Till Alexander Heusner MD, Presenter: Nothing to Disclose

Lutz S. Freudenberg MD, Abstract Co-Author: Nothing to Disclose

Hilmar Kuehl MD, PhD, Abstract Co-Author: Nothing to Disclose

Elke Anni Maria Hauth, Abstract Co-Author: Nothing to Disclose

Patrick Veit-Haibach MD, Abstract Co-Author: Nothing to Disclose

Gerald Antoch MD, Abstract Co-Author: Nothing to Disclose

To evaluate the feasibility and potential advantages of a dedicated PET/CT protocol in breast cancer patients.

24 breast cancer patients with suspected disease progression underwent whole-body PET/CT in supine position (SP) followed by PET/CT of the breasts and axillae in prone position (PP) using a breast positioning aid. Patient comfort and additional time required for PP were reported. To evaluate a potential benefit of PP imaging, PP and SP images were compared with regard to tumor-to-thoracic-wall-distance, tumor-to-skin-distance, lesion volume, diameter, density, SUVmax, and localization of the breast lesions. The size of axillary areas, transverse diameters of intraaxillary lymph nodes, the SUVmax of intraaxillary lymph nodes and the number of distant metastases were compared between the prone and the supine protocol. Differences were tested for significance with student’s t-test.

All patients tolerated imaging in the PP well. The mean additional time required for the prone PET/CT was 20 min. Mean tumor-to-thoracic-wall-distance (PP: 21 mm, SP: 10 mm, p=0.011) and tumor-to-skin-distance (PP: 12 mm, SP: 8 mm, p=0.033) were significantly larger in PP than in SP. Potential thoracic wall or skin infiltration and quadrant localization were determined more easily in PP. 80% of recurrent breast cancers were detected both in SP and PP. The axillary area was wider in PP as compared to SP (PP: 14.0 cm², SP: 10.8 cm², p=0.001); the number of lymph nodes detected (PP and SP: n=41, p=1), lymph node transverse diameters (PP and SP: 6 mm, p=0.366) and lymph node SUVmax (PP: 5.2, SP: 5.4, p=0.141) were not significantly different. The same number of distant metastases (PP and SP: n=33, p=1) was detected in SP and PP.

A dedicated breast PET/CT examination is feasible in clinical routine and may allow for more accurate delineation of a breast tumor from the adjacent thoracic wall and skin. There seems to be no additional benefit of the prone position when assessing the axillary lymph nodes.

A dedicated breast PET/CT examination is feasible in clinical routine and may allow for more accurate delineation of a breast tumor from the adjacent thoracic wall and skin.

Heusner, T, Freudenberg, L, Kuehl, H, Hauth, E, Veit-Haibach, P, Antoch, G, Whole Body PET/CT Mammography: A Feasibility Study.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5006883.html