Diagnostic performance of PET/computed tomography versus PET/MRI and diffusion-weighted imaging in the N- and M-staging of breast cancer patients

Mooij, Cornelis M de; Amador, I. Suñén; Mitea, Cristina; Lalji, Ulrich; Vanwetswinkel, Sigrid; Smidt, Marjolein L.; Nijnatten, Thiemo J A van

doi:10.1097/mnm.0000000000001254

Cited by 15 publications

(8 citation statements)

References 57 publications

(153 reference statements)

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“…In the subgroup analysis, 18F-FDG PET/MRI had a higher sensitivity and specificity than PET/CT for evaluating distant metastases of breast cancers. This is in accordance with the findings of another systematic review conducted by de Mooij et al [27], who also concluded that 18F-FDG PET/MRI has achieved higher diagnostic accuracy than 18F-FDG PET/CT in the distant staging of patients with breast cancer. Botsikas D et al [10] compared the whole-body PET/ MRI with PET/CT in breast cancer and found no statistically significant difference in the sensitivity, specificity, PPV, or NPV of the two tools for detecting distant metastases in a patient-per-patient analysis.…”

Section: Discussionsupporting

confidence: 92%

Comparison of whole-body 18F-FDG PET/CT and PET/MRI for distant metastases in patients with malignant tumors: a meta-analysis

Zhang¹,

Liang

Liu³

et al. 2023

BMC Cancer

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Background As a first-line imaging modality, whole-body fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) and 18F-FDG PET/magnetic resonance imaging (MRI) had been widely applied in clinical practice. However, 18F-FDG PET/MRI may be superior to PET/CT for the diagnosis of distant metastases in patients with advanced-stage. Therefore, it is timely and important to systematically determine the diagnostic accuracy of 18F-FDG PET/MRI compared with that of 18F-FDG PET/CT for the diagnosis of distant metastases. Methods This study aimed to compare the diagnostic accuracy of 18F-FDG PET/CT and PET/MRI for the diagnosis of distant metastases in patients with malignant tumors. Relevant studies using both 18F-FDG PET/CT and PET/MRI for assessment of distant metastases in patients with malignant tumors were searched in PubMed, Embase, The Cochrane Library, and Scopus from January 2010 to November 2023. Two reviewers independently selected studies according to the inclusion and exclusion criteria. A reviewer extracted relevant data and assessed the quality of the eligible studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the summary receiver operating characteristic curve (AUC) for 18F-FDG PET/CT and PET/MRI were analyzed. Subgroup analysis was performed. Results Across 14 studies (1042 patients), 18F-FDG PET/MRI had a higher sensitivity (0.87 versus 0.81), AUC value (0.98 versus 0.95), and similar specificity (0.97 versus 0.97), than PET/CT for detecting distant metastases. In 3 studies of breast cancer (182 patients), 18F-FDG PET/MRI had a higher sensitivity (0.95 versus 0.87) and specificity (0.96 versus 0.94) than PET/CT. In 5 studies of lung cancer (429 patients), 18F-FDG PET/CT had a higher sensitivity (0.87 versus 0.84) and a lower specificity (0.95 versus 0.96) to PET/MRI. Conclusions 18F-FDG PET/MRI and PET/CT both performed well as detectors of distant metastases in patients with malignant tumors, and the former has higher sensitivity. The subgroup analysis highlights that 18F-FDG PET/MRI and PET/CT hold different advantages for distant metastases staging in different tumors, PET/MRI has a higher accuracy in patients with breast cancer patients, while PET/CT has a higher accuracy in patients with lung cancer.

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Section: Discussionsupporting

confidence: 92%

Comparison of whole-body 18F-FDG PET/CT and PET/MRI for distant metastases in patients with malignant tumors: a meta-analysis

Zhang¹,

Liang

Liu³

et al. 2023

BMC Cancer

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“…Inflammation, infection, and reactive hyperplasia may create a false-positive result for FDG uptake at the IMLNs during PET/CT. Based on better soft tissue contrast and motion correction possibilities [43], compared to PET/CT, statistics display a definite trend toward lower specificity and higher sensitivity of PET/MRI in the lesion-by-lesion analysis [44,45]. Moreover, PET/CT or PET/MRI are currently available only at select hospitals, and these modalities are more expensive than more traditional modalities.…”

Section: Preoperative Functional Imagingmentioning

confidence: 99%

Internal mammary lymph node metastasis in breast cancer patients based on anatomical imaging and functional imaging

Wang

Qiu

2022

Breast Cancer

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Internal mammary lymph node (IMLN) metastasis forms part of the clinical node classification for primary breast cancer, which influences the treatment strategy. However, because of the IMLNs’ complicated anatomical structures and relationships with adjacent structures, IMLN biopsy or resection is associated with a limited improvement in prognosis and a high complication rate. The positivity rate also varies broadly according to imaging modality, and there is a low rate of agreement between the imaging and pathological diagnoses, which creates imprecision in the preoperative staging. The IMLN positivity rate also varies remarkably, and there are no clear, accurate, and non-invasive modalities for diagnosing the pre-mastectomy IMLN status. Nevertheless, medical imaging modalities continue to evolve, with functional imaging and image-guided thoracoscopic biopsy of sentinel IMLNs being well established. Thus, personalized decision-making and treatment selection should be based on the modality-specific differences in the diagnosis of IMLN metastasis/recurrence and the patient’s specific risk factors.

