Research Article A Dedicated Breast Positron Emission Tomography Scanner: Proof of Concept Shyam M. Srinivas, MD, PhD a * , Lacey R. Greene, BS, CNMT bc , Geoffrey M. Currie, BPharm, MMedRadSc(NucMed), MAppMngt(Hlth), MBA, PhD de , Richard H. Freifelder, PhD f , Janet R. Reddin, PhD f , Abass Alavi, MD f , Mitchell D. Schnall, MD, PhD f and Joel S. Karp, PhD f a Department of Nuclear Medicine, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA b Department of Nuclear Medicine, Lutheran Hospital, A Cleveland Clinic Regional Hospital, Cleveland, Ohio, USA c Faculty of Health Studies, Wheeling Jesuit University, Wheeling, West Virginia, USA d Faculty of Science, Charles Sturt University, Wagga Wagga, Australia e Australian School of Advanced Medicine, Macquarie University, Sydney, Australia f Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA ABSTRACT Purpose: This study developed and tested a novel scanner con- structed for dedicated positron emission tomography (PET) of the breast. The breast PET (B-PET) scanner is designed with two opposing detectors using curve plate NaI(Tl) detectors to achieve a combination of high spatial resolution and energy resolution. Methods: Phantom and clinical studies (n ¼ 20) with 18 F-fluoro- deoxyglucose were carried out on the whole-body Philips Allegro scanner and the B-PET scanner. Images were subjectively assessed by an expert panel. Results: Phantom studies indicated improved contrast for B-PET over conventional PET. Of the 20 clinical studies with breast cancer demonstrated on whole-body fluorodeoxyglucose PET, 10 B-PET scans showed agreement. Of the remaining 10 studies, three had breasts that were too small to be imaged, four had lesions that were too deep to be captured in the field of view, and three were excluded due to technical errors. Conclusions: Compared with conventional PET, B-PET images provided greater detail in breast lesions suggesting that the low- cost and relatively simple design of B-PET may potentially be an important adjunct to traditional mammography in helping deter- mine the nature of a lesion. R  ESUM  E Objectif : Les auteurs de cette  etude ont d evelopp e et mis  a l’essai un nouveau scanner construit pour la tomographie par  emission de pos- itrons du sein (TEP-S). Le scanner TEP-S est conc ¸u avec deux d etecteurs oppos  es utilisant des d etecteurs NaI(Tl)  a plaque courbe pour obtenir une combinaison de r  esolution spatiale et de r  esolution  energ etique  elev  ees. M erhodologie : Des  etudes sur fant^ omes et des  etudes cliniques (n¼20) au F-18 FDG ont  et  e effectu ees au moyen d’un scanner cor- porel Philips Allegro et du scanner PET-S. Les images ont ensuite fait l’objet d’une  evaluation subjective par un groupe d’experts. R esultats : Les  etudes sur fant^ omes ont montr  e une am elioration du contraste pour le scanner TEP-S par rapport au scanner TEP conven- tionnel. Sur les 20  etudes cliniques de cancer du sein d emontr  e sur balayage corporel TEP au FDG, dix balayages TEP-S ont d emontr  e un accord complet. Parmi les dix  etudes restantes, trois portaient sur un sein trop petit pour l’imagerie, quatre pr  esentaient des l  esions trop profondes pour ^ etre captur  ees et trois ont  et  e exclues en raison d’erreurs techniques. Conclusion : Comparativement au balayage TEP conventionnel, les images TEP-S pr  esentent un degr  e de d etail plus  elev  e des l  esions mammaires, ce qui laisse penser que le faible co^ ut et la conception relativement simple du scanner TEP-S pourraient en faire un ajout potentiellement important  a la mammographie traditionnelle pour aider  ad eterminer la nature d’une l  esion. Introduction Breast cancer remains a major health priority, accounting for 30% of all new cancer cases in women but only 15% of cancer deaths in women [1]. Early detection remains a powerful tool in reducing Financial support: This work was supported by funding from National Institutes of Health P01-CA85424 and DOE DE-FGO2-88ER60642. * Corresponding author: Shyam M. Srinivas, MD, PhD, Department of Nuclear Medicine, Imaging Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Jb-3, Cleveland, OH 44195. E-mail address: srinivs@ccf.org (S.M. Srinivas). 1939-8654/$ - see front matter Ó 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jmir.2014.06.005 Journal of Medical Imaging and Radiation Sciences 45 (2014) 435-439 Journal of Medical Imaging and Radiation Sciences Journal de l’imagerie médicale et des sciences de la radiation www.elsevier.com/locate/jmir