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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-12-2018 | Original Article

Local and whole-body staging in patients with primary breast cancer: a comparison of one-step to two-step staging utilizing ¹⁸F-FDG-PET/MRI

Authors: Julian Kirchner, Johannes Grueneisen, Ole Martin, Mark Oehmigen, Harald H. Quick, Ann-Kathrin Bittner, Oliver Hoffmann, Marc Ingenwerth, Onofrio Antonio Catalano, Philipp Heusch, Christian Buchbender, Michael Forsting, Gerald Antoch, Ken Herrmann, Lale Umutlu

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 13/2018

Abstract

Objectives

The purpose of this study was to compare the diagnostic value of a one-step to a two-step staging algorithm utilizing ¹⁸F-FDG PET/MRI in breast cancer patients.

Methods

A total of 38 patients (37 females and one male, mean age 57 ± 10 years; range 31–78 years) with newly diagnosed, histopathologically proven breast cancer were prospectively enrolled in this trial. All PET/MRI examinations were assessed for local tumor burden and metastatic spread in two separate reading sessions: (1) One-step algorithm comprising supine whole-body ¹⁸F-FDG PET/MRI, and (2) Two-step algorithm comprising a dedicated prone ¹⁸F-FDG breast PET/MRI and supine whole-body ¹⁸F-FDG PET/MRI.

Results

On a patient based analysis the two-step algorithm correctly identified 37 out of 38 patients with breast carcinoma (97%), while five patients were missed by the one-step ¹⁸F-FDG PET/MRI algorithm (33/38; 87% correct identification). On a lesion-based analysis 56 breast cancer lesions were detected in the two-step algorithm and 44 breast cancer lesions could be correctly identified in the one-step ¹⁸F-FDG PET/MRI (79%), resulting in statistically significant differences between the two algorithms (p = 0.0015). For axillary lymph node evaluation sensitivity, specificity and accuracy was 93%, 95 and 94%, respectively. Furthermore, distant metastases could be detected in seven patients in both algorithms.

Conclusion

The results demonstrate the necessity and superiority of a two-step ¹⁸F-FDG PET/MRI algorithm, comprising dedicated prone breast imaging and supine whole-body imaging, when compared to the one-step algorithm for local and whole-body staging in breast cancer patients.

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Title: Local and whole-body staging in patients with primary breast cancer: a comparison of one-step to two-step staging utilizing 18F-FDG-PET/MRI
Authors: Julian Kirchner
Johannes Grueneisen
Ole Martin
Mark Oehmigen
Harald H. Quick
Ann-Kathrin Bittner
Oliver Hoffmann
Marc Ingenwerth
Onofrio Antonio Catalano
Philipp Heusch
Christian Buchbender
Michael Forsting
Gerald Antoch
Ken Herrmann
Lale Umutlu
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 13/2018
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-018-4102-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Local and whole-body staging in patients with primary breast cancer: a comparison of one-step to two-step staging utilizing ¹⁸F-FDG-PET/MRI

Abstract

Objectives

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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