Course Description
Positron emission mammography (PEM) is part of the diagnostic toolkit used to help assess patients that have detectable abnormalities in their mammogram.  Both PEM and positron emission tomography (PET) can provide functional imaging by using ¹⁸F-fluorodeoxyglucose (18F-FDG) that provides detailed information on localization and normal and abnormal contrast uptake in breast tissue. It also provides biochemical and physiological activity of cells at the molecular level and assists in identifying the grade and stage during presurgical planning and helps evaluate treatment options.  Unlike PET, PEM is designed for imaging small body parts and utilizes gentle immobilization of the breast to attain higher spatial resolution.

The dedicated PET breast scanner (PEM) has much higher sensitivity and spatial resolution compared with whole-body PET computed tomography scanners. The crystal detectors in PEM are constructed to provide this improved spatial resolution. The design of a dedicated PET system for breast imaging was first presented in 1994, and since then, different approaches have been developed to enhance the detectability of breast lesions. These scanners can use positioning like mammography or patients can be imaged in the prone position. Multiple scanner designs were developed and evaluated in a small number of patients which set the stage for the currently available commercial PEM scanners.

This book chapter will first discuss the principles behind molecular imaging with positron emitting isotopes and the technical and performance parameters important to the design of dedicated PEM scanners. Early clinical results and comparisons to whole-body PET and magnetic resonance imaging with various systems will also be reviewed. The potential for PEM-guided biopsy is also discussed, however, the clinical utility requires further investigation.

Learning Objectives

After reading the content, the participant should be able to:

• EXPLAIN the mechanism of ¹⁸F-fluorodeoxyglucose in the evaluation of breast cancer.
• LIST the key technical performance factors of whole-body PET scanners limiting their use for breast imaging.
• DESCRIBE the common scintillation crystals used in PET scanners and their use in PEM.
• DISCUSS the differences in early prototype PEM scanners.
• COMPARE various types PEM scanners based on technical capabilities, construction, and performance in clinical trials.

 

Categories: Mammography, Nuclear Medicine, Technology

In order to receive CE credit, you must first complete the activity content. When completed, go to the "Take CE Test!" link to access the post-test.

Submit the completed answers to determine if you have passed the post-test assessment. You must answer 12 out of 15 questions correctly to receive the CE credit. You will have no more than 3 attempts to successfully complete the post-test.

Participants successfully completing the activity content and passing the post-test will receive 1.5 ARRT Category A credits.

Approved by the state of Florida for ARRT Category A credit.

Approved by the Medical Dosimetrist Certification Board for MDCB credit.

This activity may be available in multiple formats or from different sponsors. ARRT does not allow CE activities such as Internet courses, home study programs, or directed readings to be repeated for CE credit in the same biennium.    

Category	Content Area	Credits
Nuclear Medicine	Procedures	0.75

Category	Subcategory	Credits
Nuclear Medicine	Endocrine and Oncology Procedures	0.75

Category	Credits
Digital	0
Fluoroscopy	0
Mammography	0.25