In a European trial (BrIMA) reported in JAMA Surgery, Göker et al found that specimen PET/CT imaging was associated with improved detection of positive margins in surgery for early breast cancer.
Study Details
The study recruited patients from six European breast centers between June 2022 and March 2025. Patients received an intravenous injection of F-18–fluorodeoxyglucose at a low dose of 0.8 MBq/kg. After tumor excision, the specimen was imaged intraoperatively using a specimen PET/CT scanner; surgeons interpreted the images intraoperatively, removing additional tissue when findings were considered suspicious for positive margins. The primary outcome measure was the success rate of specimen PET/CT vs that of no intraoperative margin assessment (IMA) in detecting positive margins for the invasive component in patients undergoing breast-conserving surgery for invasive ductal carcinoma (IDC).
Key Findings
The cohort consisted of 148 women with a median age of 65 years and a median preoperative tumor size of 17 mm. A total of 84 patients had IDC.
For the invasive component of IDC, success rates increased from 83.3% without IMA to 86.9% with routine margin assessment and to 95.2% with specimen PET/CT (P < .001 vs no IMA).
Across all patients, success rates improved from 76.4% without IMA to 81.8% with routine margin assessment and to 91.9% with specimen PET/CT (P < .001 vs no IMA; P = .009 vs routine margin assessment).
The investigators concluded: “Study findings show that specimen [PET/CT] imaging was associated with an improvement in the assessment of positive margins for invasive component in patients undergoing conserving surgery for early breast cancer. The use of this integrated approach might lead to a substantial reduction of re-excision rates after breast-conserving surgery.”
Menekse Göker, MD, of Cancer Research Institute Ghent, Belgium, is the corresponding author for the JAMA Surgery article.
DISCLOSURE: The study was supported by XEOS Medical NV. For full disclosures of the study authors, visit jamanetwork.com.
