Literature DB >> 23568361

The role of the breast radiologist in evaluation of breast incidentalomas detected on 18-fludeoxyglucose positron emission tomography/CT.

R M Dunne1, D O'Mahony, G Wilson, R McDermott, S A O'Keeffe.   

Abstract

OBJECTIVE: To evaluate the significance of incidentally discovered breast lesions on 18-fludeoxyglucose ((18)F-FDG) positron emission tomography (PET)/CT.
METHODS: 6050 (18)F-FDG PET/CT studies, performed between January 2009 and February 2012, were retrospectively reviewed. 55 lesions in 50 patients were identified. Additional work-up, including mammography, ultrasound, follow-up (18)F-FDG PET/CT and biopsy, was available for 39 incidental breast lesions in 36 patients. All patients were female, with mean age 61.5 years (range 36-90 years). The maximum standardised uptake value (SUVmax), CT size and CT Breast Imaging Reporting and Data System (BI-RADS®) scores were compared between the malignant and the benign subgroups, using the unpaired t-test and Fisher's exact test. Tests were two-sided and a p-value of <0.05 was considered to be significant.
RESULTS: Incidental breast lesions were identified in 50 (0.8%) of 6050 (18)F-FDG PET/CT studies. 21 (53.8%) of the 39 breast incidentalomas were malignant on biopsy or imaging, of which 15 (38.5%) represented a second primary breast cancer. A statistically significant difference in the mean SUVmax between malignant and benign breast lesions was observed (p=0.021). Malignancy was significantly more common in the CT BI-RADS Category 4 or greater groups (76.2%; p=0.0105).
CONCLUSION: Incidental breast lesions detected at (18)F-FDG PET/CT are uncommon. When detected, however, they may represent malignancy in up to 53.8% of cases. ADVANCES IN KNOWLEDGE: SUVmax and CT findings at (18)F-FDG PET/CT can assist with differentiating benign and malignant breast conditions, guiding further evaluation with dedicated breast imaging. Review of (18)F-FDG PET/CT-detected breast lesions by a breast radiologist may be helpful in determining the need for and correlation with further breast imaging. Radiologists and nuclear medicine physicians should be cognisant of breast pathology when reporting (18)F-FDG PET/CT image data sets.

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Year:  2013        PMID: 23568361      PMCID: PMC3664982          DOI: 10.1259/bjr.20130034

Source DB:  PubMed          Journal:  Br J Radiol        ISSN: 0007-1285            Impact factor:   3.039


  19 in total

1.  Breast imaging with fluorine-18-FDG PET: quantitative image analysis.

Authors:  N Avril; S Bense; S I Ziegler; J Dose; W Weber; C Laubenbacher; W Römer; F Jänicke; M Schwaiger
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2.  PET/CT detection of unexpected gastrointestinal foci of 18F-FDG uptake: incidence, localization patterns, and clinical significance.

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5.  Clinical significance of incidental finding of focal activity in the breast at 18F-FDG PET/CT.

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8.  Unexpected foci of 18F-FDG uptake in the breast detected by PET/CT: incidence and clinical significance.

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  4 in total

Review 1.  Prevalence and clinical significance of incidental F18-FDG breast uptake: a systematic review and meta-analysis.

Authors:  Francesco Bertagna; Giorgio Treglia; Emanuela Orlando; Lodovica Dognini; Luca Giovanella; Ramin Sadeghi; Raffaele Giubbini
Journal:  Jpn J Radiol       Date:  2013-12-13       Impact factor: 2.374

2.  Incidental Breast Lesions Identified by (18)F-FDG PET/CT: Which Clinical Variables Differentiate between Benign and Malignant Breast Lesions?

Authors:  Kyung Min Shin; Hye Jung Kim; Su Jin Jung; Hyo Soon Lim; Sang Woo Lee; Seung Hyun Cho; Yun-Jin Jang; Hui Joong Lee; Gab Chul Kim; Jin Hyang Jung; Ji Young Park
Journal:  J Breast Cancer       Date:  2015-03-27       Impact factor: 3.588

Review 3.  Prevalence of focal incidental breast uptake on FDG-PET/CT and risk of malignancy: a systematic review and meta-analysis.

Authors:  Else Marie Aarstad; Petter Nordhaug; Mohammad Naghavi-Behzad; Lisbet Brønsro Larsen; Oke Gerke; Malene Grubbe Hildebrandt
Journal:  Eur J Hybrid Imaging       Date:  2019-09-30

4.  Two Uncommon Sites of Metastasis: Breast and Hypophysis Metastases of Head and Neck Adenoid Cystic Carcinoma Detected by FDG PET/CT.

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Journal:  Mol Imaging Radionucl Ther       Date:  2017-10-03
  4 in total

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