Murthy K, Aznar M, Thompson C J, Loutfi A, Lisbona R, Gagnon J H
Montreal Neurological Institute, Medical Physics Unit, and Royal Victoria Hospital, McGill University, Quebec, Canada.
J Nucl Med. 2000 Nov;41(11):1851-8.
Early detection of breast cancer is crucial for efficient and effective treatment. We have developed an instrument for positron emission mammography (PEM) called PEM-I that performs high-resolution metabolic imaging of breast cancer. Images of glucose metabolism are obtained after injection of 75 MBq FDG. The PEM detectors are integrated into a conventional mammography system, allowing acquisition of the emission images immediately after the mammogram, without subject repositioning, and accurate coregistration of images from the 2 modalities. In this article, we present the results of the first clinical pilot study with the instrument.
Sixteen subjects (age range, 34-76 y) were studied. All subjects were nondiabetic, nonpregnant, and without a history of cancer. They had recently been found to have suggestive mammography findings or a palpable breast mass and underwent lumpectomy or mastectomy within 2 wk of the study. Results from the PEM study were compared with those from mammography and pathology. A PEM test was classified positive (indicating the presence of cancer) if significant focal uptake was seen in the image or if the counting rate in the breast with suggestive findings was significantly higher than in the contralateral breast.
Of the 16 subjects studied, 14 were evaluable. Ten cancerous tumors and 4 benign tumors were confirmed by pathologic examination after complete removal of the tumor. PEM correctly detected the presence of disease in 8 of 10 subjects. Findings were false-negative in 2 instances and false-positive in none, giving the instrument 80% sensitivity, 100% specificity, and 86% accuracy.
Our preliminary results suggest that PEM can offer a noninvasive method for the diagnosis of breast cancer. Metabolic images from PEM contain unique information not available from conventional morphologic imaging techniques and aid in expeditiously establishing the diagnosis of cancer. In all subjects, the PEM images were of diagnostic quality, with an imaging time of 2-5 min.
早期发现乳腺癌对于高效且有效的治疗至关重要。我们开发了一种名为PEM - I的正电子发射乳腺断层成像（PEM）仪器，可对乳腺癌进行高分辨率代谢成像。注射75 MBq氟代脱氧葡萄糖（FDG）后获取葡萄糖代谢图像。PEM探测器集成到传统乳腺摄影系统中，使得在乳腺摄影后无需重新摆放患者体位即可立即采集发射图像，并能对两种模态的图像进行精确配准。在本文中，我们展示了使用该仪器进行的首次临床试点研究结果。
对16名受试者（年龄范围34 - 76岁）进行了研究。所有受试者均非糖尿病患者、非孕妇且无癌症病史。他们近期乳腺摄影检查结果可疑或可触及乳腺肿块，并在研究的2周内接受了肿块切除术或乳房切除术。将PEM研究结果与乳腺摄影和病理学结果进行比较。如果在图像中看到明显的局灶性摄取，或者有可疑发现的乳房计数率显著高于对侧乳房，则PEM检测结果分类为阳性（表明存在癌症）。
在研究的16名受试者中，14名可进行评估。在肿瘤完全切除后，病理检查确认了10个癌性肿瘤和4个良性肿瘤。PEM在10名受试者中的8名中正确检测出疾病存在。有2例结果为假阴性，无假阳性，该仪器的灵敏度为80%，特异性为100%，准确率为86%。
我们的初步结果表明，PEM可为乳腺癌诊断提供一种非侵入性方法。PEM的代谢图像包含传统形态学成像技术无法提供的独特信息，有助于快速确立癌症诊断。在所有受试者中，PEM图像具有诊断质量，成像时间为2 - 5分钟。
