Dual-time-point 18F-FDG PET/CT versus dynamic breast MRI of suspicious breast lesions

Massimo Imbriaco, Maria Grazia Caprio, Gennaro Limite, Leonardo Pace, Teresa De Falco, Ermanno Capuano, Marco Salvatore

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of our study was to compare dual-time-point 18F-FDG PET/CT, performed with the patient in the prone position, and contrast-enhanced MRI in patients with suspected breast malignancy. SUBJECTS AND METHODS. Forty-four patients with 55 breast lesions underwent two PET/CT scans (dual-time-point imaging) in the prone position and breast MRI. Sensitivity, specificity, and overall accuracy were calculated. In addition, the average percentage of change in standard uptake values (Δ%SUV max) between time point 1 and time point 2 was calculated for PET/CT. A final histopathologic diagnosis was available for all patients. RESULTS. MRI showed an overall accuracy of 95%, with sensitivity and specificity of 98% and 80%. Conversely, dual-time-point PET/CT showed an accuracy of 84% for lesions with an SUVmax ≥ 2.5 or with a positive Δ%SUVmax, with sensitivity and specificity of 80% and 100% versus 69% accuracy, 62% sensitivity (both, p <0.001), and 100% specificity (p not significant) for single-time-point PET/CT. On PET/CT, malignant lesions showed an increase in FDG between time points 1 and 2, with a Δ%SUVmax of 11 ± 24. Benign lesions showed either no change or a decrease in SUVmax between time points 1 and 2, with a Δ%SUVmax of 21 ± 7. CONCLUSION. A dual time point improves PET/CT accuracy in patients with a suspected breast malignancy over single-time-point PET/CT. On PET/CT, FDG is increasingly taken up over time in breast tumors; conversely, benign lesions show a decrease in FDG uptake over time. These changes in SUV might represent a reliable parameter that can be used to differentiate benign from malignant lesions of the breast on PET/CT examination.

Original languageEnglish
Pages (from-to)1323-1330
Number of pages8
JournalAmerican Journal of Roentgenology
Volume191
Issue number5
DOIs
Publication statusPublished - Nov 2008

Keywords

  • Breast carcinoma
  • FDG PET
  • MRI
  • PET/CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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