Positron emission mammography (PEM) is a nuclear medicine imaging modality used to detect or characterise breast cancer.[1] Mammography typically refers to x-ray imaging of the breast, while PEM uses an injected positron emitting isotope and a dedicated scanner to locate breast tumors. Scintimammography is another nuclear medicine breast imaging technique, however it is performed using a gamma camera. Breasts can be imaged on standard whole-body PET scanners, however dedicated PEM scanners offer advantages including improved resolution.[2][3]
PEM is not recommended for routine use or for breast cancer screening, in part due to higher radiation dose compared to other modalities.[4] Compared to breast MRI, PEM offers higher specificity.[5] Specific indications can include "high-risk patients with masses > 2 cm or aggressive malignancy and serum tumor marker elevation".[6][7]18F-FDG is the most common radiopharmaceutical used for PEM.[8]
^MacDonald, L.; Edwards, J.; Lewellen, T.; Haseley, D.; Rogers, J.; Kinahan, P. (October 2009). "Clinical imaging characteristics of the positron emission mammography camera: PEM Flex Solo II". J. Nucl. Med. 50 (10): 1666–75. doi:10.2967/jnumed.109.064345. PMC 2873041. PMID 19759118.
^Specht, Jennifer M; Mankoff, David A (16 March 2012). "Advances in molecular imaging for breast cancer detection and characterization". Breast Cancer Research. 14 (2): 206. doi:10.1186/bcr3094. PMC 3446362. PMID 22423895.
^Marino, Maria Adele; Helbich, Thomas H.; Blandino, Alfredo; Pinker, Katja (9 June 2015). "The role of positron emission tomography in breast cancer: a short review". Memo - Magazine of European Medical Oncology. 8 (2): 130–135. doi:10.1007/s12254-015-0210-z. S2CID 68723912.
^Drukteinis, Jennifer S.; Mooney, Blaise P.; Flowers, Chris I.; Gatenby, Robert A. (June 2013). "Beyond Mammography: New Frontiers in Breast Cancer Screening". The American Journal of Medicine. 126 (6): 472–479. doi:10.1016/j.amjmed.2012.11.025. PMC 4010151. PMID 23561631.
^Kalles, Vasileios; Zografos, George C.; Provatopoulou, Xeni; Koulocheri, Dimitra; Gounaris, Antonia (13 December 2012). "The current status of positron emission mammography in breast cancer diagnosis". Breast Cancer. 20 (2): 123–130. doi:10.1007/s12282-012-0433-3. PMID 23239242. S2CID 42928316.
^Fletcher, J. W.; Djulbegovic, B.; Soares, H. P.; Siegel, B. A.; Lowe, V. J.; Lyman, G. H.; Coleman, R. E.; Wahl, R.; Paschold, J. C.; Avril, N.; Einhorn, L. H.; Suh, W. W.; Samson, D.; Delbeke, D.; Gorman, M.; Shields, A. F. (20 February 2008). "Recommendations on the Use of 18F-FDG PET in Oncology". Journal of Nuclear Medicine. 49 (3): 480–508. doi:10.2967/jnumed.107.047787. PMID 18287273.
^Cintolo, Jessica Anna; Tchou, Julia; Pryma, Daniel A. (16 March 2013). "Diagnostic and prognostic application of positron emission tomography in breast imaging: emerging uses and the role of PET in monitoring treatment response". Breast Cancer Research and Treatment. 138 (2): 331–346. doi:10.1007/s10549-013-2451-z. PMID 23504108. S2CID 21975083.
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