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FDG PET/CT for the Detection and Evaluation of Breast Diseases: Usefulness and Limitations¹

¹ From the Departments of Diagnostic Radiology (H.S.L., W.Y., T.W.C., J.K.K., J.G.P., H.K.K.), Nuclear Medicine (H.S.B.), and Surgery (J.H.Y.), Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 160 Ilsimri, Hwasuneup, Hwasungun, Jeollanam-do 519-809, South Korea. Presented as an education exhibit at the 2006 RSNA Annual Meeting. Received February 20, 2007; revision requested March 20 and received April 9; accepted April 18. All authors have no financial relationships to disclose.

View larger version (91K): [in this window] [in a new window] [Download PPT slide]   Figure 1a.  Invasive ductal carcinoma in a 52-year-old woman with a palpable breast mass. (a) US image shows an irregular hypoechoic mass (arrows) with a diameter of approximately 7 cm in the right breast. The posterior aspect of the mass could not be fully evaluated with US. A US-guided biopsy was performed, and cancer was diagnosed on the basis of pathologic analysis. PET/CT then was performed for pretreatment staging. (b) Axial CT attenuation–corrected PET image shows hypermetabolic lesions in the right breast and axilla. (c) Axial fused PET/CT image helped localize areas of FDG uptake (arrowheads) indicative of invasion of the pectoralis muscle.

 

View larger version (49K): [in this window] [in a new window] [Download PPT slide]   Figure 1b.  Invasive ductal carcinoma in a 52-year-old woman with a palpable breast mass. (a) US image shows an irregular hypoechoic mass (arrows) with a diameter of approximately 7 cm in the right breast. The posterior aspect of the mass could not be fully evaluated with US. A US-guided biopsy was performed, and cancer was diagnosed on the basis of pathologic analysis. PET/CT then was performed for pretreatment staging. (b) Axial CT attenuation–corrected PET image shows hypermetabolic lesions in the right breast and axilla. (c) Axial fused PET/CT image helped localize areas of FDG uptake (arrowheads) indicative of invasion of the pectoralis muscle.

 

View larger version (93K): [in this window] [in a new window] [Download PPT slide]   Figure 1c.  Invasive ductal carcinoma in a 52-year-old woman with a palpable breast mass. (a) US image shows an irregular hypoechoic mass (arrows) with a diameter of approximately 7 cm in the right breast. The posterior aspect of the mass could not be fully evaluated with US. A US-guided biopsy was performed, and cancer was diagnosed on the basis of pathologic analysis. PET/CT then was performed for pretreatment staging. (b) Axial CT attenuation–corrected PET image shows hypermetabolic lesions in the right breast and axilla. (c) Axial fused PET/CT image helped localize areas of FDG uptake (arrowheads) indicative of invasion of the pectoralis muscle.

 

View larger version (50K): [in this window] [in a new window] [Download PPT slide]   Figure 2a.  Abscess in a 58-year-old woman with a palpable breast lesion and a previously detected lung mass. (a) Axial CT attenuation–corrected PET image shows a focus of intense FDG uptake (maximum SUV, 11.5) (arrow) in the right anterior thorax. Exact localization of the area of increased uptake (confined to the breast or extending to the chest wall) was difficult on the basis of PET images. (b) Axial CT image shows an isoattenuating lesion (arrow) in the chest wall beneath the breast. (c) Axial PET/CT image shows areas of increased FDG uptake indicative of hypermetabolic lesions in the chest wall (arrow) and lung (arrowhead). (d) US image shows an ill-defined hypoechoic lesion (arrows) in the chest wall. At pathologic analysis, the lesion was diagnosed as a tuberculous abscess. Inflammation surrounding the abscess led to the increased FDG uptake.

