Malhotra Anmol, Tincey Sophia, Naidu Vishnu, Papagiorcopulo Carla, Ghosh Debashis, Tan Peng H, Wickham Fred, Wagner Thomas
Radiology Department, Royal Free Hospital NHS Trust, London NW3 2QG, UK.
J Pers Med. 2020 Sep 25;10(4):148. doi: 10.3390/jpm10040148.
Magnetic resonance imaging (MRI) in patients with breast cancer to assess extent of disease or multifocal disease can demonstrate indeterminate lesions requiring second-look ultrasound and ultrasound or MRI-guided biopsies. Prone positron emission tomography-computed tomography (PET-CT) is a dedicated acquisition performed with a breast-supporting device on a standard PET-CT scanner. The MAMmography with Molecular Imaging (MAMMI, Oncovision, Valencia, Spain) PET system (PET-MAMMI) is a true tomographic ring scanner for the breast. We investigated if PET-MAMMI and prone PET-CT were able to characterise these MRI- indeterminate lesions further. A total of 10 patients with breast cancer and indeterminate lesions on breast MRI were included. Patients underwent prone PET-MAMMI and prone PET-CT after injection of FDG subsequently on the same day. Patients then resumed their normal pathway, with the clinicians blinded to the results of the PET-MAMMI and prone PET-CT. Of the MRI-indeterminate lesions, eight were histopathologically proven to be malignant and two were benign. PET-MAMMI and prone PET-CT only were able to demonstrate increased FDG uptake in 1/8 and 0/8 of the MRI-indeterminate malignant lesions, respectively. Of the MRI-indeterminate benign lesions, both PET-MAMMI and prone PET-CT demonstrated avidity in 1/2 of these lesions. Our findings do not support the use of PET-MAMMI to characterise indeterminate breast MRI lesions requiring a second look ultrasound.
对于乳腺癌患者，使用磁共振成像（MRI）评估疾病范围或多灶性疾病时，可能会发现一些不确定的病变，需要进行二次超声检查以及超声或MRI引导下的活检。俯卧位正电子发射断层扫描-计算机断层扫描（PET-CT）是在标准PET-CT扫描仪上使用乳房支撑装置进行的专门检查。乳腺分子成像乳腺X线摄影（MAMMI，Oncovision，西班牙巴伦西亚）PET系统（PET-MAMMI）是一种真正用于乳房的断层环形扫描仪。我们研究了PET-MAMMI和俯卧位PET-CT是否能够进一步明确这些MRI不确定的病变。共纳入10例乳腺癌患者，其乳房MRI检查发现有不确定病变。患者在同一天注射氟代脱氧葡萄糖（FDG）后接受俯卧位PET-MAMMI和俯卧位PET-CT检查。然后患者恢复正常诊疗流程，临床医生对PET-MAMMI和俯卧位PET-CT的结果不知情。在MRI不确定的病变中，8例经组织病理学证实为恶性，2例为良性。PET-MAMMI和俯卧位PET-CT分别仅能在1/8和0/8的MRI不确定恶性病变中显示FDG摄取增加。在MRI不确定的良性病变中，PET-MAMMI和俯卧位PET-CT均在1/2的此类病变中显示出摄取。我们的研究结果不支持使用PET-MAMMI来明确需要二次超声检查的MRI不确定乳腺病变。
