Reproducibility assessment of uptake on dedicated breast PET for noise discrimination.

Autor: Yuge S; Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan., Miyake KK; Department of Advanced Medical Imaging Research, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-Cho, Sakyo-Ku, Kyoto City, Kyoto, Japan, 606-8507. kanaek@kuhp.kyoto-u.ac.jp., Ishimori T; Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan., Kataoka M; Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan., Matsumoto Y; Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan., Fujimoto K; Department of Real World Data Research and Development, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto, Japan., Sugie T; Department of Breast Surgery, Kansai Medical University Hospital, Hirakata City, Osaka, Japan., Toi M; Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan., Nakamoto Y; Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan.
Jazyk: angličtina
Zdroj: Annals of nuclear medicine [Ann Nucl Med] 2023 Feb; Vol. 37 (2), pp. 121-130. Date of Electronic Publication: 2022 Nov 25.
DOI: 10.1007/s12149-022-01809-6
Abstrakt: Objectives: Dedicated breast PET (dbPET) systems have improved the detection of small breast cancers but have increased false-positive diagnoses due to an increased chance of noise detection. This study examined whether reproducibility assessment using paired images helped to improve noise discrimination and diagnostic performance in dbPET.
Methods: This study included 21 patients with newly diagnosed breast cancer who underwent [ 18 F]FDG-dbPET and contrast-enhanced breast MRI. A 10-min dbPET data scan was acquired per breast, and two sets of reconstructed images were generated (named dbPET-1 and dbPET-2, respectively), each of which consisted of randomly allocated 5-min data from the 10-min data. Uptake spots higher than the background were indexed for the study with visual assessment. All indexed uptakes on dbPET-1 were evaluated using dbPET-2 for reproducibility. MRI findings based on the Breast Imaging-Reporting and Data System (BI-RADS) 2013 were used as the gold standard. Uptake spots that corresponded to BI-RADS 1 on MRI were considered noise, while those with BI-RADS 4b-6 were considered malignancies. The diagnostic performance of dbPET for malignancy was evaluated using four different criteria: any uptake on dbPET-1 regarded as positive (criterion A), a subjective visual assessment of dbPET-1 (criterion B), reproducibility assessment between dbPET-1 and dbPET-2 (criterion C), and a combination of B and C (criterion D).
Results: A total of 213 indexed uptake spots were identified on dbPET-1, including 152, 15, 6, 6, and 34 lesions classified as BI-RADS MRI categories 1, 2, 4b, 4c, and 5, respectively. Overall, 31.9% of the index uptake values were reproducible. All malignant lesions were reproducible, whereas 93.4% of noise was not reproducible. The sensitivities for malignancy for criteria A, B, C, and D were 100%, 91.3%, 100%, and 91.3%, respectively, with positive predictive values (PPVs) of 21.4%, 68.9%, 67.6%, and 82.4%, respectively.
Conclusions: Our results demonstrated that reproducibility assessment helped reduce false-positive findings caused by noise on dbPET without lowering the sensitivity for malignancy. While subjective visual assessment was also efficient in increasing PPV, it occasionally missed malignant uptake.
(© 2022. The Author(s) under exclusive licence to The Japanese Society of Nuclear Medicine.)
Databáze: MEDLINE
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