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Breast PET Lexicon and Usage
Wendie A. Berg, MD, PhD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Positron emission mammography (PEM) lexicon provides standardized terms to describe imaging findings, impression, and management recommendations
              • Analogous to Breast Imaging Reporting and Data System (BI-RADS) for MR, US, and mammography
              • Structured reporting facilitates communication of results and auditing of outcomes
              • Moderate agreement on terms, management
                • Lesion type, κ = 0.57; final assessment, κ = 0.63
            • Descriptors listed in increasing order of risk of malignancy when possible/applicable
            • Millicurie (mCi): 3.7 x 10⁷ disintegrations per second [where 1 disintegration per second = 1 becquerel (Bq)]
            • Maximum PEM uptake value (PUVmax): Maximum voxel uptake in region of interest (ROI) on single PEM slice
            • LTB ratio: Ratio of PUVmax to mean background uptake

          IMAGING

          • Physiology

            PATHOLOGY

            • Pathology-Based Imaging Issues

              DIAGNOSTIC CHECKLIST

              • Reporting Tips

                • Assessment and Recommendations

                  Selected References

                  1. Narayanan D and Berg WA. Dedicated breast gamma camera imaging and breast PET: Current status and future directions. PET Clinics N Amer. 2018
                  2. Narayanan D and Berg WA: Use of breast-specific PET scanners and comparison with MR imaging. Magn Reson Imaging Clin N Am. 26(2):265-272, 2018
                  3. Noritake M et al: Evaluation of the response to breast cancer neoadjuvant chemotherapy using 18F-FDG positron emission mammography compared with whole-body 18F-FDG PET: A prospective observational study. Clin Nucl Med. 42(3):169-175, 2017
                  4. Berg WA et al: Comparative effectiveness of positron emission mammography and MRI in the contralateral breast of women with newly diagnosed breast cancer. AJR Am J Roentgenol. 198(1):219-32, 2012
                  5. Eo JS et al: Imaging sensitivity of dedicated positron emission mammography in relation to tumor size. Breast. 21(1):66-71, 2012
                  6. Berg WA et al: Breast cancer: comparative effectiveness of positron emission mammography and MR imaging in presurgical planning for the ipsilateral breast. Radiology. 258(1):59-72, 2011
                  7. Narayanan D et al: Interpretation of positron emission mammography and MRI by experienced breast imaging radiologists: performance and observer reproducibility. AJR Am J Roentgenol. 196(4):971-81, 2011
                  8. Narayanan D et al: Interpretation of positron emission mammography: feature analysis and rates of malignancy. AJR Am J Roentgenol. 196(4):956-70, 2011
                  Related Anatomy
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                  References
                  Tables

                  Tables

                  KEY FACTS

                  • Terminology

                    • Imaging

                      • Pathology

                        • Diagnostic Checklist

                          TERMINOLOGY

                          • Definitions

                            • Positron emission mammography (PEM) lexicon provides standardized terms to describe imaging findings, impression, and management recommendations
                              • Analogous to Breast Imaging Reporting and Data System (BI-RADS) for MR, US, and mammography
                              • Structured reporting facilitates communication of results and auditing of outcomes
                              • Moderate agreement on terms, management
                                • Lesion type, κ = 0.57; final assessment, κ = 0.63
                            • Descriptors listed in increasing order of risk of malignancy when possible/applicable
                            • Millicurie (mCi): 3.7 x 10⁷ disintegrations per second [where 1 disintegration per second = 1 becquerel (Bq)]
                            • Maximum PEM uptake value (PUVmax): Maximum voxel uptake in region of interest (ROI) on single PEM slice
                            • LTB ratio: Ratio of PUVmax to mean background uptake

                          IMAGING

                          • Physiology

                            PATHOLOGY

                            • Pathology-Based Imaging Issues

                              DIAGNOSTIC CHECKLIST

                              • Reporting Tips

                                • Assessment and Recommendations

                                  Selected References

                                  1. Narayanan D and Berg WA. Dedicated breast gamma camera imaging and breast PET: Current status and future directions. PET Clinics N Amer. 2018
                                  2. Narayanan D and Berg WA: Use of breast-specific PET scanners and comparison with MR imaging. Magn Reson Imaging Clin N Am. 26(2):265-272, 2018
                                  3. Noritake M et al: Evaluation of the response to breast cancer neoadjuvant chemotherapy using 18F-FDG positron emission mammography compared with whole-body 18F-FDG PET: A prospective observational study. Clin Nucl Med. 42(3):169-175, 2017
                                  4. Berg WA et al: Comparative effectiveness of positron emission mammography and MRI in the contralateral breast of women with newly diagnosed breast cancer. AJR Am J Roentgenol. 198(1):219-32, 2012
                                  5. Eo JS et al: Imaging sensitivity of dedicated positron emission mammography in relation to tumor size. Breast. 21(1):66-71, 2012
                                  6. Berg WA et al: Breast cancer: comparative effectiveness of positron emission mammography and MR imaging in presurgical planning for the ipsilateral breast. Radiology. 258(1):59-72, 2011
                                  7. Narayanan D et al: Interpretation of positron emission mammography and MRI by experienced breast imaging radiologists: performance and observer reproducibility. AJR Am J Roentgenol. 196(4):971-81, 2011
                                  8. Narayanan D et al: Interpretation of positron emission mammography: feature analysis and rates of malignancy. AJR Am J Roentgenol. 196(4):956-70, 2011