Effect of patients' being prone during FDG PET for the diagnosis of breast cancer.

Yutani, Kenji; Tatsumi, Mitsuaki; Uehara, Toshiisa; Nishimura, T

doi:10.2214/ajr.173.5.10541114

Cited by 36 publications

(20 citation statements)

References 3 publications

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“…Breast MRI has been shown to be highly effective in identifying occult tumor, but FP findings may occur (6,(29)(30)(31)(32)(33)(34). As both MRI and PET/CT are frequently requested for disease evaluation for suspected breast cancer, a mechanism to foster direct comparison of lesions detected with both modalities would be useful (7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

“…The breasts become markedly distorted when supine/prone images are registered and it is challenging to identify the corresponding lesion in all 3 orthogonal planes of the fused images (35). Several groups have suggested that an independent PET scan should be acquired in the prone position to increase the quality of PET in the breast (7,8,(36)(37)(38)(39)(40).…”

Section: Problems With Supine Petmentioning

confidence: 99%

“…This work was partially supported by a New York University Department of Radiology Seed grant and was presented in part at the 53rd Annual Meeting of the Society of Nuclear Medicine, San Diego, California, June [3][4][5][6][7] 2006.…”

Section: Acknowledgmentsmentioning

confidence: 99%

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Improving Specificity of Breast MRI Using Prone PET and Fused MRI and PET 3D Volume Datasets

Moy

Ponzo²,

Noz³

et al. 2007

Journal of Nuclear Medicine

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MRI is a sensitive method for detecting invasive breast cancer, but it lacks specificity. To examine the effect of combining PET with MRI on breast lesion characterization, a prototype positioning device was fabricated to allow PET scans to be acquired in the same position as MRI scans-that is, prone. Methods: To test the hypothesis that fusion of 18 F-FDG PET and MRI scans improves detection of breast cancer, 23 patients with suspected recurrent or new breast cancer underwent a routine whole-body PET scan, a prone PET scan of the chest, and a routine breast MRI scan. The attenuation-corrected prone PET and MRI datasets were registered twice by different operators. The fusion results were judged for quality by visual inspection and statistical analysis. A joint reading of the MRI and PET scans side by side and integrated images was performed by a nuclear medicine physician and a radiologist. Sensitivity and specificity of MRI and combined MRI and PET scans were calculated on the basis of pathology reports or at least 1 y of clinical and radiologic follow-up. Results: All fusions were verified to be well matched using specific anatomic criteria. A total of 45 lesions was assessed. Lesion size range was 0.6 to 10.0 cm. Of the 44 breasts examined, 29 were suspicious for cancer, of which 15 were found to be positive on surgical excision. In lesion-by-lesion analysis, sensitivity and specificity of MRI alone were 92% and 52%, respectively; after MRI and PET fusion, they were 63% and 95%, respectively. The positive predictive value and the negative predictive value for MRI alone were 69% and 85%, respectively; after MRI and PET fusion, they were 94% and 69%, respectively. Conclusion: Acquisition of prone PET scans using the new positioning device permitted acquisition of prone scans suitable for fusion with breast MRI scans. Fused PET and MRI scans increased the specificity of MRI but decreased the sensitivity in this small group of patients. Additional data are needed to confirm the statistical significance of these preliminary findings.

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Section: Discussionmentioning

confidence: 99%

Section: Problems With Supine Petmentioning

confidence: 99%

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Improving Specificity of Breast MRI Using Prone PET and Fused MRI and PET 3D Volume Datasets

Moy

Ponzo²,

Noz³

et al. 2007

Journal of Nuclear Medicine

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“…Detection and classification of breast cancer lesions are potentially improved with prone imaging relative to conventional supine imaging. [1][2][3][4][5] Compared to supine, prone 18F-FDG-PET/CT provides statistically identical information on anatomical disease distribution in locally advanced breast cancer (LABC), with prone scanning performing better than supine at determining the number of involved lymph nodes. 6 In order to integrate information from different imaging modalities and/or to serially assess FDG-PET data from breast tissue at the voxel level, one must be able to spatially coregister the data obtained at each imaging session, a goal that is greatly facilitated by imaging the breast while patients lay in the prone position on a supportive device.…”

Section: Introductionmentioning

confidence: 99%

Comparison of prone versus supine 18F‐FDG‐PET of locally advanced breast cancer: Phantom and preliminary clinical studies

