Wendie A. Berg MD, Abstract Co-Author: Nothing to Disclose

Irving Norman Weinberg MD, PhD, Abstract Co-Author: Nothing to Disclose

Mary Elizabeth Lobrano MD, Abstract Co-Author: Nothing to Disclose

Lorraine Tafra MD, Abstract Co-Author: Nothing to Disclose

Eric Ross PhD, Abstract Co-Author: Nothing to Disclose

Laura Ann Amodei MD, Presenter: Nothing to Disclose

Deepa Narayanan MS, Abstract Co-Author: Nothing to Disclose

To study the biochemical behavior of breast lesions as uncovered by high resolution breast PET with compression (positron emission mammography, or "PEM").

Standardized uptake values (SUV) for lesions were derived as part of a multi-center study of 42 women with breast cancer (48 lesions). The lesions included 11 cases of DCIS (1 grade I, 9 grade II, 1 grade III), and 37 of invasive carcinomas with median size 21 mm. Of the invasive cancers, (15 T1, 13 T2, and 5 T3, with one unknown T), 30 were pure ductal (4 grade I, 12 grade II, 13 grade III and one unknown grade), 4 invasive lobular carcinoma (ILC), and 3 were mixed IDC and ILC. Measurements were obtained with a high resolution PET scanner (PEM Flex, Naviscan PET Systems) employing breast compression for 10-minutes per breast after injection with 12 mCi of FDG, with an average of one million reconstructed counts per breast.

Mean SUV for invasive ductal carcinoma (IDC) was 2.62 (standard error 0.33), with reduced SUV (0.98 +/- SE 0) noted for T1a lesions. Grade III IDC lesions had higher SUV values than lower grades (3.37 +/- SE 0.54, compared to 2.27 +/- SE 1.20 for Grade I and 1.88 +/- SE 0.35 for Grade II). Cancer-to-fat ratios in the same breast were high for all IDC lesions (9.54 +/- SE 2.0). Pure invasive lobular carcinoma had reduced SUV (0.97 +/- SE 0.46), with high cancer-to-fat ratio (4.1 +/- SE 2.6), while mixed invasive ductal/invasive lobular (2.96 +/- SE 0.82) had characteristics similar to pure invasive ductal carcinoma. DCIS had SUV of 2.1 +/- SE 0.36 and cancer-to-fat ratio of 4.82+/- SE 0.97. Benign lesions had SUV of 1.1 +/- SE 0.1 and atypical ductal hyperplasia had SUV 1.5 +/- SE 0.08.

High resolution PEM reveals biochemical differences between invasive ductal and lobular lesions, between high grade and low grade invasive ductal cancer, in situ and invasive ductal cancers, and between benign and atypical lesions. Reduced SUV for T1a lesions is most likely due to volume averaging.

L.T.: Anne Arundel Health Systems has received a subcontract from Naviscan PET Systems.D.N.: Author is an employee of company funding studyI.N.W.: Author is an officer of company funding study.W.A.B.,M.E.L.,E.R.: Authors are consultants to company funding study.

Berg, W, Weinberg, I, Lobrano, M, Tafra, L, Ross, E, Amodei, L, Narayanan, D, SUV Differences in Breast Epithelial Subtypes with High Resolution Positron Emission Mammography.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4418691.html