diagnostic accuracy of positron emission mammography with 18ffluorodeoxyglucose in breast cancer tumor of less than 20 mm in size

Objective(s): to investigate the diagnostic accuracy of positron emission mammography (pem) and positron emission tomography/computed tomography (pet/ct) for small breast tumors of less than 20 mm in size.methods: the study was conducted on a total of 100 subjects (i.e., 50 patients with pathologically proven breast cancer and 50 normal cases of medical screening). the total number of tumors was 54 (mean size: 11±5.1 mm, range:420 mm). the diagnostic accuracy of pem alone, pet/ct alone, and combined pet/ct and pem was evaluated by two nuclear medicine physicians based on visual inspection. the two groups (i.e., tumors of ≤ 10 mm and > 1020 mm) werecompared in terms of the diagnostic capability of the three modalities (pem alone, pet/ct alone, and pet/ct+pem).results: the sensitivities of pem alone, pet/ct alone, and combined pet/ct and pem were 72%, 60%, and 76%, respectively. the specificities of these tests were 98%, 100%, and 98%, respectively. furthermore, the accuracies of these diagnostic modalities were 85%, 79%, and 87%, respectively. the combined pet/ct and pem showed significantly higher sensitivity and accuracy than pet/ct alone (p=0.005 and p=0.02, respectively). in addition, pem demonstrated asignificantly higher sensitivity than pet/ct in the ≤ 10 mm group (p=0.03); however, no difference was observed between the two modalities in the > 10 mm group in terms of sensitivity.conclusion: 18f-fluorodeoxyglucose pet had limited capability for the detection of small breast cancers of <10 mm. combined pet/ct and pem showed higher sensitivity and accuracy, compared to pet/ct alone.