Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020, Brussels, Belgium.
Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium.
Eur Radiol. 2024 Jan;34(1):165-178. doi: 10.1007/s00330-023-10060-0. Epub 2023 Aug 9.
The aim of this study was to assess the diffusion-weighted whole-body-MRI (WBMRI) in the initial staging of breast cancer at high risk of metastases in comparison with positron emission tomography (PET)-CT.
Forty-five women were prospectively enrolled. The inclusion criteria were female gender, age >18, invasive breast cancer, an initial PET-CT, and a performance status of 0-2. The exclusion criteria were contraindication to WB-MRI and breast cancer recurrence. The primary outcome was the concordance of WB-MRI and PET-CT in the diagnosis of distant metastases, whereas secondary outcomes included their concordance for the primary tumor and regional lymph nodes (LN), as well as the agreement of WB-MRI interpretation between two radiologists.
The mean age was 51.2 years with a median size of the primary tumor of 30 mm. Concordance between the two modalities was almost perfect for metastases staging, all sites included (k = 0.862), with excellent interobserver agreement. The accuracy of WB-MRI for detecting regional LN, distant LN, lung, liver, or bone metastases ranged from 91 to 96%. In 2 patients, WB-MRI detected bone metastases that were overlooked by PET-CT. WB-MRI showed a substantial agreement with PET-CT for staging the primary tumor, regional LN status, and stage (k = 0.766, k = 0.756, and k = 0.785, respectively) with a high interobserver agreement.
WB-MRI including DWI could be a reliable and reproducible examination in the initial staging of breast cancer patients at high risk of metastases, especially for bone metastases and therefore could be used as a surrogate to PET-CT.
Whole-body-MRI including DWI is a promising technique for detecting metastases in the initial staging of breast cancer at high risk of metastases.
Whole-body-MRI (WB-MRI) was effective for detecting metastases in the initial staging of 45 breast cancer patients at high risk of metastases in comparison with PET-CT. Concordance between WB-MRI and PET-CT was almost perfect for metastases staging, all sites included, with excellent interobserver agreement. The accuracy of WB-MRI for detecting bone metastases was 92%.
本研究旨在评估全身磁共振弥散加权成像（WB-MRI）在高危转移性乳腺癌初始分期中的应用，与正电子发射断层扫描（PET-CT）进行比较。
本研究前瞻性纳入了 45 名女性患者。纳入标准为：女性、年龄＞18 岁、浸润性乳腺癌、初始 PET-CT 检查、体力状态 0-2 分。排除标准为：WB-MRI 禁忌证和乳腺癌复发。主要研究终点为 WB-MRI 与 PET-CT 对远处转移诊断的一致性，次要研究终点包括两者对原发性肿瘤和区域淋巴结（LN）的一致性，以及两名放射科医生对 WB-MRI 解读的一致性。
患者平均年龄为 51.2 岁，中位原发肿瘤大小为 30mm。两种检查方法对转移灶分期的一致性几乎为完美（所有部位 k 值为 0.862），观察者间一致性极好。WB-MRI 检测区域 LN、远处 LN、肺、肝或骨转移的准确率为 91%-96%。在 2 例患者中，WB-MRI 检测到了 PET-CT 漏诊的骨转移。WB-MRI 与 PET-CT 对原发性肿瘤、区域 LN 状态和分期的评估具有高度一致性（k 值分别为 0.766、0.756 和 0.785），观察者间一致性极好。
WB-MRI 包括弥散加权成像可作为高危转移性乳腺癌患者初始分期的一种可靠且可重复的检查方法，特别是在骨转移方面，可替代 PET-CT。
全身磁共振弥散加权成像（WB-MRI）是一种很有前途的技术，可用于检测高危转移性乳腺癌患者的初始转移灶。
与 PET-CT 相比，WB-MRI 可有效检测 45 例高危转移性乳腺癌患者的转移灶。WB-MRI 与 PET-CT 对转移灶分期的一致性几乎为完美（所有部位），观察者间一致性极好。WB-MRI 检测骨转移的准确率为 92%。
