [23,24]. This configuration is well suited for the integration with conventional X-ray mammography units for emissiontransmission image fusion or guided biopsy [25,26]. In USA the FDA has recently approved the clinical use of a PEM instrument, called PEM Flex (http://www.naviscanpet.com/), for the secondary screening of cancer in the breast and other organs (e.g., prostate).…”