Tohoku J. Exp. Med., 2018 May, 245(1)

Newly-Developed Positron Emission Mammography (PEM) Device for the Detection of Small Breast Cancer

AI YANAI,1,5 MASATOSHI ITOH,2,4 HISASHI HIRAKAWA,3 KAZUHIKO YANAI,4,5 MANABU TASHIRO,4 RYUICHI HARADA,5 AKIRA YOSHIKAWA,6 SEIICHI YAMAMOTO,7 NORIAKI OHUCHI1 and TAKANORI ISHIDA1

1Department of Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
2Sendai Medical Imaging Center, Sendai, Miyagi, Japan
3KKR Tohoku Kosai Hospital, Sendai, Miyagi, Japan
4Cyclotron Radioisotope Center (CYRIC), Tohoku University, Sendai, Miyagi, Japan
5Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
6Institute for Material Research, Tohoku University, Sendai, Miyagi, Japan
7Department of Radiological Technology, Nagoya University, Nagoya, Aichi, Japan

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 [18F]fluoro-2-deoxy-2-fluoro-D-glucose ([18F]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 [18F]FDG molecular imaging for T1 (N = 82) and T1a plus T1b breast cancer (N = 23) were 90% and 70%, respectively. The uptake of [18F]FDG was proportional to the histological malignancy of breast cancer. Using the newly-developed PEM with [18F]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.

Key words —— breast cancer; 18F-FDG; histology; PET/CT; positron emission mammography (PEM)

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Tohoku J. Exp. Med., 2018, 245, 13-19

Correspondence: Kazuhiko Yanai, M.D., Ph.D., Department of Pharmacology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.

e-mail: yanai@med.tohoku.ac.jp