Diagnostic Characteristics and Clinical Relevance of Incidental Hypermetabolic Breast Lesions Detected on 18F-FDG PET-CT: A Retrospective Evaluation
Academic Radiology, cilt.32, sa.4, ss.1806-1815, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.1016/j.acra.2024.11.031
- Dergi Adı: Academic Radiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Sayfa Sayıları: ss.1806-1815
- Anahtar Kelimeler: 18F-FDG PET-CT, Breast, Diagnostic imaging, Incidental
- İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet
Özet
Rationale and Objectives: The study aimed to evaluate demographic and radiological characteristics of breast incidentalomas found on 18-fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (18F-FDG PET-CT) performed for extramammary indications. Materials and Methods: A total of 12633 18F-FDG PET-CT scans performed between January 1, 2018 and January 1, 2024, were retrospectively reviewed. Breast incidentalomas that had undergone breast imaging, tissue diagnosis, or at least 2-year radiological follow-up were included. Demographic data and lesion size were recorded. Maximum and average standardized uptake values (SUVmax-SUVavg) and SUV corrected for lean body mass (SUL) were calculated using region of interest (ROI). Results: The inclusion criteria were met in 101 lesions (81 benign and 20 malignant). The most common benign lesion was fibroadenoma (n = 21), followed by stable lesions during follow-up (n = 18) and benign breast parenchyma (n = 11). The most common malignant lesion was invasive ductal carcinoma (n = 11). The diagnostic characteristics of SUVmax≥ 3, SULmax≥ 2, SUVavg≥ 0.735, SULavg≥ 0.48, and BI-RADS≥ 4 were 75%, 70%, 75%, 70% and 100% for sensitivity, 69%, 69%, 62%, 62% and 67% for specificity, and 69.3%, 68.3%, 62.4%, 61.4% and 73.3% for accuracy, respectively. The highest negative predictive values (NPV) were obtained with BI-RADS and SUVmax (100% and 92%, respectively). No significant difference in malignancy rate was observed for the lesion size and age of the patients (p > 0.05). Conclusion: There is a risk of detecting malignancy in incidental lesions showing 18F-FDG uptake. Radiological workup must be done, but SUVmax, with a high NPV value, can be used in conjunction with BI-RADS assessment for appropriate patient selection and effective management of resources.