Molecular Imaging and Biology

, Volume 8, Issue 6, pp 355–362 | Cite as

Standardized Uptake Values of Normal Breast Tissue with 2-Deoxy-2-[F-18]Fluoro-d-glucose Positron Emission Tomography: Variations with Age, Breast Density, and Menopausal Status

  • Rakesh KumarEmail author
  • Anil Chauhan
  • Hongming Zhuang
  • Prem Chandra
  • Mitchell Schnall
  • Abass Alavi
Research Article



This study was conducted to assess the effect of breast density, age, and menopausal status on the 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) uptake in normal breast tissue by quantitative standardized uptake values (SUV).


A total of 96 patients (premenopausal 54; postmenopausal 42) with histologically proven unilateral breast cancer who underwent FDG-positron emission tomography (PET) scans for staging were included in this study. The median age was 52±11 years (range 32–79 years). Fifty-nine patients had grade III or IV mammographic density (dense breast), whereas 37 patients had grade I or II breast density (nondense) according to the ACR Lexicon criteria. In the present study, we analyzed maximum and average SUVs for contralateral normal breast.


Maximum and average SUVs for normal dense breasts were 1.02±0.30 and 0.84±0.27, respectively. Similar values for the nondense breasts were 0.66±0.24 and 0.53±0.23, respectively. Both maximum and average SUVs of dense breasts were significantly higher than those of nondense breasts (p<0.001). There was no significant difference in SUVs of nipple in patients with dense and nondense breasts. There was no significant effect of age and menopausal status on SUVs of normal breast. However, there were trends of negative relationship, i.e., decreasing SUVs with increasing age.


There was a significant difference in SUVs between the dense and nondense normal breast. However, the maximum SUVs in the dense breasts were well below the threshold of 2.5, a widely used cutoff value for malignancy. Menopausal status and age do not significantly affect the uptake of FDG.

Key words

FDG-PET Breast cancer Breast density Menopause Standardized uptake value 



This work was supported by Public Health Services Research Grant M01-RR00040 from NIH. Rakesh Kumar, M.D., was financially supported by UICC (International Union Against Cancer) Geneva, Switzerland under ACSBI fellowship.


