Maria J Garcia-Velloso1, Maria J Ribelles2, Macarena Rodriguez2, Alejandro Fernandez-Montero3, Lidia Sancho2, Elena Prieto2, Marta Santisteban4, Natalia Rodriguez-Spiteri5, Miguel A Idoate6, Fernando Martinez-Regueira5, Arlette Elizalde7, Luis J Pina7. 1. Department of Nuclear Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. mjgarciave@unav.es. 2. Department of Nuclear Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. 3. Department of Occupational Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. 4. Department of Oncology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. 5. Department of Surgery, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. 6. Department of Pathology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. 7. Department of Radiology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
Abstract
OBJECTIVE: Our aim was to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in primary tumour staging of patients with breast cancer. METHODS: This retrospective study evaluated 45 women with 49 pathologically proven breast carcinomas. MRI and prone PET-CT scans with time-of-flight and point-spread-function reconstruction were performed with the same dedicated breast coil. The studies were assessed by a radiologist and a nuclear medicine physician, and evaluation of fused images was made by consensus. The final diagnosis was based on pathology (90 lesions) or follow-up ≥ 24 months (17 lesions). RESULTS: The study assessed 72 malignant and 35 benign lesions with a median size of 1.8 cm (range 0.3-8.4 cm): 31 focal, nine multifocal and nine multicentric cases. In lesion-by-lesion analysis, sensitivity, specificity, positive and negative predictive values were 97%, 80%, 91% and 93% for MRI, 96%, 71%, 87%, and 89% for prone PET, and 97%. 94%, 97% and 94% for MRI fused with PET. Areas under the curve (AUC) were 0.953, 0.850, and 0.983, respectively (p < 0.01). CONCLUSIONS: MRI fused with FDG-PET is more accurate than FDG-PET in primary tumour staging of breast cancer patients and increases the specificity of MRI. KEY POINTS: • FDG PET-CT may improve the specificity of MRI in breast cancer staging. • MRI fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose PET-CT has better overall diagnostic performance than MRI. • The clinical role of fused PET-MRI has not yet been established.
OBJECTIVE: Our aim was to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in primary tumour staging of patients with breast cancer. METHODS: This retrospective study evaluated 45 women with 49 pathologically proven breast carcinomas. MRI and prone PET-CT scans with time-of-flight and point-spread-function reconstruction were performed with the same dedicated breast coil. The studies were assessed by a radiologist and a nuclear medicine physician, and evaluation of fused images was made by consensus. The final diagnosis was based on pathology (90 lesions) or follow-up ≥ 24 months (17 lesions). RESULTS: The study assessed 72 malignant and 35 benign lesions with a median size of 1.8 cm (range 0.3-8.4 cm): 31 focal, nine multifocal and nine multicentric cases. In lesion-by-lesion analysis, sensitivity, specificity, positive and negative predictive values were 97%, 80%, 91% and 93% for MRI, 96%, 71%, 87%, and 89% for prone PET, and 97%. 94%, 97% and 94% for MRI fused with PET. Areas under the curve (AUC) were 0.953, 0.850, and 0.983, respectively (p < 0.01). CONCLUSIONS: MRI fused with FDG-PET is more accurate than FDG-PET in primary tumour staging of breast cancerpatients and increases the specificity of MRI. KEY POINTS: • FDG PET-CT may improve the specificity of MRI in breast cancer staging. • MRI fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose PET-CT has better overall diagnostic performance than MRI. • The clinical role of fused PET-MRI has not yet been established.
Entities:
Keywords:
Breast cancer; FDG; Magnetic resonance imaging (MRI); Prone positron emission tomography computed tomography (PET-CT); Staging
Authors: Wendie A Berg; Kathleen S Madsen; Kathy Schilling; Marie Tartar; Etta D Pisano; Linda Hovanessian Larsen; Deepa Narayanan; Al Ozonoff; Joel P Miller; Judith E Kalinyak Journal: Radiology Date: 2010-11-12 Impact factor: 11.105
Authors: Nicky H G M Peters; Inne H M Borel Rinkes; Nicolaas P A Zuithoff; Willem P T M Mali; Karel G M Moons; Petra H M Peeters Journal: Radiology Date: 2007-11-16 Impact factor: 11.105
Authors: Linda Moy; Marilyn E Noz; Gerald Q Maguire; Amy Melsaether; Abby E Deans; Antoinette D Murphy-Walcott; Fabio Ponzo Journal: Breast J Date: 2010-04-23 Impact factor: 2.431
Authors: Carol E DeSantis; Stacey A Fedewa; Ann Goding Sauer; Joan L Kramer; Robert A Smith; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2015-10-29 Impact factor: 508.702
Authors: Almir G V Bitencourt; Eduardo N P Lima; Rubens Chojniak; Elvira F Marques; Juliana A Souza; Wesley P Andrade; Marcos D Guimarães Journal: Eur J Radiol Date: 2014-05-27 Impact factor: 3.528
Authors: Gerhard W Goerres; Sven C A Michel; Mathias K Fehr; Achim H Kaim; Hans C Steinert; Burkhardt Seifert; Gustav K von Schulthess; Rahel A Kubik-Huch Journal: Eur Radiol Date: 2002-11-13 Impact factor: 5.315
Authors: Julian Kirchner; Johannes Grueneisen; Ole Martin; Mark Oehmigen; Harald H Quick; Ann-Kathrin Bittner; Oliver Hoffmann; Marc Ingenwerth; Onofrio Antonio Catalano; Philipp Heusch; Christian Buchbender; Michael Forsting; Gerald Antoch; Ken Herrmann; Lale Umutlu Journal: Eur J Nucl Med Mol Imaging Date: 2018-07-28 Impact factor: 9.236
Authors: Tibor Vag; Katja Steiger; Andreas Rossmann; Ulrich Keller; Aurelia Noske; Peter Herhaus; Johannes Ettl; Markus Niemeyer; Hans-Jürgen Wester; Markus Schwaiger Journal: EJNMMI Res Date: 2018-09-06 Impact factor: 3.138