Positron Emission Tomography/Magnetic Resonance Imaging for Local Tumor Staging in Patients With Primary Breast Cancer

Grueneisen, Johannes; Nagarajah, James; Buchbender, Christian; Hoffmann, Oliver; Schaarschmidt, Benedikt Michael; Poeppel, Thorsten D.; Forsting, Michael; Quick, Harald H.; Umutlu, Lale; Kinner, Sonja

doi:10.1097/rli.0000000000000197

Cited by 90 publications

(89 citation statements)

References 32 publications

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“…The treatment plan was adjusted in all these patients. Considering cT-stage, a recent study by Grueneisen et al found that both PET/MRI and MRI enable better determination of breast tumor extent in comparison to PET/CT [26]. Similar to our results, PET/MRI did not provide diagnostic advantages for breast tumor staging compared to MRI alone.…”

Section: Discussionsupporting

confidence: 80%

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Hybrid 18F–FDG PET/MRI might improve locoregional staging of breast cancer patients prior to neoadjuvant chemotherapy

Goorts

Vöö

Nijnatten

et al. 2017

Eur J Nucl Med Mol Imaging

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Purpose Our purpose in this study was to assess the added clinical value of hybrid 18 F-FDG-PET/MRI compared to conventional imaging for locoregional staging in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). Methods In this prospective study, primary invasive cT2-4 N0 or cT1-4 N+ breast cancer patients undergoing NAC were included. A PET/MRI breast protocol was performed before treatment. MR images were evaluated by a breast radiologist, blinded for PET images. PET images were evaluated by a nuclear physician. Afterwards, a combined PET/MRI report was written. PET/MRI staging was compared to conventional imaging, i.e., mammography, ultrasound and MRI. The proportion of patients with a modified treatment plan based on PET/MRI findings was analyzed.Results A total of 40 patients was included. PET/MRI was of added clinical value in 20.0% (8/40) of patients, changing the treatment plan in 10% and confirming the malignancy of suspicious lesions on MRI in another 10%. In seven (17.5%) patients radiotherapy fields were extended because of additional or affirmative PET/MRI findings being lymph node metastases (n = 5) and sternal bone metastases (n = 2). In one (2.5%) patient radiotherapy fields were reduced because of fewer lymph node metastases on PET/MRI compared to conventional imaging. Interestingly, all treatment changes were based on differences in number of lymph nodes suspicious for metastasis or number of distant metastasis, whereas differences in intramammary tumor extent were not observed. Conclusion Prior to NAC, PET/MRI shows promising results for locoregional staging compared to conventional imaging, changing the treatment plan in 10% of patients and potentially replacing PET/CT or tissue sampling in another 10% of patients.

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Section: Discussionsupporting

confidence: 80%

“…PET/MRI, MRI and PET/ CT allowed for a correct positive or negative axillary nodal status in 86%, 80% and 88%, respectively (p > 0,05) [26]. Similar to our results, PET shows best results for axillary lymph node staging.…”

Section: Discussionsupporting

confidence: 79%

Hybrid 18F–FDG PET/MRI might improve locoregional staging of breast cancer patients prior to neoadjuvant chemotherapy

Goorts

Vöö

Nijnatten

et al. 2017

Eur J Nucl Med Mol Imaging

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“…PET/CT was compared with PET/MRI in two studies totaling 85 patients (Table 4) (57,58). In the first, Pace et al confirmed the feasibility of PET/MRI in 36 breast cancer patients (57).…”

Section: Clinical Indications For Pet/mrimentioning

confidence: 99%

“…In the second study, on another 49 patients with 83 lesions, the modalities performed at a comparable level (58). However, T-stage was determined correctly in more patients with PET/MRI (41/50; 82%) than with PET/CT (34/50; 68% [ P < 0.05]).…”