  1. 1.
    Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, et al. (2005) Cancer statistics, 2005. CA Cancer J Clin 55:10–30PubMedCrossRefGoogle Scholar
  2. 2.
    Surveillance, Epidemiology, and End Results (SEER) Program SEER Statistics Database: Incidence—SEE (1973–2000), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch
  3. 3.
    Rosenberg RD, Hunt WC, Williamson MR, Gilliland FD, Wiest PW, Kelsey CA, et al. (1998) Effects of age, breast density, ethnicity, and estrogen replacement therapy on screening mammographic sensitivity and cancer stage at diagnosis: review of 183,134 screening mammograms in Albuquerque, New Mexico. Radiology 209:511–518PubMedGoogle Scholar
  4. 4.
    Baines CJ, Miller AB, Wall C, McFarlane DV, Simor IS, Jong R, et al. (1986) Sensitivity and specificity of first screen mammography in the Canadian National Breast Screening Study: a preliminary report from five centers. Radiology 160:295–298PubMedGoogle Scholar
  5. 5.
    Fletcher SW, Black W, Harris R, Rimer BK, Shapiro S (1993) Report of the International Workshop on Screening for Breast Cancer. J Natl Cancer Inst 85:1644–1656PubMedGoogle Scholar
  6. 6.
    Tabar L, Fagerberg G, Chen HH, Duffy SW, Smart CR, Gad A, et al. (1995) Efficacy of breast cancer screening by age. New results from the Swedish Two-County Trial. Cancer 75:2507–2517CrossRefPubMedGoogle Scholar
  7. 7.
    Frisell J, Klund G, Hellstrom L (1991) Randomized study of mammography screening: preliminary report on mortality in the Stockholm trial. Breast Cancer Res Treat 18:49–56CrossRefPubMedGoogle Scholar
  8. 8.
    Kolb TM, Lichy J, Newhouse JH (2002) Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology 225:165–175PubMedGoogle Scholar
  9. 9.
    Salvatore M, Del Vecchio S (1998) Dynamic imaging: scintimammography. Eur J Radiol 27 Suppl 2:S259–264CrossRefPubMedGoogle Scholar
  10. 10.
    Mandelson MT, Oestreicher N, Porter PL, White D, Finder CA, Taplin SH, et al. (2000) Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst 92:1081–1087CrossRefPubMedGoogle Scholar
  11. 11.
    Lehman CD, White E, Peacock S, Drucker MJ, Urban N (1999) Effect of age and breast density on screening mammograms with false-positive findings. AJR 173:1651–1655PubMedGoogle Scholar
  12. 12.
    Nieweg OE, Kim EE, Wong WH (1993) Positron emission tomography with fluorine-18-deoxyglucose in the detection and staging of breast cancer. Cancer 71:3920–3925CrossRefPubMedGoogle Scholar
  13. 13.
    Hoh CK, Schiepers C (1999) 18-FDG imaging in breast cancer. Semin Nucl Med 29:49–56CrossRefPubMedGoogle Scholar
  14. 14.
    Adler LP, Crowe JP, al-Kaisi NK, Sunshine JL (1993) Evaluation of breast masses and axillary lymph nodes with [F-18]2-deoxy-2-fluoro- d-glucose PET. Radiology 187:743–750PubMedGoogle Scholar
  15. 15.
    Palmedo H, Bender H, Grunwald F, Mallmann P, Zamora P, Krebs D, et al. (1997) Comparison of fluorine-18 fluorodeoxyglucose positron emission tomography and technetium-99m methoxyisobutylisonitrile scintimammography in the detection of breast tumours. Eur J Nucl Med 24:1138–1145PubMedGoogle Scholar
  16. 16.
    Avril N, Dose J, Janicke F, Bense S, Ziegler S, Laubenbacher C, et al. (1996) Metabolic characterization of breast tumors with positron emission tomography using F-18 fluorodeoxyglucose. J Clin Oncol 14:1848–1857PubMedGoogle Scholar
  17. 17.
    Alavi A, Kung JW, Zhuang H (2004) Implications of PET based molecular imaging on the current and future practice of medicine. Semin Nucl Med 34:56–69CrossRefPubMedGoogle Scholar
  18. 18.
    Vranjesevic D, Schiepers C, Silverman DH, Quon A, Villalpando J, Dahlbom M, et al. (2003) Relationship between 18F-FDG uptake and breast density in women with normal breast tissue. J Nucl Med 44:1238–1242PubMedGoogle Scholar
  19. 19.
    Kumar R, Schnall MD, Alavi A (2004) 18F-FDG uptake and breast density in women with normal breast tissue. J Nucl Med 45:1423–1424PubMedGoogle Scholar
  20. 20.
    Pisano ED, Yaffe MJ (2005) Digital mammography. Radiology 234:353–362PubMedGoogle Scholar
  21. 21.
    Kumar R, Alavi A (2004) Fluorodeoxyglucose-PET in the management of breast cancer. Radiol Clin North Am 42:1113–1122CrossRefPubMedGoogle Scholar
  22. 22.
    Ciatto S, Zappa MA (1993) A prospective study of the value of mammographic patterns as indicators of breast cancer risk in a screening experience. Eur J Radiol 17:122–125CrossRefPubMedGoogle Scholar
  23. 23.
    Flook D, Gilhome RW, Harman J, Gravelle IH, Webster DJ (1987) Changes in Wolfe mammographic patterns with aging. Br J Radiol 60:455–456PubMedCrossRefGoogle Scholar
  24. 24.
    Wolfe JN (1976) Breast parenchymal patterns and their changes with age. Radiology 121:545–552PubMedGoogle Scholar
  25. 25.
    Kerlikowske K, Grady D, Barclay J, Sickles EA, Ernster V (1996) Effect of age, breast density, and family history on the sensitivity of first screening mammography. JAMA 276:33–38CrossRefPubMedGoogle Scholar
  26. 26.
    Zasadny KR, Wahl RL (1993) Standardised uptake values of normal tissues at PET with 2-[fluorine-18]-fluoro-2-deoxy-d-glucose: variations with body weight and a method for correction. Radiology 189:847–850PubMedGoogle Scholar

Copyright information

© Academy of Molecular Imaging 2006

Authors and Affiliations

  • Rakesh Kumar
    • 1
    • 2
    Email author
  • Anil Chauhan
    • 1
  • Hongming Zhuang
    • 2
  • Prem Chandra
    • 1
  • Mitchell Schnall
    • 2
  • Abass Alavi
    • 2
  1. 1.Department of Nuclear MedicineAll-India Institute of Medical SciencesNew DelhiIndia
  2. 2.Division of Nuclear Medicine, Department of RadiologyHospital of the University of PennsylvaniaPhiladelphiaUSA

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