Williams

Rani

et al. 2015

Medical Physics

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Purpose: Previous studies have demonstrated how imaging of the breast with patients lying prone using a supportive positioning device markedly facilitates longitudinal and/or multimodal image registration. In this contribution, the authors' primary objective was to determine if there are differences in the standardized uptake value (SUV) derived from [ 18 F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in breast tumors imaged in the standard supine position and in the prone position using a specialized positioning device. Methods: A custom positioning device was constructed to allow for breast scanning in the prone position. Rigid and nonrigid phantom studies evaluated differences in prone and supine PET. Clinical studies comprised 18F-FDG-PET of 34 patients with locally advanced breast cancer imaged in the prone position (with the custom support) followed by imaging in the supine position (without the support). Mean and maximum values (SUV peak and SUV max , respectively) were obtained from tumor regions-of-interest for both positions. Prone and supine SUV were linearly corrected to account for the differences in 18F-FDG uptake time. Correlation, Bland-Altman, and nonparametric analyses were performed on uptake time-corrected and uncorrected data. Results: SUV from the rigid PET breast phantom imaged in the prone position with the support device was 1.9% lower than without the support device. In the nonrigid PET breast phantom, prone SUV with the support device was 5.0% lower than supine SUV without the support device. In patients, the median (range) difference in uptake time between prone and supine scans was 16.4 min (13.4-30.9 min), which was significantly-but not completely-reduced by the linear correction method. SUV peak and SUV max from prone versus supine scans were highly correlated, with concordance correlation coefficients of 0.91 and 0.90, respectively. Prone SUV peak and SUV max were significantly lower than supine in both original and uptake time-adjusted data across a range of index times (P << 0.0001, Wilcoxon signed rank test). Before correcting for uptake time differences, Bland-Altman analyses revealed proportional bias between prone and supine measurements (SUV peak and SUV max ) that increased with higher levels of FDG uptake. After uptake time correction, this bias was significantly reduced (P < 0.01). Significant prone-supine differences, with regard to the spatial distribution of lesions relative to isocenter, were observed between the two scan positions, but this was poorly correlated with the residual (uptake time-corrected) prone-supine SUV peak difference (P = 0.78).Conclusions: Quantitative 18F-FDG-PET/CT of the breast in the prone position is not deleteriously affected by the support device but yields SUV that is consistently lower than those obtained in the standard supine position. SUV differences between scans arising from FDG uptake time differences can be substantially reduced, but not removed entirely, with the current correction method. SUV from the two sca...

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“…7 FDG-PET detects primary breast carcinoma with sensitivities from 64% to 96% 10 and identifies metastatic disease with a sensitivity of 86%. 11 Acquisition of PET scans in prone position with freely pendant breasts, 12 as well as dual-time-point imaging, has been suggested to improve breast cancer imaging. 13 In contrast to 99m TcO 4 Ϫ and 123 I scintigraphy that are not expected to accumulate in inflammatory sites, nonspecific FDG accumulation occurs in inflammatory cells.…”

Section: Introductionmentioning

confidence: 99%

Comparison of ^99mTechnetium-Pertechnetate and ¹²³Iodide SPECT with FDG-PET in Patients Suspicious for Breast Cancer

Buchmann

Riedmüller

Hoffner

et al. 2007

Cancer Biotherapy and Radiopharmaceuticals

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We conducted a single-arm study to determine the biodistribution of intraperitoneally (i.p.) administered 90yttrium-labeled murine monoclonal antibody HMFG1 (90Y-muHMFG1) in patients with advanced stage ovarian cancer. Seventeen (17) patients in complete clinical remission for epithelial ovarian cancer were included. After completion of chemotherapy, a mixture of 111indium-labeled muHMFG1 (imaging) and 90Y-muHMFG1 (therapy) was i.p. administered by a surgically placed, indwelling i.p. catheter. Planar and single-photon emission computed tomography images were recorded to determine the distribution of the study medication during the first 6 days postinjection. Of the first 3 patients, 2 patients had extraperitoneal leakage of up to 50% of the injected dose within 24 hours after injection of the study medication. Extraperitoneal leakage was mainly seen in the retroperitoneal spaces covering the upper and lower quadrant of the abdomen. After adjustments in the procedure, leakage was observed in 2 of the remaining 14 patients. Extraperitoneal leakage of i.p. administered therapy does occur. Such leakage would reduce the locally delivered dose of a drug and could potentially have a negative impact on therapeutic efficacy. Given the potential attraction of developing i.p. treatments for intra-abdominal cancer, the observations in this study need to be taken into consideration.

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Effect of patients' being prone during FDG PET for the diagnosis of breast cancer.

Cited by 36 publications

References 3 publications

Improving Specificity of Breast MRI Using Prone PET and Fused MRI and PET 3D Volume Datasets

Improving Specificity of Breast MRI Using Prone PET and Fused MRI and PET 3D Volume Datasets

Comparison of prone versus supine 18F‐FDG‐PET of locally advanced breast cancer: Phantom and preliminary clinical studies

Comparison of ^99mTechnetium-Pertechnetate and ¹²³Iodide SPECT with FDG-PET in Patients Suspicious for Breast Cancer

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Effect of patients' being prone during FDG PET for the diagnosis of breast cancer.

Cited by 36 publications

References 3 publications

Improving Specificity of Breast MRI Using Prone PET and Fused MRI and PET 3D Volume Datasets

Improving Specificity of Breast MRI Using Prone PET and Fused MRI and PET 3D Volume Datasets

Comparison of prone versus supine 18F‐FDG‐PET of locally advanced breast cancer: Phantom and preliminary clinical studies

Comparison of 99mTechnetium-Pertechnetate and 123Iodide SPECT with FDG-PET in Patients Suspicious for Breast Cancer

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Comparison of ^99mTechnetium-Pertechnetate and ¹²³Iodide SPECT with FDG-PET in Patients Suspicious for Breast Cancer