Yanai Ai, Itoh Masatoshi, Hirakawa Hisashi, Yanai Kazuhiko, Tashiro Manabu, Harada Ryuichi, Yoshikawa Akira, Yamamoto Seiichi, Ohuchi Noriaki, Ishida Takanori
Department of Surgical Oncology, Tohoku University Graduate School of Medicine.
Department of Pharmacology, Tohoku University Graduate School of Medicine.
Tohoku J Exp Med. 2018 May;245(1):13-19. doi: 10.1620/tjem.245.13.
Positron emission mammography (PEM) has higher detection sensitivity for breast cancer compared with whole-body positron emission tomography (PET) due to higher spatial resolution. We have developed a new PEM device with high resolution over a wide field of view. This PEM device comprises novel scintillation crystals, praseodymium-doped lutetium aluminum garnet (Pr:LuAG). In the present study, the clinical use of the newly developed PEM for the detection of small breast cancer was compared with that of the conventional PET-computed tomography (PET/CT). Eighty-two patients with breast cancer less than 20 mm (UICC T1) participated in this study, including 23 patients with T1a or T1b breast cancer (less than 10 mm). Histologically-proved lesions were examined by PET/CT and PEM on the same day after injection of [F]fluoro-2-deoxy-2-fluoro-D-glucose ([F]FDG), a marker of glycolytic activity. The newly developed PEM showed better sensitivity of cancer detection compared with PET/CT especially in case of the small T1a or T1b lesions. Moreover, when the conventional PET/CT and new PEM were combined, the detection sensitivity with [F]FDG molecular imaging for T1 (N = 82) and T1a plus T1b breast cancer (N = 23) were 90% and 70%, respectively. The uptake of [F]FDG was proportional to the histological malignancy of breast cancer. Using the newly-developed PEM with [F]FDG, we are able to identify and characterize exactly the small breast tumors less than 10 mm in combination with the conventional PET/CT. These data indicate that PEM and PET/CT are synergic and complementary for the detection of small breast cancer.
由于具有更高的空间分辨率，与全身正电子发射断层扫描（PET）相比，正电子发射乳腺断层成像（PEM）对乳腺癌具有更高的检测灵敏度。我们开发了一种在宽视野范围内具有高分辨率的新型PEM设备。这种PEM设备包含新型闪烁晶体，掺镨钇铝石榴石（Pr:LuAG）。在本研究中，将新开发的PEM用于检测小乳腺癌的临床应用与传统的PET计算机断层扫描（PET/CT）进行了比较。82例乳腺癌小于20mm（国际抗癌联盟T1期）的患者参与了本研究，其中包括23例T1a或T1b期乳腺癌（小于10mm）患者。在注射[F]氟-2-脱氧-2-氟-D-葡萄糖（[F]FDG）（一种糖酵解活性标志物）后的同一天，通过PET/CT和PEM对组织学证实的病变进行检查。新开发的PEM在癌症检测方面显示出比PET/CT更好的灵敏度，尤其是在小T1a或T1b病变的情况下。此外，当将传统的PET/CT和新的PEM结合使用时，[F]FDG分子成像对T1期（N = 82）和T1a加T1b期乳腺癌（N = 23）的检测灵敏度分别为90%和70%。[F]FDG的摄取与乳腺癌的组织学恶性程度成正比。使用新开发的带有[F]FDG的PEM，我们能够结合传统的PET/CT准确识别和表征小于10mm的小乳腺肿瘤。这些数据表明，PEM和PET/CT在检测小乳腺癌方面具有协同作用和互补性。
