1. 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.
- Author
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Kirchner, Julian, Martin, Ole, Heusch, Philipp, Buchbender, Christian, Antoch, Gerald, Grueneisen, Johannes, Forsting, Michael, Umutlu, Lale, Oehmigen, Mark, Quick, Harald H., Bittner, Ann-Kathrin, Hoffmann, Oliver, Ingenwerth, Marc, Catalano, Onofrio Antonio, and Herrmann, Ken
- Subjects
BREAST cancer ,TUMOR classification ,FLUORODEOXYGLUCOSE F18 ,POSITRON emission ,HISTOPATHOLOGY - Abstract
Objectives: The purpose of this study was to compare the diagnostic value of a one-step to a two-step staging algorithm utilizing
18 F-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-body18 F-FDG PET/MRI, and (2) Two-step algorithm comprising a dedicated prone18 F-FDG breast PET/MRI and supine whole-body18 F-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-step18 F-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-step18 F-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-step18 F-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. [ABSTRACT FROM AUTHOR]- Published
- 2018
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