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“…Given the high diagnostic performance of PET/CT to detect malignant lesions, several authors have recommended its routine use for the initial work-up of HNSCC and for imaging at 3-4 months after radio(chemo)therapy [6,7,[9][10][11]. Clinical PET/MRI systems have been introduced 10 years ago and in many academic centers they are routinely used in the clinical setting as they allow the acquisition of MRI and PET data in the same patient during a single examination, thus facilitating high-quality fusion of MRI and PET images [12][13][14][15][16][17][18][19][20][21]. The advantages of PET/ MRI versus PET/CT are mainly the higher soft tissue contrast resolution, more detailed anatomic information and lower radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

“…The advantages of PET/ MRI versus PET/CT are mainly the higher soft tissue contrast resolution, more detailed anatomic information and lower radiation exposure. Moreover, the MRI component of PET/MRI systems can perform as a standalone system offering the possibility of functional imaging with diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI), therefore, making the combination with PET even more promising [13][14][15][16]18]. Some authors have reported the superiority of PET/MRI compared to PET/CT for detecting distant metastases in breast cancer, prostate cancer, gastrointestinal cancer and melanoma, thus allowing an efficient loco-regional and distant staging in one step [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the MRI component of PET/MRI systems can perform as a standalone system offering the possibility of functional imaging with diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI), therefore, making the combination with PET even more promising [13][14][15][16]18]. Some authors have reported the superiority of PET/MRI compared to PET/CT for detecting distant metastases in breast cancer, prostate cancer, gastrointestinal cancer and melanoma, thus allowing an efficient loco-regional and distant staging in one step [15][16][17]. However, most studies evaluating the diagnostic performance of PET/MRI in HNSCC have focused on assessing primary tumors, lymph node metastases or post-treatment local recurrence [14,18].…”

Section: Introductionmentioning

confidence: 99%

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Detection of distant metastases and distant second primary cancers in head and neck squamous cell carcinoma: comparison of [18F]FDG PET/MRI and [18F]FDG PET/CT

et al. 2022

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Purpose This prospective study aimed to compare the diagnostic performance of [18]FDG PET/MRI and PET/CT for the detection of distant metastases and distant second primary cancers in patients with head and neck squamous cell carcinoma (HNSCC). Methods A total of 103 [18F]FDG PET/MRI examinations immediately followed by PET/CT were obtained in 82 consecutive patients for staging of primary HNSCC (n = 38), suspected loco-regional recurrence/follow-up (n = 41) or unknown primary HNSCC (n = 3). Histology and follow-up > 2 years formed the standard of reference. Blinded readers evaluated the anonymized PET/MRI and PET/CT examinations separately using a 5-point Likert score. Statistical analysis included: receiver operating characteristic (ROC) analysis, jackknife alternative free-response ROC (JAFROC) and region-of-interest (ROI)-based ROC to account for data clustering and sensitivity/specificity/accuracy comparisons for a score ≥ 3. Results Distant metastases and distant second primary cancers were present in 23/103 (22%) examinations in 16/82 (19.5%) patients, and they were more common in the post-treatment group (11/41, 27%) than in the primary HNSCC group (3/38, 8%), p = 0.039. The area under the curve (AUC) per patient/examination/lesion was 0.947 [0.927–1]/0.965 [0.917–1]/0.957 [0.928–0.987] for PET/MRI and 0.975 [0.950–1]/0.968 [0.920–1]/0.944 [0.910–0.979] for PET/CT, respectively (p > 0.05). The diagnostic performance of PET/MRI and PET/CT was similar according to JAFROC (p = 0.919) and ROI-based ROC analysis (p = 0.574). Sensitivity/specificity/accuracy for PET/MRI and PET/CT for a score ≥ 3 was 94%/88%/89% and 94%/91%/91% per patient, 96%/90%/91% and 96%/93%/93% per examination and 95%/85%/90% and 90%/86%/88% per lesion, respectively, p > 0.05. Conclusions In HNSCC patients, PET/MRI and PET/CT had a high and similar diagnostic performance for detecting distant metastases and distant second primary cancers.

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Diagnostic performance of PET/computed tomography versus PET/MRI and diffusion-weighted imaging in the N- and M-staging of breast cancer patients

Abstract: Supplemental Digital Content is available in the text.

Cited by 15 publications

References 57 publications

Comparison of whole-body 18F-FDG PET/CT and PET/MRI for distant metastases in patients with malignant tumors: a meta-analysis

Comparison of whole-body 18F-FDG PET/CT and PET/MRI for distant metastases in patients with malignant tumors: a meta-analysis

Internal mammary lymph node metastasis in breast cancer patients based on anatomical imaging and functional imaging

Detection of distant metastases and distant second primary cancers in head and neck squamous cell carcinoma: comparison of [18F]FDG PET/MRI and [18F]FDG PET/CT

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