 

View larger version (84K): [in this window] [in a new window] [Download PPT slide]   Figure 2b.  Abscess in a 58-year-old woman with a palpable breast lesion and a previously detected lung mass. (a) Axial CT attenuation–corrected PET image shows a focus of intense FDG uptake (maximum SUV, 11.5) (arrow) in the right anterior thorax. Exact localization of the area of increased uptake (confined to the breast or extending to the chest wall) was difficult on the basis of PET images. (b) Axial CT image shows an isoattenuating lesion (arrow) in the chest wall beneath the breast. (c) Axial PET/CT image shows areas of increased FDG uptake indicative of hypermetabolic lesions in the chest wall (arrow) and lung (arrowhead). (d) US image shows an ill-defined hypoechoic lesion (arrows) in the chest wall. At pathologic analysis, the lesion was diagnosed as a tuberculous abscess. Inflammation surrounding the abscess led to the increased FDG uptake.

 

View larger version (96K): [in this window] [in a new window] [Download PPT slide]   Figure 2c.  Abscess in a 58-year-old woman with a palpable breast lesion and a previously detected lung mass. (a) Axial CT attenuation–corrected PET image shows a focus of intense FDG uptake (maximum SUV, 11.5) (arrow) in the right anterior thorax. Exact localization of the area of increased uptake (confined to the breast or extending to the chest wall) was difficult on the basis of PET images. (b) Axial CT image shows an isoattenuating lesion (arrow) in the chest wall beneath the breast. (c) Axial PET/CT image shows areas of increased FDG uptake indicative of hypermetabolic lesions in the chest wall (arrow) and lung (arrowhead). (d) US image shows an ill-defined hypoechoic lesion (arrows) in the chest wall. At pathologic analysis, the lesion was diagnosed as a tuberculous abscess. Inflammation surrounding the abscess led to the increased FDG uptake.

 

View larger version (95K): [in this window] [in a new window] [Download PPT slide]   Figure 2d.  Abscess in a 58-year-old woman with a palpable breast lesion and a previously detected lung mass. (a) Axial CT attenuation–corrected PET image shows a focus of intense FDG uptake (maximum SUV, 11.5) (arrow) in the right anterior thorax. Exact localization of the area of increased uptake (confined to the breast or extending to the chest wall) was difficult on the basis of PET images. (b) Axial CT image shows an isoattenuating lesion (arrow) in the chest wall beneath the breast. (c) Axial PET/CT image shows areas of increased FDG uptake indicative of hypermetabolic lesions in the chest wall (arrow) and lung (arrowhead). (d) US image shows an ill-defined hypoechoic lesion (arrows) in the chest wall. At pathologic analysis, the lesion was diagnosed as a tuberculous abscess. Inflammation surrounding the abscess led to the increased FDG uptake.

 

View larger version (92K): [in this window] [in a new window] [Download PPT slide]   Figure 3a.  Increased FDG uptake in both breasts at whole-body PET/CT performed for cancer screening in a 43-year-old woman. (a) Axial PET/CT image shows areas of diffuse FDG uptake (maximum SUV, 2.2) in both breasts because of higher than normal tissue density. (b) Both craniocaudal mammograms show dense breast tissue, which has higher FDG uptake at PET than does fatty breast tissue.

 

View larger version (109K): [in this window] [in a new window] [Download PPT slide]   Figure 3b.  Increased FDG uptake in both breasts at whole-body PET/CT performed for cancer screening in a 43-year-old woman. (a) Axial PET/CT image shows areas of diffuse FDG uptake (maximum SUV, 2.2) in both breasts because of higher than normal tissue density. (b) Both craniocaudal mammograms show dense breast tissue, which has higher FDG uptake at PET than does fatty breast tissue.

 

View larger version (120K): [in this window] [in a new window] [Download PPT slide]   Figure 4a.  Invasive ductal carcinoma in a 42-year-old woman. (a) US image shows a lobular hypoechoic mass (arrows) in the right breast. The mass was diagnosed as carcinoma on the basis of pathologic analysis of a specimen from US-guided biopsy. PET/CT was performed for pretreatment staging. (b) Axial PET/CT image shows markedly increased FDG uptake (maximum SUV, 8.9) indicative of hypermetabolism in the lesion (arrow).

