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New studies suggest that Fluoro-deoxy Glucose PET/CT can detect small breast lesions, also lesions in dense breast.

The Journal of ‘Clinical Radiology’ states that a prospective study was conducted to study the efficacy of dual time point imaging technique using 2- [18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography/computed tomography (PET/CT) to detect primary breast cancer and to determine whether it is useful for the detection of small and non-invasive cancers, as well as cancers in dense breast tissue.

FDG, a glucose analog, is taken up by high-glucose-using cells such as brain, kidney, and cancer cells, where phosphorylation prevents the glucose from being released intact. FDG-PET can be used for diagnosis, staging, and monitoring treatment of cancers. FDG in solution is typically injected rapidly into a saline drip running into a vein, in a patient who has been fasting for at least 6 hours. Then, the patient is placed in the PET scanner for a series of one or more scans. PET scans will detect the areas with increased glucose uptake.

In the study, two sequential PET/CT examinations (dual time point imaging) was done on one hundred and eleven patients with newly diagnosed breast cancer for preoperative staging. The maximum standardized uptake value (SUVmax) of FDG was measured from both time points. The percentage change in SUVmax (ΔSUVmax %) between time points 1 (SUVmax1) and 2 (SUVmax2) was calculated. The patients were divided into groups: invasive, non invasive; large, small; tumours in dense breasts, and tumours in non-dense breasts. The tumour: background (T: B) ratios at both time points were measured and the ΔSUVmax%, ΔT: B% values were calculated. All PET study results were correlated with the histopathology results.

The author, A.A. Zytoon, Faculty of Medicine, Radiology Department, Menoufiya University Shebin El-Koom, Egypt, concludes the study that dual time point FDG-PET/CT improves the discrimination between non-invasive and invasive cancers, and provided superior sensitivity for the detection of small cancers and cancers in dense breast.