Section: Clinical Indications For Pet/mrimentioning

confidence: 99%

¹⁸F-FDG PET/CT and PET/MRI Perform Equally Well in Cancer: Evidence from Studies on More Than 2,300 Patients

2016

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18F-FDG PET/CT has become the reference standard in oncologic imaging against which the performance of other imaging modalities is measured. The promise of PET/MRI includes multiparametric imaging to further improve diagnosis and phenotyping of cancer. Rather than focusing on these capabilities, many investigators have examined whether 18F-FDG PET combined with mostly anatomic MRI improves cancer staging and restaging. After a description of PET/MRI scanner designs and a discussion of technical and operational issues, we review the available literature to determine whether cancer assessments are improved with PET/MRI. The available data show that PET/MRI is feasible and performs as well as PET/CT in most types of cancer. Diagnostic advantages may be achievable in prostate cancer and in bone metastases, whereas disadvantages exist in lung nodule assessments. We conclude that 18F-FDG PET/MRI and PET/CT provide comparable diagnostic information when MRI is used simply to provide the anatomic framework. Thus, PET/MRI could be used in lieu of PET/CT if this approach becomes economically viable and if reasonable workflows can be established. Future studies should explore the multiparametric potential of MRI.

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“…For the N-staging, PET/MRI showed similar results of diagnostic accuracy with PET/CT (86 % vs. 88 %) and tended to be higher than MRI (80 %) [41]. Another study showed that PET/MRI provided lower sensitivity for primary tumor than MRI (77 % vs. 100 %), but higher specificity (100 % vs. 67 %).…”

Section: Breast Cancermentioning

confidence: 53%

FDG Whole-Body PET/MRI in Oncology: a Systematic Review

Kwon

Becker

Goo

et al. 2016

Nucl Med Mol Imaging

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The recent advance in hybrid imaging techniques enables offering simultaneous positron emission tomography (PET)/magnetic resonance imaging (MRI) in various clinical fields. 18F-fluorodeoxyglucose (FDG) PET has been widely used for diagnosis and evaluation of oncologic patients. The growing evidence from research and clinical experiences demonstrated that PET/MRI with FDG can provide comparable or superior diagnostic performance more than conventional radiological imaging such as computed tomography (CT), MRI or PET/CT in various cancers. Combined analysis using structural information and functional/molecular information of tumors can draw additional diagnostic information based on PET/MRI. Further studies including determination of the diagnostic efficacy, optimizing the examination protocol, and analysis of the hybrid imaging results is necessary for extending the FDG PET/MRI application in clinical oncology.

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Positron Emission Tomography/Magnetic Resonance Imaging for Local Tumor Staging in Patients With Primary Breast Cancer

Cited by 90 publications

References 32 publications

Hybrid 18F–FDG PET/MRI might improve locoregional staging of breast cancer patients prior to neoadjuvant chemotherapy

Hybrid 18F–FDG PET/MRI might improve locoregional staging of breast cancer patients prior to neoadjuvant chemotherapy

¹⁸F-FDG PET/CT and PET/MRI Perform Equally Well in Cancer: Evidence from Studies on More Than 2,300 Patients

FDG Whole-Body PET/MRI in Oncology: a Systematic Review

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Positron Emission Tomography/Magnetic Resonance Imaging for Local Tumor Staging in Patients With Primary Breast Cancer

Cited by 90 publications

References 32 publications

Hybrid 18F–FDG PET/MRI might improve locoregional staging of breast cancer patients prior to neoadjuvant chemotherapy

Hybrid 18F–FDG PET/MRI might improve locoregional staging of breast cancer patients prior to neoadjuvant chemotherapy

18F-FDG PET/CT and PET/MRI Perform Equally Well in Cancer: Evidence from Studies on More Than 2,300 Patients

FDG Whole-Body PET/MRI in Oncology: a Systematic Review

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¹⁸F-FDG PET/CT and PET/MRI Perform Equally Well in Cancer: Evidence from Studies on More Than 2,300 Patients