 

View larger version (79K): [in this window] [in a new window] [Download PPT slide]   Figure 4b.  Invasive ductal carcinoma in a 42-year-old woman. (a) US image shows a lobular hypoechoic mass (arrows) in the right breast. The mass was diagnosed as carcinoma on the basis of pathologic analysis of a specimen from US-guided biopsy. PET/CT was performed for pretreatment staging. (b) Axial PET/CT image shows markedly increased FDG uptake (maximum SUV, 8.9) indicative of hypermetabolism in the lesion (arrow).

 

View larger version (115K): [in this window] [in a new window] [Download PPT slide]   Figure 5a.  Invasive lobular carcinoma in a 50-year-old woman. (a) US image shows an irregular hypoechoic mass (arrows) in the left breast. After a US-guided biopsy, the mass was diagnosed as carcinoma. PET/CT was performed for pretreatment staging. (b) Axial PET/CT image shows slight FDG uptake (maximum SUV, 2.0) in the mass (arrow), a finding characteristic of invasive lobular carcinoma; an invasive ductal carcinoma would have shown more marked uptake.

 

View larger version (96K): [in this window] [in a new window] [Download PPT slide]   Figure 5b.  Invasive lobular carcinoma in a 50-year-old woman. (a) US image shows an irregular hypoechoic mass (arrows) in the left breast. After a US-guided biopsy, the mass was diagnosed as carcinoma. PET/CT was performed for pretreatment staging. (b) Axial PET/CT image shows slight FDG uptake (maximum SUV, 2.0) in the mass (arrow), a finding characteristic of invasive lobular carcinoma; an invasive ductal carcinoma would have shown more marked uptake.

 

View larger version (72K): [in this window] [in a new window] [Download PPT slide]   Figure 6a.  Local metastasis at PET/CT performed for pretreatment staging of invasive ductal carcinoma in a 65-year-old woman. (a) Axial CT image shows an enlarged lymph node (arrow) in the left axillary area, a finding that was not considered to represent metastasis. (b) Axial PET/CT image shows high FDG uptake (maximum SUV, 4.2) in the lymph node (arrow), a finding suggestive of metastasis. Metastasis was confirmed at pathologic analysis.

 

View larger version (84K): [in this window] [in a new window] [Download PPT slide]   Figure 6b.  Local metastasis at PET/CT performed for pretreatment staging of invasive ductal carcinoma in a 65-year-old woman. (a) Axial CT image shows an enlarged lymph node (arrow) in the left axillary area, a finding that was not considered to represent metastasis. (b) Axial PET/CT image shows high FDG uptake (maximum SUV, 4.2) in the lymph node (arrow), a finding suggestive of metastasis. Metastasis was confirmed at pathologic analysis.

 

View larger version (83K): [in this window] [in a new window] [Download PPT slide]   Figure 7a.  Regional metastases at PET/CT performed for pretreatment staging of invasive ductal carcinoma in a 62-year-old woman. (a) Axial PET/CT image shows an area of high FDG uptake (maximum SUV, 12.0) (arrowhead) in the left breast. (b) Axial PET/CT image shows a left supraclavicular lymph node (arrow) with high FDG uptake (maximum SUV, 5.5). (c) Maximum intensity projection reconstruction of CT attenuation–corrected PET image data shows invasive ductal carcinoma (arrowhead) in the left breast and multiple metastases in the left axillary and supraclavicular lymph nodes (arrows).

 

View larger version (97K): [in this window] [in a new window] [Download PPT slide]   Figure 7b.  Regional metastases at PET/CT performed for pretreatment staging of invasive ductal carcinoma in a 62-year-old woman. (a) Axial PET/CT image shows an area of high FDG uptake (maximum SUV, 12.0) (arrowhead) in the left breast. (b) Axial PET/CT image shows a left supraclavicular lymph node (arrow) with high FDG uptake (maximum SUV, 5.5). (c) Maximum intensity projection reconstruction of CT attenuation–corrected PET image data shows invasive ductal carcinoma (arrowhead) in the left breast and multiple metastases in the left axillary and supraclavicular lymph nodes (arrows).

