Scientific publications

MRI fused with prone FDG PET/CT improves the primary tumour staging of patients with breast cancer

Garcia-Velloso MJ (1), Ribelles MJ (2), Rodriguez M (2), Fernandez-Montero A (3), Sancho L (2), Prieto E (2), Santisteban M (4), Rodriguez-Spiteri N (5), Idoate MA (6), Martinez-Regueira F (5), Elizalde A (7), Pina LJ (7).

(1) Department of Nuclear Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
(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.

Magazine: European Radiology

Date: Aug 1, 2017

Mammary Pathology Area General and Digestive Surgery Breast Cancer Area Radiophysics and Radiological Protection [SP] Pathological Anatomy [SP] Radiology [SP] Nuclear Medicine [SP]

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.

CITATION  Eur Radiol. 2017 Aug;27(8):3190-3198. doi: 10.1007/s00330-016-4685-8. Epub 2016 Dec 21

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