Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul 137-040, Korea.
AJR Am J Roentgenol. 2011 Aug;197(2):341-7. doi: 10.2214/AJR.10.6126.
The purpose of this study was to determine the clinical significance of the incidental finding of hypermetabolic foci in the breast at (18)F-FDG PET/CT in patients with malignant disease other than breast cancer or during a screening examination.
The files of 13,897 women who underwent FDG PET/CT from November 2004 to October 2009 were retrospectively reviewed. Forty-eight patients with incidental breast uptake had undergone either tissue confirmation or clinical follow-up with additional sonographic imaging. The following four variables were evaluated: age, maximum standard uptake value (SUV(max)) of breast uptake at FDG PET, findings in the CT portion of PET/CT, and sonographic findings. Malignancy rates were calculated for each variable.
Malignancy was diagnosed in 18 (37.5%) patients and a benign condition in 30 (62.5%) patients. Statistically significant differences in malignancy rate were found between the groups with SUV(max) less than 2 (24.2%) and the group with SUV(max) of 2 or greater (66.7%) and between the group with lesions in a BI-RADS ultrasound category lower than 4 (10.7%) and the group with lesions in category 4 or higher (75.0%) (p < 0.05). There was no significant difference in malignancy rates between the groups younger than 45 years (11.1%) and 45 years and older (53.3%) or between the group with lesions in a BI-RADS category lower than 4 (30.2%) and that with lesions in category 4 or higher (100%) on the CT portion of PET/CT.
Incidental hypermetabolic foci in the breast may represent malignancy in as many as 37.5% of cases. The SUV(max) and sonographic findings can be useful for differentiating benign from malignant lesions.
本研究旨在确定在患有乳腺癌以外的恶性疾病或在筛查检查中，（18）F-FDG PET/CT 偶然发现乳腺高代谢灶的临床意义。
回顾性分析了 2004 年 11 月至 2009 年 10 月期间接受 FDG PET/CT 检查的 13897 名女性患者的档案。48 例偶然发现乳腺摄取的患者接受了组织确认或临床随访，包括额外的超声成像。评估了以下四个变量：年龄、FDG PET 中乳腺摄取的最大标准摄取值（SUV(max))、PET/CT 的 CT 部分的结果以及超声检查结果。计算了每个变量的恶性肿瘤发生率。
18 例（37.5%）患者诊断为恶性肿瘤，30 例（62.5%）患者为良性疾病。SUV(max)小于 2 的组（24.2%）和 SUV(max)为 2 或更高的组（66.7%）以及 BI-RADS 超声分类低于 4 的组（10.7%）与分类 4 或更高的组（75.0%）之间的恶性肿瘤发生率存在统计学差异（p < 0.05）。年龄小于 45 岁的组（11.1%）与 45 岁及以上的组（53.3%）或 PET/CT 的 CT 部分 BI-RADS 分类较低的组（30.2%）与分类 4 或更高的组（100%）之间的恶性肿瘤发生率无显著差异。
乳腺偶然出现高代谢灶在多达 37.5%的病例中可能代表恶性肿瘤。SUV(max)和超声检查结果可用于区分良性和恶性病变。
