Dedicated breast PET value to evaluate BI-RADS 4 breast lesions

Clinical Applications of Dedicated Breast Positron Emission Tomography

Breast-specific positron imaging systems provide higher sensitivity than whole-body PET for breast cancer detection. The clinical applications for breast-specific positron imaging are similar to breast MRI including preoperative local staging and neoadjuvant therapy response assessment. Breast-specific positron imaging may be an alternative for patients who cannot undergo breast MRI. Further research is needed in expanding the field-of-view for posterior breast lesions, increasing biopsy capability, and reducing radiation dose. Efforts are also necessary for developing appropriate use criteria, increasing availability, and advancing insurance coverage.

Molecular Breast Imaging and Positron Emission Mammography

There is growing interest in application of functional imaging modalities for adjunct breast imaging due to their unique ability to evaluate molecular/pathophysiologic changes, not visible by standard anatomic breast imaging. This has led to increased use of nuclear medicine dedicated breast-specific single photon and coincidence imaging systems for multiple indications, such as supplemental screening, staging of newly diagnosed breast cancer, evaluation of response to neoadjuvant treatment, diagnosis of local disease recurrence in the breast, and problem solving. Studies show that these systems maybe especially useful for specific subsets of patients, not well served by available anatomic breast imaging modalities.

Application-specific nuclear medicalin vivoimaging devices

Nuclear medical imaging devices, such as those enabling photon emission imaging (gamma camera, single photon emission computed tomography, or positron emission imaging), that are typically used in today's clinics are optimized for assessing large portions of the human body, and are classified as whole-body imaging systems. These systems have known limitations for organ imaging, therefore application-specific devices have been designed, constructed and evaluated. These devices, given their compact nature and superior technical characteristics, such as their higher detection sensitivity and spatial resolution for organ imaging compared to whole-body imaging systems, have shown promise for niche applications. Several of these devices have further been integrated with complementary anatomical imaging devices. The objectives of this review article are to (1) provide an overview of such application-specific nuclear imaging devices that were developed over the past two decades (in the twenty-first century), with emphasis on brain, cardiac, breast, and prostate imaging; and (2) discuss the rationale, advantages and challenges associated with the translation of these devices for routine clinical imaging. Finally, a perspective on the future prospects for application-specific devices is provided, which is that sustained effort is required both to overcome design limitations which impact their utility (where these exist) and to collect the data required to define their clinical value.