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E1548. Imaging Review of PET/CT Findings in the Breast: A Radiologist's Primer with Pearls and Pitfalls
Authors
  1. Katherine Copely; University of Kentucky
  2. Kavya Sudanagunta; University of Kentucky
  3. Margaret Szabunio; University of Kentucky
  4. Riham El Khouli; University of Kentucky
  5. Xiaoqin Wang; University of Kentucky
  6. Wendy Owen; University of Kentucky
  7. Aurela Clark; University of Kentucky
Background
While body CT and bone scintigraphy are the conventional modalities for staging breast cancer, PET/CT has shown its usefulness in staging and treatment planning for breast cancer patients with locoregional and distal metastatic disease. However, there are benign findings that may mimic the appearance of suspicious ones which may result in unnecessary work-up. The purpose of this exhibit is to familiarize the radiologist-in-training with the various patterns of benign uptake that they may encounter, as well as how to recognize suspicious uptake that will require further investigation.

Educational Goals / Teaching Points
Following this case-based presentation, the learner will be able to describe the normal physiological pattern of FDG uptake in the breast, identify the unique patterns of FDG update in various benign breast conditions, understand the role of F18 FDG PET/CT in breast cancer imaging and staging, as well as recognize the major limitations and pitfalls of breast diseases on PET/CT.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This educational exhibit will be divided into two parts. The first part will review 5-6 cases that illustrate the physiologic pattern of uptake in normal breast tissue and various benign breast conditions. These include proliferative changes of lactation, benign post lumpectomy changes, the spectrum of uptake in evolving fat necrosis in the reconstructed breast, among others. The second part will review 7-8 cases that illustrate the pattern of uptake seen in breast cancer and incidental lesions seen within the breast. There will also be discussion on the role of PET/CT in breast cancer staging. Each case will highlight the important teaching points and pitfalls of PET/CT interpretation in breast disease, as well as emphasize strategies on how to recognize these limitations. Patient history and multimodality correlation for problem-solving will be stressed.

Conclusion
PET/CT can be an important tool for radiologists and clinicians to use to optimize care planning for breast cancer patients. Therefore, it is consequential that the radiologist has a strong grasp on the many appearances of benign and malignant breast findings. Where there is smoke, there is not always fire.