 

View larger version (80K): [in this window] [in a new window] [Download PPT slide]   Figure 7c.  Regional metastases at PET/CT performed for pretreatment staging of invasive ductal carcinoma in a 62-year-old woman. (a) Axial PET/CT image shows an area of high FDG uptake (maximum SUV, 12.0) (arrowhead) in the left breast. (b) Axial PET/CT image shows a left supraclavicular lymph node (arrow) with high FDG uptake (maximum SUV, 5.5). (c) Maximum intensity projection reconstruction of CT attenuation–corrected PET image data shows invasive ductal carcinoma (arrowhead) in the left breast and multiple metastases in the left axillary and supraclavicular lymph nodes (arrows).

 

View larger version (83K): [in this window] [in a new window] [Download PPT slide]   Figure 8a.  Extensive metastatic disease at PET/CT performed for pretreatment staging of invasive ductal carcinoma in a 48-year-old woman. (a–c) Axial fused PET/CT images of the upper thorax (a), abdomen (b), and pelvis (c) show multiple areas of increased FDG uptake. (d) Maximum intensity projection reconstruction of CT attenuation–corrected PET image data shows extensive metastases in the liver, bones (left clavicle, both scapulae, sternum, ribs, cervical spine, thoracolumbar spine, pelvis, and both femora), and lymph nodes (axillary, neck, aortocaval, and portacaval).

 

View larger version (85K): [in this window] [in a new window] [Download PPT slide]   Figure 8b.  Extensive metastatic disease at PET/CT performed for pretreatment staging of invasive ductal carcinoma in a 48-year-old woman. (a–c) Axial fused PET/CT images of the upper thorax (a), abdomen (b), and pelvis (c) show multiple areas of increased FDG uptake. (d) Maximum intensity projection reconstruction of CT attenuation–corrected PET image data shows extensive metastases in the liver, bones (left clavicle, both scapulae, sternum, ribs, cervical spine, thoracolumbar spine, pelvis, and both femora), and lymph nodes (axillary, neck, aortocaval, and portacaval).

 

View larger version (80K): [in this window] [in a new window] [Download PPT slide]   Figure 8c.  Extensive metastatic disease at PET/CT performed for pretreatment staging of invasive ductal carcinoma in a 48-year-old woman. (a–c) Axial fused PET/CT images of the upper thorax (a), abdomen (b), and pelvis (c) show multiple areas of increased FDG uptake. (d) Maximum intensity projection reconstruction of CT attenuation–corrected PET image data shows extensive metastases in the liver, bones (left clavicle, both scapulae, sternum, ribs, cervical spine, thoracolumbar spine, pelvis, and both femora), and lymph nodes (axillary, neck, aortocaval, and portacaval).

 

View larger version (71K): [in this window] [in a new window] [Download PPT slide]   Figure 8d.  Extensive metastatic disease at PET/CT performed for pretreatment staging of invasive ductal carcinoma in a 48-year-old woman. (a–c) Axial fused PET/CT images of the upper thorax (a), abdomen (b), and pelvis (c) show multiple areas of increased FDG uptake. (d) Maximum intensity projection reconstruction of CT attenuation–corrected PET image data shows extensive metastases in the liver, bones (left clavicle, both scapulae, sternum, ribs, cervical spine, thoracolumbar spine, pelvis, and both femora), and lymph nodes (axillary, neck, aortocaval, and portacaval).

 

View larger version (129K): [in this window] [in a new window] [Download PPT slide]   Figure 9a.  Initial and follow-up imaging of recurrent invasive ductal carcinoma in a 60-year-old woman with a palpable right breast mass after a left total mastectomy. (a) Initial US image shows an irregular hypoechoic mass (arrows) in the right breast. The mass was diagnosed on the basis of US-guided biopsy as invasive ductal carcinoma. Because of the patient’s generally poor clinical condition, chemotherapy was administered. (b) Pretreatment coronal PET/CT image shows increased FDG uptake (maximum SUV, 8.7) indicative of hypermetabolism in the lesion (arrow). (c) Posttreatment coronal PET/CT image shows decreased FDG uptake (maximum SUV, 5.6) indicative of a chemotherapy-induced reduction in metabolic activity in the tumor (arrow).

