T J A van Nijnatten1, E H Ploumen2, R J Schipper3, B Goorts4, E H Andriessen2, S Vanwetswinkel5, M Schavemaker5, P Nelemans6, B de Vries7, R G H Beets-Tan8, M L Smidt9, M B I Lobbes5. 1. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands; Department of Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands; GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands. Electronic address: Thiemovn@gmail.com. 2. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands; Department of Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands. 3. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands; Department of Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands; GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands. 4. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands; Department of Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands; GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands. 5. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands. 6. Department of Epidemiology, Maastricht University Medical Center+, Maastricht, The Netherlands. 7. Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands. 8. GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands; Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 9. Department of Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands; GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands.
Abstract
OBJECTIVES: To compare standard breast MRI to dedicated axillary ultrasound (with or without tissue sampling) for differentiating between no, limited and advanced axillary nodal disease in breast cancer patients. METHODS: All patients who underwent breast MRI and dedicated axillary ultrasound between 2009 and 2014 were eligible. Exclusion criteria were recurrent disease, neoadjuvant systemic therapy and not receiving completion axillary lymph node dissection after positive sentinel lymph node biopsy (SLNB). Two radiologists independently reassessed all MRI exams. Axillary ultrasound findings were retrospectively collected. Probability of advanced axillary nodal disease (pN2-3) given clinically node negative (cN0) or limited (cN1) findings was calculated, with corresponding negative predictive value (NPV) to exclude pN2-3 and positive predictive value (PPV) to identify axillary nodal disease. Histopathology served as gold standard. RESULTS: A total of 377 cases resulted in 81.4% no, 14.4% limited and 4.2% advanced axillary nodal disease at final histopathology. Probability of pN2-3 given cN0 for breast MRI and axillary ultrasound was 0.7-0.9% versus 1.5% and probability of pN2-3 given cN1 was 11.6-15.4% versus 29.0%. When cN1 on breast MRI was observed, PPV to identify positive axillary nodal disease was 50.7% and 59.0%. CONCLUSIONS: Evaluation of axillary nodal status on standard breast MRI is comparable to dedicated axillary ultrasound in breast cancer patients. In patients who underwent preoperative standard breast MRI, axillary ultrasound is only required in case of suspicious nodal findings on MRI.
OBJECTIVES: To compare standard breast MRI to dedicated axillary ultrasound (with or without tissue sampling) for differentiating between no, limited and advanced axillary nodal disease in breast cancerpatients. METHODS: All patients who underwent breast MRI and dedicated axillary ultrasound between 2009 and 2014 were eligible. Exclusion criteria were recurrent disease, neoadjuvant systemic therapy and not receiving completion axillary lymph node dissection after positive sentinel lymph node biopsy (SLNB). Two radiologists independently reassessed all MRI exams. Axillary ultrasound findings were retrospectively collected. Probability of advanced axillary nodal disease (pN2-3) given clinically node negative (cN0) or limited (cN1) findings was calculated, with corresponding negative predictive value (NPV) to exclude pN2-3 and positive predictive value (PPV) to identify axillary nodal disease. Histopathology served as gold standard. RESULTS: A total of 377 cases resulted in 81.4% no, 14.4% limited and 4.2% advanced axillary nodal disease at final histopathology. Probability of pN2-3 given cN0 for breast MRI and axillary ultrasound was 0.7-0.9% versus 1.5% and probability of pN2-3 given cN1 was 11.6-15.4% versus 29.0%. When cN1 on breast MRI was observed, PPV to identify positive axillary nodal disease was 50.7% and 59.0%. CONCLUSIONS: Evaluation of axillary nodal status on standard breast MRI is comparable to dedicated axillary ultrasound in breast cancerpatients. In patients who underwent preoperative standard breast MRI, axillary ultrasound is only required in case of suspicious nodal findings on MRI.
Authors: Briete Goorts; Stefan Vöö; Thiemo J A van Nijnatten; Loes F S Kooreman; Maaike de Boer; Kristien B M I Keymeulen; Romy Aarnoutse; Joachim E Wildberger; Felix M Mottaghy; Marc B I Lobbes; Marjolein L Smidt Journal: Eur J Nucl Med Mol Imaging Date: 2017-06-10 Impact factor: 9.236
Authors: Rosalind P Candelaria; Beatriz E Adrada; Kenneth Hess; Lumarie Santiago; Deanna L Lane; Alastair M Thompson; Stacy L Moulder; Monica L Huang; Elsa M Arribas; Gaiane M Rauch; Jessica W T Leung; W Fraser Symmans; Vicente Valero; Elizabeth E Ravenberg; Jason B White; Wei Tse Yang Journal: Eur J Radiol Date: 2020-07-10 Impact factor: 3.528
Authors: Thiemo J A van Nijnatten; B Goorts; S Vöö; M de Boer; L F S Kooreman; E M Heuts; J E Wildberger; F M Mottaghy; M B I Lobbes; M L Smidt Journal: Eur J Nucl Med Mol Imaging Date: 2017-09-14 Impact factor: 9.236
Authors: Won Hwa Kim; Sang-Woo Lee; Hye Jung Kim; Yee Soo Chae; Shin Young Jeong; Jin Hyang Jung; Ho Yong Park; Won Kee Lee Journal: Sci Rep Date: 2018-02-16 Impact factor: 4.379
Authors: Won Hwa Kim; Hye Jung Kim; So Mi Lee; Seung Hyun Cho; Kyung Min Shin; Sang Yub Lee; Jae Kwang Lim Journal: Cancer Imaging Date: 2019-02-01 Impact factor: 3.909