Conventional Imaging, MRI and <sup>18</sup>F-FDG PET/MRI for N and M Staging in Patients with Newly Diagnosed Breast Cancer
<b>Background:</b> This study compares the diagnostic potential of conventional staging (computed tomography (CT), axillary sonography and bone scintigraphy), whole-body magnetic resonance imaging (MRI) and whole-body <sup>18</sup>F-fluorodeoxyglucose positron emission tomogr...
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| Format: | Article |
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MDPI AG
2023-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/14/3646 |
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| author | Janna Morawitz Nils-Martin Bruckmann Kai Jannusch Frederic Dietzel Aleksandar Milosevic Ann-Kathrin Bittner Oliver Hoffmann Svjetlana Mohrmann Eugen Ruckhäberle Lena Häberle Wolfgang Peter Fendler Ken Herrmann Frederik Lars Giesel Gerald Antoch Lale Umutlu Bernd Kowall Andreas Stang Julian Kirchner |
| author_facet | Janna Morawitz Nils-Martin Bruckmann Kai Jannusch Frederic Dietzel Aleksandar Milosevic Ann-Kathrin Bittner Oliver Hoffmann Svjetlana Mohrmann Eugen Ruckhäberle Lena Häberle Wolfgang Peter Fendler Ken Herrmann Frederik Lars Giesel Gerald Antoch Lale Umutlu Bernd Kowall Andreas Stang Julian Kirchner |
| author_sort | Janna Morawitz |
| collection | DOAJ |
| description | <b>Background:</b> This study compares the diagnostic potential of conventional staging (computed tomography (CT), axillary sonography and bone scintigraphy), whole-body magnetic resonance imaging (MRI) and whole-body <sup>18</sup>F-fluorodeoxyglucose positron emission tomography (<sup>18</sup>F-FDG PET/)MRI for N and M staging in newly diagnosed breast cancer. <b>Methods:</b> A total of 208 patients with newly diagnosed breast cancer were prospectively included in this study and underwent contrast-enhanced thoracoabdominal CT, bone scintigraphy and axillary sonography as well as contrast-enhanced whole-body <sup>18</sup>F-FDG PET/MRI. The datasets were analyzed with respect to lesion localization and characterization. Histopathology and follow-up imaging served as the reference standard. A McNemar test was used to compare the diagnostic performance of conventional staging, MRI and <sup>18</sup>F-FDG PET/MRI and a Wilcoxon test was used to compare differences in true positive findings for nodal staging. <b>Results:</b> Conventional staging determined the N stage with a sensitivity of 80.9%, a specificity of 99.2%, a PPV (positive predictive value) of 98.6% and a NPV (negative predictive value) of 87.4%. The corresponding results for MRI were 79.6%, 100%, 100% and 87.0%, and were 86.5%, 94.1%, 91.7% and 90.3% for <sup>18</sup>F-FDG PET/MRI. <sup>18</sup>F-FDG PET/MRI was significantly more sensitive in determining malignant lymph nodes than conventional imaging and MRI (<i>p</i> < 0.0001 and <i>p</i> = 0.0005). Furthermore, <sup>18</sup>F-FDG PET/MRI accurately estimated the clinical lymph node stage in significantly more cases than conventional imaging and MRI (each <i>p</i> < 0.05). Sensitivity, specificity, PPV and NPV for the M stage in conventional staging were 83.3%, 98.5%, 76.9% and 98.9%, respectively. The corresponding results for both MRI and <sup>18</sup>F-FDG PET/MRI were 100.0%, 98.5%, 80.0% and 100.0%. No significant differences between the imaging modalities were seen for the staging of distant metastases. <b>Conclusions:</b><sup>18</sup>F-FDG PET/MRI detects lymph node metastases in significantly more patients and estimates clinical lymph node stage more accurately than conventional imaging and MRI. No significant differences were found between imaging modalities with respect to the detection of distant metastases. |
| first_indexed | 2024-03-11T01:13:22Z |
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| id | doaj.art-2f0be3f23a294af7a093795ecf48c00e |
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| language | English |
| last_indexed | 2024-03-11T01:13:22Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
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| series | Cancers |
| spelling | doaj.art-2f0be3f23a294af7a093795ecf48c00e2023-11-18T18:42:07ZengMDPI AGCancers2072-66942023-07-011514364610.3390/cancers15143646Conventional Imaging, MRI and <sup>18</sup>F-FDG PET/MRI for N and M Staging in Patients with Newly Diagnosed Breast CancerJanna Morawitz0Nils-Martin Bruckmann1Kai Jannusch2Frederic Dietzel3Aleksandar Milosevic4Ann-Kathrin Bittner5Oliver Hoffmann6Svjetlana Mohrmann7Eugen Ruckhäberle8Lena Häberle9Wolfgang Peter Fendler10Ken Herrmann11Frederik Lars Giesel12Gerald Antoch13Lale Umutlu14Bernd Kowall15Andreas Stang16Julian Kirchner17Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, GermanyDepartment of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, GermanyDepartment of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, GermanyDepartment of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, GermanyDepartment of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, GermanyDepartment Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, GermanyDepartment Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, GermanyDepartment