 

View larger version (95K): [in this window] [in a new window] [Download PPT slide]   Figure 9b.  Initial and follow-up imaging of recurrent invasive ductal carcinoma in a 60-year-old woman with a palpable right breast mass after a left total mastectomy. (a) Initial US image shows an irregular hypoechoic mass (arrows) in the right breast. The mass was diagnosed on the basis of US-guided biopsy as invasive ductal carcinoma. Because of the patient’s generally poor clinical condition, chemotherapy was administered. (b) Pretreatment coronal PET/CT image shows increased FDG uptake (maximum SUV, 8.7) indicative of hypermetabolism in the lesion (arrow). (c) Posttreatment coronal PET/CT image shows decreased FDG uptake (maximum SUV, 5.6) indicative of a chemotherapy-induced reduction in metabolic activity in the tumor (arrow).

 

View larger version (110K): [in this window] [in a new window] [Download PPT slide]   Figure 9c.  Initial and follow-up imaging of recurrent invasive ductal carcinoma in a 60-year-old woman with a palpable right breast mass after a left total mastectomy. (a) Initial US image shows an irregular hypoechoic mass (arrows) in the right breast. The mass was diagnosed on the basis of US-guided biopsy as invasive ductal carcinoma. Because of the patient’s generally poor clinical condition, chemotherapy was administered. (b) Pretreatment coronal PET/CT image shows increased FDG uptake (maximum SUV, 8.7) indicative of hypermetabolism in the lesion (arrow). (c) Posttreatment coronal PET/CT image shows decreased FDG uptake (maximum SUV, 5.6) indicative of a chemotherapy-induced reduction in metabolic activity in the tumor (arrow).

 

View larger version (92K): [in this window] [in a new window] [Download PPT slide]   Figure 10a.  Pretreatment staging and follow-up imaging of non-Hodgkin lymphoma in a 32-year-old woman. (a) Axial PET/CT image shows a hypermetabolic (maximum SUV, 21.0) lesion (arrow) in the right breast. US-guided biopsy revealed lymphomatous involvement of the right breast. (b) Axial PET/CT image, obtained after chemotherapy, shows a lessening of lymphomatous involvement.

 

View larger version (82K): [in this window] [in a new window] [Download PPT slide]   Figure 10b.  Pretreatment staging and follow-up imaging of non-Hodgkin lymphoma in a 32-year-old woman. (a) Axial PET/CT image shows a hypermetabolic (maximum SUV, 21.0) lesion (arrow) in the right breast. US-guided biopsy revealed lymphomatous involvement of the right breast. (b) Axial PET/CT image, obtained after chemotherapy, shows a lessening of lymphomatous involvement.

 

View larger version (118K): [in this window] [in a new window] [Download PPT slide]   Figure 11.  Extensive metastatic disease at PET/CT in a 38-year-old woman with elevated blood serum levels of tumor markers after a left total mastectomy for invasive ductal carcinoma. Axial fused PET/CT images at progressively lower levels (left and bottom) show multiple areas of increased FDG uptake. Maximum intensity projection reconstruction of CT attenuation–corrected PET image data (right) shows multiple metastases in the right lower internal jugular, right supraclavicular, paratracheal, internal mammary, and tracheobronchial lymph nodes; the left adrenal gland; and the left pubic bone and right acromion.

 

View larger version (82K): [in this window] [in a new window] [Download PPT slide]   Figure 12a.  False-positive finding at PET/CT during preoperative staging of rectal cancer in a 47-year-old woman. (a) Axial PET/CT image shows a hypermetabolic (maximum SUV, 5.7) lesion (arrow) in the right breast, a finding that was believed to represent breast cancer. (b) Subsequent US image shows an oval circumscribed mass (arrows) in the right subareolar area. A US-guided biopsy was performed, and the mass was diagnosed on the basis of pathologic analysis as a chronic abscess.

