一項(xiàng)近期進(jìn)行的研究試圖確定是否正電子發(fā)射乳房影像檢查(PEM)通過(guò)高清晰度正電子發(fā)射影像掃描捕獲影像能否有效鑒別那些已經(jīng)被傳統(tǒng)乳房影像檢查手段發(fā)現(xiàn)的乳房病變是良性的還是惡性的。

前瞻性的、研究院評(píng)審委員會(huì)（Institutional Review Board）批準(zhǔn)的臨床試驗(yàn)是由Naviscan PET系統(tǒng)集團(tuán)主持的，該集團(tuán)公司是這項(xiàng)臨床試驗(yàn)中使用的PET掃描儀(Pem Flex)的開(kāi)發(fā)商，28例女性患者通過(guò)乳房X線攝影術(shù)、超聲波、核磁共振、和/或者觸診發(fā)現(xiàn)了34個(gè)病變；在靜脈注射10-15mCI F-18deoxyglucose（FDG）后，接受了PEM影像檢查。通過(guò)在可疑病變區(qū)域?qū)哿课镔|(zhì)的局灶性增加來(lái)評(píng)估影像；定量比例為病變/背景。對(duì)影像的解釋結(jié)果與27例患者32個(gè)病變的活檢結(jié)果進(jìn)行了比較。其余兩例乳房病變?cè)诮邮芑顧z之前已經(jīng)縮小或者消退，因此取消了活檢。

PEM影像檢查成功地鑒別了88％的乳房病變，陽(yáng)性預(yù)測(cè)值為94％。PEM鑒別出了幾個(gè)乳房X線影像檢查沒(méi)有發(fā)現(xiàn)的病變，導(dǎo)致了患者治療方法的改變。在2例患者中發(fā)現(xiàn)了多生發(fā)中心病變。在這兩個(gè)患者中的一個(gè)，對(duì)側(cè)乳房也發(fā)現(xiàn)了病變。在1例活檢證實(shí)的不典型導(dǎo)管增生患者中，PEM鑒別出了一個(gè)不典型導(dǎo)管增生以及一個(gè)未被懷疑的腫瘤。這些結(jié)果在2004年11月芝加哥舉行的北美放射學(xué)會(huì)上進(jìn)行了報(bào)道。

根據(jù)研究人員的說(shuō)法，這項(xiàng)研究證實(shí)了PEM顯示了能夠精確預(yù)測(cè)那些由其它影像檢查或者體檢發(fā)現(xiàn)的乳房病變的能力。它還能有效檢測(cè)同側(cè)或者對(duì)側(cè)乳房未被懷疑的區(qū)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.