of Gynecology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, GermanyDepartment of Gynecology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, GermanyInstitute of Pathology, Medical Faculty, University Hospital Duesseldorf, Heinrich-Heine-University, D-40204 Duesseldorf, GermanyDepartment of Nuclear Medicine, German Cancer Consortium (DKTK)-University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, GermanyDepartment of Nuclear Medicine, German Cancer Consortium (DKTK)-University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, GermanyDepartment of Nuclear Medicine, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, GermanyDepartment of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, GermanyDepartment of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, GermanyInstitute of Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, D-45147 Essen, GermanyInstitute of Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, D-45147 Essen, GermanyDepartment of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany<b>Background:</b> This study compares the diagnostic potential of conventional staging (computed tomography (CT), axillary sonography and bone scintigraphy), whole-body magnetic resonance imaging (MRI) and whole-body <sup>18</sup>F-fluorodeoxyglucose positron emission tomography (<sup>18</sup>F-FDG PET/)MRI for N and M staging in newly diagnosed breast cancer. <b>Methods:</b> A total of 208 patients with newly diagnosed breast cancer were prospectively included in this study and underwent contrast-enhanced thoracoabdominal CT, bone scintigraphy and axillary sonography as well as contrast-enhanced whole-body <sup>18</sup>F-FDG PET/MRI. The datasets were analyzed with respect to lesion localization and characterization. Histopathology and follow-up imaging served as the reference standard. A McNemar test was used to compare the diagnostic performance of conventional staging, MRI and <sup>18</sup>F-FDG PET/MRI and a Wilcoxon test was used to compare differences in true positive findings for nodal staging. <b>Results:</b> Conventional staging determined the N stage with a sensitivity of 80.9%, a specificity of 99.2%, a PPV (positive predictive value) of 98.6% and a NPV (negative predictive value) of 87.4%. The corresponding results for MRI were 79.6%, 100%, 100% and 87.0%, and were 86.5%, 94.1%, 91.7% and 90.3% for <sup>18</sup>F-FDG PET/MRI. <sup>18</sup>F-FDG PET/MRI was significantly more sensitive in determining malignant lymph nodes than conventional imaging and MRI (<i>p</i> < 0.0001 and <i>p</i> = 0.0005). Furthermore, <sup>18</sup>F-FDG PET/MRI accurately estimated the clinical lymph node stage in significantly more cases than conventional imaging and MRI (each <i>p</i> < 0.05). Sensitivity, specificity, PPV and NPV for the M stage in conventional staging were 83.3%, 98.5%, 76.9% and 98.9%, respectively. The corresponding results for both MRI and <sup>18</sup>F-FDG PET/MRI were 100.0%, 98.5%, 80.0% and 100.0%. No significant differences between the imaging modalities were seen for the staging of distant metastases. <b>Conclusions:</b><sup>18</sup>F-FDG PET/MRI detects lymph node metastases in significantly more patients and estimates clinical lymph node stage more accurately than conventional imaging and MRI. No significant differences were found between imaging modalities with respect to the detection of distant metastases.https://www.mdpi.com/2072-6694/15/14/3646breast cancermetastasesstaging<sup>18</sup>F-FDG PET/MRI |
| spellingShingle | Janna Morawitz Nils-Martin Bruckmann Kai Jannusch Frederic Dietzel Aleksandar Milosevic Ann-Kathrin Bittner Oliver Hoffmann Svjetlana Mohrmann Eugen Ruckhäberle Lena Häberle Wolfgang Peter Fendler Ken Herrmann Frederik Lars Giesel Gerald Antoch Lale Umutlu Bernd Kowall Andreas Stang Julian Kirchner Conventional Imaging, MRI and <sup>18</sup>F-FDG PET/MRI for N and M Staging in Patients with Newly Diagnosed Breast Cancer Cancers breast cancer metastases staging <sup>18</sup>F-FDG PET/MRI |
| title | Conventional Imaging, MRI and <sup>18</sup>F-FDG PET/MRI for N and M Staging in Patients with Newly Diagnosed Breast Cancer |
| title_full | Conventional Imaging, MRI and <sup>18</sup>F-FDG PET/MRI for N and M Staging in Patients with Newly Diagnosed Breast Cancer |
| title_fullStr | Conventional Imaging, MRI and <sup>18</sup>F-FDG PET/MRI for N and M Staging in Patients with Newly Diagnosed Breast Cancer |
| title_full_unstemmed | Conventional Imaging, MRI and <sup>18</sup>F-FDG PET/MRI for N and M Staging in Patients with Newly Diagnosed Breast Cancer |
| title_short | Conventional Imaging, MRI and <sup>18</sup>F-FDG PET/MRI for N and M Staging in Patients with Newly Diagnosed Breast Cancer |
| title_sort | conventional imaging mri and sup 18 sup f fdg pet mri for n and m staging in patients with newly diagnosed breast cancer |
| topic | breast cancer metastases staging <sup>18</sup>F-FDG PET/MRI |
| url | https://www.mdpi.com/2072-6694/15/14/3646 |
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