Naviscan公司的PEM能够有效检测乳房小肿瘤

一项近期进行的研究试图确定是否正电子发射乳房影像检查(PEM)通过高清晰度正电子发射影像扫描捕获影像能否有效鉴别那些已经被传统乳房影像检查手段发现的乳房病变是良性的还是恶性的。

前瞻性的、研究院评审委员会（Institutional Review Board）批准的临床试验是由Naviscan PET系统集团主持的，该集团公司是这项临床试验中使用的PET扫描仪(Pem Flex)的开发商，28例女性患者通过乳房X线摄影术、超声波、核磁共振、和/或者触诊发现了34个病变；在静脉注射10-15mCI F-18deoxyglucose（FDG）后，接受了PEM影像检查。通过在可疑病变区域对痕量物质的局灶性增加来评估影像；定量比例为病变/背景。对影像的解释结果与27例患者32个病变的活检结果进行了比较。其余两例乳房病变在接受活检之前已经缩小或者消退，因此取消了活检。

PEM影像检查成功地鉴别了88％的乳房病变，阳性预测值为94％。PEM鉴别出了几个乳房X线影像检查没有发现的病变，导致了患者治疗方法的改变。在2例患者中发现了多生发中心病变。在这两个患者中的一个，对侧乳房也发现了病变。在1例活检证实的不典型导管增生患者中，PEM鉴别出了一个不典型导管增生以及一个未被怀疑的肿瘤。这些结果在2004年11月芝加哥举行的北美放射学会上进行了报道。

根据研究人员的说法，这项研究证实了PEM显示了能够精确预测那些由其它影像检查或者体检发现的乳房病变的能力。它还能有效检测同侧或者对侧乳房未被怀疑的区域。
 
Positron Emission Mammography Detects Small Breast Tumors
 
A recent study was performed to determine whether positron emission mammography (PEM) imaging of the breast captured with a high-resolution positron emission tomography (PET) scanner could effectively identify benign or malignant abnormalities in the breast already detected by traditional breast imaging.

In a prospective, Institutional Review Board- (IRB)-approved clinical study conducted by Naviscan PET Systems, Inc. (Rockville, MD, USA), the developer of the PET scanner used in the study (Pem Flex), 28 consecutive women with 34 abnormalities detected by mammography, ultrasound, magnetic resonance imaging (MRI), and/or palpation underwent imaging of each breast with PEM, following an intravenous injection of 10-15 mCI F-18 fluorodeoxyglucose (FDG). Images were assessed for a focally increased uptake of trace at the area of a suspicious abnormality; a quantitative ratio of lesion/background. The image interpretation findings were compared to biopsy results in 27 patients with 32 lesions. The remaining two breast abnormalities decreased or resolved in size before biopsy, and the biopsy was thereby cancelled.

PEM imaging successfully characterized 88% of the breast lesions, with a positive predictive value of 94%. PEM identified several lesions not found on mammography that then led to changes in patient treatment. In two patients, multicentricity was found. In one of two patients, the contralateral breast was involved. In one patient with biopsy-confirmed atypical ductal hyperplasia, PEM identified an atypical ductal hyperplasia and an unsuspected tumor. The results were presented at the 2004 Radiological Society of North America Congress held in Chicago, IL, USA, last November.

This study demonstrated that PEM shows potential as a way to accurately predict the status of breast abnormalities detected by other imaging modalities or physical examination, according to the investigators. It may also play a role in detecting unsuspected additional areas of disease in the same or contralateral breast.