Rezk Mahmoud, Nasr Ibrahim, Ali Ismail, Abdelhamed Heba
Department of Radiology, National Cancer Institute, Cairo University, Cairo, Egypt.
Department of Oncology and Nuclear Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Indian J Nucl Med. 2019 Jan-Mar;34(1):1-9. doi: 10.4103/ijnm.IJNM_121_18.
This study aims to assess the diagnostic performance of F-fluorodeoxyglucose-positron emission tomography/computerized tomography (FDG-PET/CT) compared to whole body (WB) magnetic resonance diffusion-weighted imaging (DWI) with background body signal suppression (MR/DWIBS) in lesions detection in patients with recurrent breast cancer.
Twenty-three female patients with suspected breast cancer recurrence by clinical, laboratory, or conventional imaging underwent both FDG-PET/CT and WB MR/DWIBS. WB FDG-PET/CT was performed using the standard technique. WB MR/DWIBS acquired sequences were WB DWI with short tau inversion recovery (STIR), coronal T1, and coronal STIR. Both FDG-PET/CT and WB-magnetic resonance imaging/DWIBS were independently interpreted using visual qualitative and quantitative analysis. Pathological findings and combined clinical/radiological follow-up data were used as a reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated for both techniques.
PET/CT demonstrated higher specificity and sensitivity indices than MR/DWIBS in the detection of the nodal and distant lesions, while the latter displayed higher sensitivity in the detection of local breast lesions. The overall sensitivity, specificity, NPV, PPV, and accuracy of PET/CT were 84.8%, 86.3%, 90.4%, 78.7%, and 85.4% versus 82.1%, 78.0%, 85.2%, 74.0%, and 80.5% for MR/DWIBS. A high degree of agreement existed between PET/CT and MR-DWIBS.
FDG-PET/CT is more sensitive and has superiority in the assessment of nodal and distant lesions than DWIBS that has a potential superior role in the assessment of local breast lesions. DWIBS has a promising and helpful complementary tool for FDG-PET/CT in the evaluation of patients with proven malignancies.
本研究旨在评估氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）与全身（WB）背景体部信号抑制磁共振扩散加权成像（MR/DWIBS）在复发性乳腺癌患者病变检测中的诊断性能。
23例经临床、实验室或传统影像学检查怀疑乳腺癌复发的女性患者接受了FDG-PET/CT和WB MR/DWIBS检查。采用标准技术进行WB FDG-PET/CT检查。WB MR/DWIBS采集的序列包括带短tau反转恢复（STIR）的WB DWI、冠状位T1和冠状位STIR。FDG-PET/CT和WB磁共振成像/DWIBS均采用视觉定性和定量分析进行独立解读。病理结果以及临床/放射学联合随访数据用作参考标准。计算两种技术的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和总体准确率。
在检测淋巴结和远处病变方面，PET/CT显示出比MR/DWIBS更高的特异性和敏感性指标，而后者在检测乳腺局部病变方面显示出更高的敏感性。PET/CT的总体敏感性、特异性、NPV、PPV和准确率分别为84.8%、86.3%、90.4%、78.7%和85.4%，而MR/DWIBS分别为82.1%、78.0%、85.2%、74.0%和80.5%。PET/CT与MR-DWIBS之间存在高度一致性。
FDG-PET/CT在评估淋巴结和远处病变方面比DWIBS更敏感且具有优势，而DWIBS在评估乳腺局部病变方面可能具有优势作用。在评估已确诊恶性肿瘤的患者时，DWIBS是FDG-PET/CT一种有前景且有用的补充工具。
