Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Department of Nuclear Medicine, University of Roma 'La Sapienza', Rome, RM 00161, Italy.
Int J Oncol. 2017 Jul;51(1):281-288. doi: 10.3892/ijo.2017.4012. Epub 2017 May 19.
The aim of the present study was to evaluate the performance of whole-body diffusion-weighted imaging (WB-DWI), whole-body positron emission tomography with computed tomography (WB-PET/CT), and whole-body positron emission tomography with magnetic resonance imaging (WB-PET/MRI) in staging patients with untreated invasive ductal carcinoma of the breast. Fifty-one women with newly diagnosed invasive ductal carcinoma of the breast underwent WB-DWI, WB-PET/CT and WB-PET/MRI before treatment. A radiologist and a nuclear medicine physician reviewed in consensus the images from the three modalities and searched for occurrence, number and location of metastases. Final staging, according to each technique, was compared. Pathology and imaging follow-up were used as the reference. WB-DWI, WB-PET/CT and WB-PET/MRI correctly and concordantly staged 33/51 patients: stage IIA in 7 patients, stage IIB in 8 patients, stage IIIC in 4 patients and stage IV in 14 patients. WB-DWI, WB-PET/CT and WB-PET/MRI incorrectly and concordantly staged 1/51 patient as stage IV instead of IIIA. Discordant staging was reported in 17/51 patients. WB-PET/MRI resulted in improved staging when compared to WB-PET/CT (50 correctly staged on WB-PET/MRI vs. 38 correctly staged on WB-PET/CT; McNemar's test; p<0.01). Comparing the performance of WB-PET/MRI and WB-DWI (43 correct) did not reveal a statistically significant difference (McNemar test, p=0.14). WB-PET/MRI is more accurate in the initial staging of breast cancer than WB-DWI and WB-PET/CT, however, the discrepancies between WB-PET/MRI and WB-DWI were not statistically significant. When available, WB-PET/MRI should be considered for staging patient with invasive ductal breast carcinoma.
本研究的目的是评估全身扩散加权成像（WB-DWI）、全身正电子发射断层扫描与计算机断层扫描（WB-PET/CT）和全身正电子发射断层扫描与磁共振成像（WB-PET/MRI）在分期治疗前未接受治疗的浸润性导管乳腺癌患者中的性能。51 名新诊断为浸润性导管乳腺癌的女性在治疗前接受了 WB-DWI、WB-PET/CT 和 WB-PET/MRI 检查。一位放射科医生和一位核医学医生对三种模式的图像进行了共识审查，并寻找转移的发生、数量和位置。根据每种技术进行最终分期，并进行比较。病理学和影像学随访作为参考。WB-DWI、WB-PET/CT 和 WB-PET/MRI 正确且一致地对 33/51 例患者进行分期：7 例为 IIA 期，8 例为 IIB 期，4 例为 IIC 期，14 例为 IV 期。WB-DWI、WB-PET/CT 和 WB-PET/MRI 错误且一致地将 1/51 例患者分期为 IV 期而不是 IIIA 期。在 17/51 例患者中报告了分期不一致。与 WB-PET/CT 相比，WB-PET/MRI 可改善分期（在 WB-PET/MRI 上有 50 例分期正确，而在 WB-PET/CT 上有 38 例分期正确；McNemar 检验；p<0.01）。比较 WB-PET/MRI 和 WB-DWI 的性能（43 例正确）并未显示出统计学上的显著差异（McNemar 检验，p=0.14）。在初始乳腺癌分期中，WB-PET/MRI 比 WB-DWI 和 WB-PET/CT 更准确，但是 WB-PET/MRI 与 WB-DWI 之间的差异没有统计学意义。在有条件的情况下，应考虑使用 WB-PET/MRI 对浸润性导管乳腺癌患者进行分期。
