Prospective comparison of CT and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients: Initial results.
Adult
Aged
Breast Neoplasms
/ diagnostic imaging
Female
Fluorodeoxyglucose F18
/ metabolism
Humans
Magnetic Resonance Imaging
/ methods
Middle Aged
Neoplasm Staging
Positron-Emission Tomography
/ methods
Prospective Studies
ROC Curve
Radiopharmaceuticals
/ metabolism
Tomography, X-Ray Computed
/ methods
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
26
07
2021
accepted:
18
11
2021
entrez:
2
12
2021
pubmed:
3
12
2021
medline:
8
1
2022
Statut:
epublish
Résumé
To compare the diagnostic accuracy of contrast-enhanced thoraco-abdominal computed tomography and whole-body 18F-FDG PET/MRI in N and M staging in newly diagnosed, histopathological proven breast cancer. A total of 80 consecutive women with newly diagnosed and histopathologically confirmed breast cancer were enrolled in this prospective study. Following inclusion criteria had to be fulfilled: (1) newly diagnosed, treatment-naive T2-tumor or higher T-stage or (2) newly diagnosed, treatment-naive triple-negative tumor of every size or (3) newly diagnosed, treatment-naive tumor with molecular high risk (T1c, Ki67 >14%, HER2neu over-expression, G3). All patients underwent a thoraco-abdominal ceCT and a whole-body 18F-FDG PET/MRI. All datasets were evaluated by two experienced radiologists in hybrid imaging regarding suspect lesion count, localization, categorization and diagnostic confidence. Images were interpreted in random order with a reading gap of at least 4 weeks to avoid recognition bias. Histopathological results as well as follow-up imaging served as reference standard. Differences in staging accuracy were assessed using Mc Nemars chi2 test. CT rated the N stage correctly in 64 of 80 (80%, 95% CI:70.0-87.3) patients with a sensitivity of 61.5% (CI:45.9-75.1), a specificity of 97.6% (CI:87.4-99.6), a PPV of 96% (CI:80.5-99.3), and a NPV of 72.7% (CI:59.8-82.7). Compared to this, 18F-FDG PET/MRI determined the N stage correctly in 71 of 80 (88.75%, CI:80.0-94.0) patients with a sensitivity of 82.1% (CI:67.3-91.0), a specificity of 95.1% (CI:83.9-98.7), a PPV of 94.1% (CI:80.9-98.4) and a NPV of 84.8% (CI:71.8-92.4). Differences in sensitivities were statistically significant (difference 20.6%, CI:-0.02-40.9; p = 0.008). Distant metastases were present in 7/80 patients (8.75%). 18 F-FDG PET/MRI detected all of the histopathological proven metastases without any false-positive findings, while 3 patients with bone metastases were missed in CT (sensitivity 57.1%, specificity 95.9%). Additionally, CT presented false-positive findings in 3 patients. 18F-FDG PET/MRI has a high diagnostic potential and outperforms CT in assessing the N and M stage in patients with primary breast cancer.
Identifiants
pubmed: 34855886
doi: 10.1371/journal.pone.0260804
pii: PONE-D-21-20884
pmc: PMC8638872
doi:
Substances chimiques
Radiopharmaceuticals
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0260804Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
PLoS One. 2017 Jul 6;12(7):e0180349
pubmed: 28683109
Eur J Radiol. 2016 Feb;85(2):459-65
pubmed: 26781152
Ann Oncol. 2015 Sep;26 Suppl 5:v8-30
pubmed: 26314782
J Clin Oncol. 2008 Oct 10;26(29):4746-51
pubmed: 18695254
Eur J Radiol. 2017 Apr;89:14-19
pubmed: 28267530
J Nucl Med. 2014 Mar;55(3):373-8
pubmed: 24504054
CA Cancer J Clin. 2019 Nov;69(6):438-451
pubmed: 31577379
Eur J Radiol. 2013 Nov;82(11):e669-75
pubmed: 24011443
Ann Surg Oncol. 2012 Jun;19(6):1825-30
pubmed: 22227922
Eur J Nucl Med Mol Imaging. 2015 Jan;42(1):56-65
pubmed: 25223420
J Nucl Med. 2016 Apr;57(4):582-6
pubmed: 26742715
Eur J Radiol. 2013 Nov;82(11):2005-10
pubmed: 23891295
Int J Radiat Oncol Biol Phys. 2008 Jul 1;71(3):695-704
pubmed: 18436392
J Nucl Med. 2016 Jan;57(1):15-20
pubmed: 26514173
Radiology. 2016 Oct;281(1):193-202
pubmed: 27023002
J Clin Oncol. 2016 Jun 1;34(16):1889-97
pubmed: 27001573
Eur J Nucl Med Mol Imaging. 2018 Feb;45(2):179-186
pubmed: 28905091
Geburtshilfe Frauenheilkd. 2018 Nov;78(11):1056-1088
pubmed: 30581198
Sci Rep. 2019 Oct 1;9(1):14111
pubmed: 31575963
Ann Oncol. 2008 Jul;19(7):1249-1254
pubmed: 18356138
AJR Am J Roentgenol. 2013 Mar;200(3):W314-20
pubmed: 23436877
Eur Radiol. 2019 Apr;29(4):1787-1798
pubmed: 30267154
Semin Nucl Med. 2015 Jul;45(4):304-21
pubmed: 26050658
J Clin Oncol. 2007 Sep 1;25(25):3923-9
pubmed: 17679726
Ann Nucl Med. 2009 Dec;23(10):855-61
pubmed: 19876704
J Natl Compr Canc Netw. 2018 Mar;16(3):310-320
pubmed: 29523670
Indian J Surg Oncol. 2019 Sep;10(3):483-488
pubmed: 31496596
Radiol Bras. 2017 Jul-Aug;50(4):211-215
pubmed: 28894327
Cancer. 2009 Nov 1;115(21):5095-107
pubmed: 19670458
JAMA. 2013 Nov 27;310(20):2191-4
pubmed: 24141714
Invest Radiol. 2015 Aug;50(8):505-13
pubmed: 26115367
Ann Thorac Surg. 2011 Nov;92(5):1826-32; discussion 1832
pubmed: 22051278
J Breast Cancer. 2012 Dec;15(4):441-8
pubmed: 23346174
Eur J Nucl Med Mol Imaging. 2019 Feb;46(2):437-445
pubmed: 30074073
Ann Oncol. 2018 Aug 1;29(8):1634-1657
pubmed: 30032243
Eur J Nucl Med Mol Imaging. 2018 Apr;45(4):622-629
pubmed: 29164299
Eur J Nucl Med Mol Imaging. 2018 Dec;45(13):2328-2337
pubmed: 30056547
Aust Fam Physician. 2012 Nov;41(11):871-4
pubmed: 23145418