Correlation between quantified breast densities from digital mammography and 18F-FDG PET uptake

To correlate breast density quantified from digital mammograms with mean and maximum standardized uptake values (SUVs) from positron emission tomography (PET). This was a prospective study that included 56 women with a history of suspicion of breast cancer (mean age 49.2 +/- 9.3 years), who underwent 18F-fluoro-2-deoxyglucose (FDG)-PET imaging of their breasts as well as digital mammography. A computer thresholding algorithm was applied to the contralateral nonmalignant breasts to quantitatively estimate the breast density on digital mammograms. The breasts were also classified into one of four Breast Imaging Reporting and Data System categories for density. Comparisons between SUV and breast density were made using linear regression and the Student's t-test. Linear regression of mean SUV versus average breast density showed a positive relationship with a Pearson's correlation coefficient of R(2) = 0.83. The quantified breast densities and mean SUVs were significantly greater for mammographically dense than nondense breasts (p < 0.0001 for both). The average quantified densities and mean SUVs of the breasts were significantly greater for premenopausal than postmenopausal patients (p < 0.05). 8/51 (16%) of the patients had maximum SUVs that equaled 1.6 or greater. There is a positive linear correlation between quantified breast density on digital mammography and FDG uptake on PET. Menopausal status affects the metabolic activity of normal breast tissue, resulting in higher SUVs in pre- versus postmenopausal patients.