 

View larger version (97K): [in this window] [in a new window] [Download PPT slide]   Figure 12b.  False-positive finding at PET/CT during preoperative staging of rectal cancer in a 47-year-old woman. (a) Axial PET/CT image shows a hypermetabolic (maximum SUV, 5.7) lesion (arrow) in the right breast, a finding that was believed to represent breast cancer. (b) Subsequent US image shows an oval circumscribed mass (arrows) in the right subareolar area. A US-guided biopsy was performed, and the mass was diagnosed on the basis of pathologic analysis as a chronic abscess.

 

View larger version (129K): [in this window] [in a new window] [Download PPT slide]   Figure 13a.  False-positive finding at PET/CT during restaging and follow-up after breast-conserving surgery and radiation therapy for invasive ductal carcinoma in a 53-year-old woman. (a) Mammogram shows an area of postoperative and radiation-induced change (arrow) in the outer region of the left breast. (b) Axial PET/CT image shows a focus of FDG uptake (maximum SUV, 3.1) (arrow) in the upper outer region of the left breast. A US-guided biopsy was performed, and pathologic analysis showed no evidence of a recurrence.

 

View larger version (78K): [in this window] [in a new window] [Download PPT slide]   Figure 13b.  False-positive finding at PET/CT during restaging and follow-up after breast-conserving surgery and radiation therapy for invasive ductal carcinoma in a 53-year-old woman. (a) Mammogram shows an area of postoperative and radiation-induced change (arrow) in the outer region of the left breast. (b) Axial PET/CT image shows a focus of FDG uptake (maximum SUV, 3.1) (arrow) in the upper outer region of the left breast. A US-guided biopsy was performed, and pathologic analysis showed no evidence of a recurrence.

 

View larger version (109K): [in this window] [in a new window] [Download PPT slide]   Figure 14a.  False-negative finding at PET/CT during staging of ovarian cancer in a 56-year-old woman. (a) Mammogram of the left breast, obtained before the administration of hormonal therapy, shows a cluster of pleomorphic and amorphous microcalcifications (arrows). The pathologic diagnosis after a wire localization biopsy was ductal carcinoma in situ. (b) Axial PET/CT image shows no corresponding area of increased FDG uptake.

 

View larger version (98K): [in this window] [in a new window] [Download PPT slide]   Figure 14b.  False-negative finding at PET/CT during staging of ovarian cancer in a 56-year-old woman. (a) Mammogram of the left breast, obtained before the administration of hormonal therapy, shows a cluster of pleomorphic and amorphous microcalcifications (arrows). The pathologic diagnosis after a wire localization biopsy was ductal carcinoma in situ. (b) Axial PET/CT image shows no corresponding area of increased FDG uptake.

 

View larger version (116K): [in this window] [in a new window] [Download PPT slide]   Figure 15a.  False-negative finding at PET/CT during restaging of ovarian cancer in a 63-year-old woman. (a) Image obtained at US, which was performed for evaluation of a palpable lesion in the left breast, shows an approximately 0.8-cm-diameter irregular mass (arrows) in the right breast. The diagnosis of the right breast lesion, based on pathologic analysis after a US-guided biopsy, was tubular carcinoma. (b) Axial PET/CT image shows no hypermetabolic lesion.

 

View larger version (99K): [in this window] [in a new window] [Download PPT slide]   Figure 15b.  False-negative finding at PET/CT during restaging of ovarian cancer in a 63-year-old woman. (a) Image obtained at US, which was performed for evaluation of a palpable lesion in the left breast, shows an approximately 0.8-cm-diameter irregular mass (arrows) in the right breast. The diagnosis of the right breast lesion, based on pathologic analysis after a US-guided biopsy, was tubular carcinoma. (b) Axial PET/CT image shows no hypermetabolic lesion.

