Staging performance of whole-body DWI, PET/CT and PET/MRI in invasive ductal carcinoma of the breast

Catalano, Onofrio A.; Daye, Dania; Signore, Alberto; Iannace, C; Vangel, Mark; Luongo, Antonella; Catalano, Marco; Mazzeo, Filomena; Mansi, Luigi; Soricelli, Andrea; Salvatore, Marco; Fuin, Niccolò; Catana, Ciprian; Mahmood, Umar; Rosen, Bruce R.

doi:10.3892/ijo.2017.4012

Cited by 54 publications

(35 citation statements)

References 44 publications

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“…Similar findings of improved detection of osseous breast cancer metastases with PET/MRI vs. PET/CT were described in a series of 65 bone metastases in 17 patients with recurrent breast cancer by Sawicki et al In a study by Catalano et al, PET/MRI identified significantly more breast cancer metastases to bone compared with PET/CT (141 vs. 90, P < 0.001) in 25 patients . Catalano et al also reported significantly improved whole‐body staging in 51 patients with invasive breast cancer using PET/MRI vs. PET/CT (50/51 vs. 38/51 correct, P < 0.01) …”

Section: Distant Metastasessupporting

confidence: 67%

PET/MRI in Breast Cancer

Pujara

Kim

Axelrod

et al. 2018

Magnetic Resonance Imaging

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Section: Distant Metastasessupporting

confidence: 67%

PET/MRI in Breast Cancer

Pujara

Kim

Axelrod

et al. 2018

Magnetic Resonance Imaging

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“…In a similar approach, Catalano et al [27] found that wholebody PET/MR was more accurate in correctly predicting the initial stage of breast cancer than whole-body DWI MRI, but the discrepancies were not statistically significant (p = 0.14). Another study [28] evaluated the diagnostic performance of PET/MR for axillary nodal staging and found that PET/MR changed the staging in 22% of patients compared with PET/ CT.…”

Section: Discussionmentioning

confidence: 99%

What is the diagnostic performance of 18-FDG-PET/MR compared to PET/CT for the N- and M- staging of breast cancer?

et al. 2018

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Purpose To compare the diagnostic performance of 18-FDG-PET/MR and PET/CT for the N-and M-staging of breast cancer. Methods and materials Two independent readers blinded to clinical/follow-up data reviewed PET/MR and PET/CT examinations performed for initial or recurrent breast cancer staging in 80 consecutive patients (mean age = 48 ± 12.9 years). The diagnostic confidence for lesions in the contralateral breast, axillary/internal mammary nodes, bones and other distant sites were recorded. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were calculated. The standard of reference included pathology and/or follow-up > 12 months. Results Nine of 80 patients had bone metastases; 13/80 had other distant metastases, 44/80 had axillary, 9/80 had internal mammary and 3/80 had contralateral breast tumours. Inter-reader agreement for lesions was excellent (weighted kappa = 0.833 for PET/CT and 0.823 for PET/MR) with similar reader confidence for the two tests (ICC = 0.875). In the patient-perpatient analysis, sensitivity and specificity of PET/MRI and PET/CT were similar (p > 0.05). In the lesion-per-lesion analysis, the sensitivity of PET/MR and PET/CT for bone metastases, other metastases, axillary and internal mammary nodes, contralateral tumours and all lesions together was 0.924 and 0.6923 (p = 0.0034), 0.923 and 0.923 (p = 1), 0.854 and 0.812 (p = 0.157), 0.9 and 0.9 (p = 1), 1 and 0.25 (p = 0.083), and 0.89 and 0.77 (p = 0.0013) respectively. The corresponding specificity was 0.953 and 1 (p = 0.0081), 1 and 1 (p = 1), 0.893 and 0.92 (p = 0.257), 1 and 1 (p = 1), 0.987 and 0.99 (p = 1) and 0.96 and 0.98 (p = 0.0075) respectively. Conclusions Reader confidence, inter-reader agreement and diagnostic performance per patient were similar with PET/MR and PET/CT. However, for all lesions together, PET/MR had a superior sensitivity and lower specificity in the lesion-per-lesion analysis. Key Points • N and M breast cancer staging performance of PET/MR and PET/CT is similar per patient. • In a lesion-per-lesion analysis PET/MR is more sensitive than PET/CT especially for bone metastasis. • Readers' diagnostic confidence is similar for both tests.

