PEM: Positron Emission Mammography – pro
Positron-emission mammography (PEM), uses isolated molecular imaging to examine the breast, producing a precise and comprehensive image tissue within. LIke for PET, F-18 tracer binding to fluorodeoxyglucose (FDG) within the breast’s cells indicates abnormailities. PEM reveals the size, shape, location and malignancy of the mass in a high-resolution 3D tomographic image.
At the 2008 Radiological Society of North America (RSNA) meeting, the single-site study of 208 women with confirmed breast cancer revealed that PEM was significantly more sensitive (93 percent) than whole-body PET (68 percent) in detecting index malignant lesions, and equivalent to breast MRI (93 percent). Of the 182 lesions detected, PEM successfully identified 90 percent of the 30 ductal carcinoma in situ (DCIS) cases, more than the 83 percent detected by MRI. PEM specificity was 74 percent versus 48 percent for MRI in the ipsilateral breast. PEM specificity was 82 percent versus 67 percent with MRI in the contralateral breast. Both PEM and MRI were 89 percent accurate in detecting index lesions in fatty breasts. Accuracy reached 77 percent with PEM in extremely dense breasts, compared with 69 percent using MRI.
Several other prospective comparative studies have been published.
Schilling K, Narayanan D, Kalinyak JE, The J, Velasquez MV, Kahn S, Saady M, Mahal R, Chrystal L.Positron emission mammography in breast cancer presurgical planning: comparisons with magnetic resonance imaging. Eur J Nucl Med Mol Imaging. 2011 Jan;38(1):23-36.
Berg WA, Weinberg IN, Narayanan D, Lobrano ME, Ross E, Amodei L, Tafra L, Adler LP, Uddo J, Stein W 3rd, Levine EA; Positron Emission Mammography Working Group.
Breast J. 2006 Jul-Aug;12(4):309-23.
David Mankoff Imaging in breast cancer – breast cancer imaging revisited, Breast Cancer Research 2005, 7:276-278
Benard F, Turcotte E: Imaging breast cancer with single photon computed tomography and positron emission tomography. Breast Cancer Res 2005, 7:153-162.
RSNA 2008: 94th Scientific Assembly and Annual Meeting of the Radiological Society of North America: Scientific Session VB31-04: Presented December 3, 2008.
Laino, Charlene RSNA Annual Meeting Newer Breast Imaging Techniques Offer Advantages over Mammography, MRI. Oncology Times:
10 February 2009 – Volume 31 – Issue 3 – pp 6-8