Garcia-Velloso Maria J, Ribelles Maria J, Rodriguez Macarena, Fernandez-Montero Alejandro, Sancho Lidia, Prieto Elena, Santisteban Marta, Rodriguez-Spiteri Natalia, Idoate Miguel A, Martinez-Regueira Fernando, Elizalde Arlette, Pina Luis J
Department of Nuclear Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
Department of Occupational Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
Eur Radiol. 2017 Aug;27(8):3190-3198. doi: 10.1007/s00330-016-4685-8. Epub 2016 Dec 21.
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.
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).
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).
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.
• FDG PET-CT may improve the specificity of MRI in breast cancer staging. • MRI fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose PET-CT has better overall diagnostic performance than MRI. • The clinical role of fused PET-MRI has not yet been established.
我们的目的是评估磁共振成像（MRI）与俯卧位2-[氟-18]-氟-2-脱氧-D-葡萄糖（FDG）正电子发射断层扫描（PET）融合在乳腺癌患者原发肿瘤分期中的诊断准确性。
这项回顾性研究评估了45名患有49例经病理证实的乳腺癌女性。使用相同的专用乳腺线圈进行了MRI和带有飞行时间及点扩散函数重建的俯卧位PET-CT扫描。这些研究由一名放射科医生和一名核医学医生进行评估，融合图像的评估通过协商达成一致。最终诊断基于病理结果（90个病灶）或随访≥24个月（17个病灶）。
该研究评估了72个恶性和35个良性病灶，中位大小为1.8厘米（范围0.3 - 8.4厘米）：31个局灶性、9个多灶性和9个多中心性病例。在逐个病灶分析中，MRI的敏感性、特异性、阳性和阴性预测值分别为97%、80%、91%和93%，俯卧位PET分别为96%、71%、87%和89%，MRI与PET融合为97%、94%、97%和94%。曲线下面积（AUC）分别为0.953、0.850和0.983（p < 0.01）。
在乳腺癌患者的原发肿瘤分期中，MRI与FDG-PET融合比FDG-PET更准确，并且提高了MRI的特异性。
• FDG PET-CT可能提高MRI在乳腺癌分期中的特异性。• MRI与俯卧位2-[氟-18]-氟-2-脱氧-D-葡萄糖PET-CT融合比MRI具有更好的整体诊断性能。• 融合PET-MRI的临床作用尚未确立。
