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

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.

keywords —— 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