 

View larger version (90K): [in this window] [in a new window] [Download PPT slide]   Figure 16a.  Unexpected primary breast cancer detected at PET/CT performed for restaging of rectal cancer in a 60-year-old woman. (a) Axial PET/CT image shows a hypermetabolic (maximum SUV, 10.4) lesion (arrow) in the right breast. Subsequent mammography and US were performed. (b) US image shows the lesion (arrows), which was diagnosed at pathologic analysis after US-guided biopsy as apocrine carcinoma of the breast.

 

View larger version (135K): [in this window] [in a new window] [Download PPT slide]   Figure 16b.  Unexpected primary breast cancer detected at PET/CT performed for restaging of rectal cancer in a 60-year-old woman. (a) Axial PET/CT image shows a hypermetabolic (maximum SUV, 10.4) lesion (arrow) in the right breast. Subsequent mammography and US were performed. (b) US image shows the lesion (arrows), which was diagnosed at pathologic analysis after US-guided biopsy as apocrine carcinoma of the breast.

 

View larger version (83K): [in this window] [in a new window] [Download PPT slide]   Figure 17a.  Unexpected primary cancer detected at PET/CT performed for restaging of invasive ductal carcinoma in a 62-year-old woman after a right total mastectomy. (a) Axial PET/CT image shows a hypermetabolic (maximum SUV, 5.5) lesion (arrow) in the right lobe of the thyroid gland. (b) US image shows a hypoechoic nodule (arrow) in the right thyroid lobe. A US-guided fine needle aspiration biopsy was performed. The pathologic diagnosis was thyroid papillary carcinoma.

 

View larger version (98K): [in this window] [in a new window] [Download PPT slide]   Figure 17b.  Unexpected primary cancer detected at PET/CT performed for restaging of invasive ductal carcinoma in a 62-year-old woman after a right total mastectomy. (a) Axial PET/CT image shows a hypermetabolic (maximum SUV, 5.5) lesion (arrow) in the right lobe of the thyroid gland. (b) US image shows a hypoechoic nodule (arrow) in the right thyroid lobe. A US-guided fine needle aspiration biopsy was performed. The pathologic diagnosis was thyroid papillary carcinoma.

 

View larger version (110K): [in this window] [in a new window] [Download PPT slide]   Figure 18a.  Fibroadenoma in the left breast of a 43-year-old woman. (a) US image obtained for routine monitoring of a previously diagnosed fibroadenoma shows a well-circumscribed oval mass (arrow). (b) Axial PET/CT image shows no significant uptake (maximum SUV, 1.6) in the mass (arrow).

 

View larger version (77K): [in this window] [in a new window] [Download PPT slide]   Figure 18b.  Fibroadenoma in the left breast of a 43-year-old woman. (a) US image obtained for routine monitoring of a previously diagnosed fibroadenoma shows a well-circumscribed oval mass (arrow). (b) Axial PET/CT image shows no significant uptake (maximum SUV, 1.6) in the mass (arrow).

 

View larger version (87K): [in this window] [in a new window] [Download PPT slide]   Figure 19a.  False-positive finding at PET/CT in a 47-year-old woman. (a) Axial PET/CT image shows a hypermetabolic (maximum SUV, 3.5) lesion (arrowhead) in the right breast, a finding suggestive of breast cancer. (b) US image shows an irregular mass (arrows) in the upper inner area of the right breast. The diagnosis, based on pathologic analysis of an excisional biopsy specimen, was fibrocystic change with florid ductal hyperplasia, columnar cell hyperplasia, and apocrine metaplasia.

 

View larger version (131K): [in this window] [in a new window] [Download PPT slide]   Figure 19b.  False-positive finding at PET/CT in a 47-year-old woman. (a) Axial PET/CT image shows a hypermetabolic (maximum SUV, 3.5) lesion (arrowhead) in the right breast, a finding suggestive of breast cancer. (b) US image shows an irregular mass (arrows) in the upper inner area of the right breast. The diagnosis, based on pathologic analysis of an excisional biopsy specimen, was fibrocystic change with florid ductal hyperplasia, columnar cell hyperplasia, and apocrine metaplasia.

 

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