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“…In the study of Sawicki et al [19], whole-body 18 F-FDG PET/MRI reported superiority regarding detection of distant malignant lesions compared to whole-body MRI in recurrent breast cancer patients. Catalano et al [38] compared whole-body 18 F-FDG PET/MRI with whole-body DWI MRI in a smaller cohort study, yielding an insignificantly better performance of PET/MRI in predicting the initial wholebody tumor stage of breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of whole-body MRI and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients

Bruckmann

Sawicki

Kirchner

et al. 2020

Eur J Nucl Med Mol Imaging

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Objectives To evaluate and compare the diagnostic potential of whole-body MRI and whole-body 18 F-FDG PET/MRI for N and M staging in newly diagnosed, histopathologically proven breast cancer. Material and methods A total of 104 patients (age 53.4 ± 12.5) with newly diagnosed, histopathologically proven breast cancer were enrolled in this study prospectively. All patients underwent a whole-body 18 F-FDG PET/MRI. MRI and 18 F-FDG PET/MRI datasets were evaluated separately regarding lesion count, lesion localization, and lesion characterization (malignant/benign) as well as the diagnostic confidence (5-point ordinal scale, 1-5). The N and M stages were assessed according to the eighth edition of the American Joint Committee on Cancer staging manual in MRI datasets alone and in 18 F-FDG PET/MRI datasets, respectively. In the majority of lesions histopathology served as the reference standard. The remaining lesions were followed-up by imaging and clinical examination. Separately for nodal-positive and nodal-negative women, a McNemar chi 2 test was performed to compare sensitivity and specificity of the N and M stages between 18 F-FDG PET/MRI and MRI. Differences in diagnostic confidence scores were assessed by Wilcoxon signed rank test. Results MRI determined the N stage correctly in 78 of 104 (75%) patients with a sensitivity of 62.3% (95% CI: 0.48-0.75), a specificity of 88.2% (95% CI: 0.76-0.96), a PPV (positive predictive value) of 84.6% % (95% CI: 69.5-0.94), and a NPV (negative predictive value) of 69.2% (95% CI: 0.57-0.8). Corresponding results for 18 F-FDG PET/MRI were 87/104 (83.7%), 75.5% (95% CI: 0.62-0.86), 92.2% (0.81-0.98), 90% (0.78-0.97), and 78.3% (0.66-0.88), showing a significantly better sensitivity of 18 F-FDG PET/MRI determining malignant lymph nodes (p = 0.008). The M stage was identified correctly in MRI and 18 F-FDG PET/MRI in 100 of 104 patients (96.2%). Both modalities correctly staged all 7 patients with distant metastases, leading to false-positive findings in 4 patients in each modality (3.8%). In a lesion-based analysis, 18 F-FDG PET/ MRI showed a significantly better performance in correctly determining malignant lesions (85.8% vs. 67.1%, difference 18.7% (95% CI: 0.13-0.26), p < 0.0001) and offered a superior diagnostic confidence compared with MRI alone (4.1 ± 0.7 vs. 3.4 ± 0.7, p < 0.0001).

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Staging performance of whole-body DWI, PET/CT and PET/MRI in invasive ductal carcinoma of the breast

Cited by 54 publications

References 44 publications

PET/MRI in Breast Cancer

PET/MRI in Breast Cancer

What is the diagnostic performance of 18-FDG-PET/MR compared to PET/CT for the N- and M- staging of breast cancer?

Prospective evaluation of whole-body MRI and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients

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