Mammography is the standard breast cancer screening procedure, although it is constrained by low specificity in the detection of malignancy and low sensitivity in women with dense breast tissue, implants, and other conditions. Magnetic resonance imaging (MRI), is used to replace or complement mammography in some patients, because the early detection of breast cancer is critical for prompt treatment and long-term survival of patients. However, some patients are unable to undergo MRI imaging. Nuclear imaging with positron emission tomography (PET) plays a role in breast cancer. PET measures metabolism and identifies changes at the cellular level. PET/computed tomography (PET/CT) imaging allows for a more accurate assessment by merging the anatomic localization to the functional image. PET is not a diagnostic tool in early breast cancer detection, primarily because of low sensitivity, especially for sub-centimeter and low-grade tumors. Positron emission mammography (PEM), now referred to as high-resolution breast PET imaging, provides increased spatial resolution to overcome some of the limitations of conventional PET/CT. These systems have demonstrated higher detectability than conventional PET/CT and comparable or better sensitivity than MRI. The ability to target the lesions visible on breast PET imaging with PET-guided breast biopsy systems adds to its utility in the early diagnosis of breast cancer. This review explores the role of breast PET imaging compared with other imaging modalities in breast cancer and discusses how these techniques are being used in clinical practice.
After reading this article, the participant should be able to:
- Explain the limitations of conventional PET/CT in breast imaging.
- Understand the differences between high-resolution breast PET scanners.
- List clinical applications/indications for high-resolution breast PET.
Categories: Nuclear Medicine, Mammography