18F-fluorodeoxyglucose specimen-positron emission mammography delineates tumour extension in breast-conserving surgery: Preliminary results

Gou Watanabe, M. Itoh, X. Duan, H. Watabe, N. Mori, H. Tada, A. Suzuki, M. Miyashita, N. Ohuchi, T. Ishida

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Objectives: We aimed to determine whether high-resolution specimen-positron emission mammography (PEM) using fluorodeoxyglucose (18F-FDG) can reveal extension of breast cancer in breast-conserving surgery (BCS), and assess the safety of radiation exposure to medical staff. Methods: Sixteen patients underwent positron emission tomography, and then BCS with intraoperative frozen section analysis on the same day. Resected specimens with remaining 18F-FDG accumulation were scanned by high-resolution PEM. At least 1 day after surgery, tumour extension was evaluated by three independent experienced readers and by binarized images from the specimen-PEM data. Intraoperative exposure of medical staff to 18F-FDG was measured. Results: Specimen-PEM evaluations of binarized images and the three investigators detected all (100 %, 12/12) invasive lesions and 94.4 % (17/18) of in situ lesions using both methods. The positive predictive value of the accumulated lesions was 74.4 % (29/39) for the binarized images and 82.9 % (29/35) for the three investigators. Analysis of intraoperative frozen sections detected 100 % (2/2) of the margin-positive cases, also detected by both specimen-PEM evaluation methods with no false-positive margin cases. The mean exposure of the medical staff to 18F was 18 μSv. Conclusions: Specimen-PEM detected invasive and in situ lesions with high accuracy and allowable radiation exposure. Key points: • Specimen-PEM detected invasive and in situ lesions with high accuracy. • Specimen-PEM predicted complete resection with the same accuracy as frozen section analysis. • Breast-conserving surgery after fluorodeoxyglucose injection was performed with low medical staff exposure.

Original languageEnglish
Pages (from-to)1929-1937
Number of pages9
JournalEuropean Radiology
Volume28
Issue number5
DOIs
Publication statusPublished - 2018 May 1

Keywords

  • Breast-conserving surgery
  • Fluorodeoxyglucose
  • Frozen section analysis
  • Positron emission mammography
  • Surgical margin

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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