Assessment of whole-body MRI including diffusion-weighted sequences in the initial staging of breast cancer patients at high risk of metastases in comparison with PET-CT: a prospective cohort study.

Autor: Hottat NA; Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020, Brussels, Belgium. nathalie.hottat@chu-brugmann.be.; Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium. nathalie.hottat@chu-brugmann.be., Badr DA; Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium., Ben Ghanem M; Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020, Brussels, Belgium., Besse-Hammer T; Clinical Research Unit, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium., Lecomte SM; Department of Oncology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium., Vansteelandt C; Department of Oncology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium., Lecomte SL; Department of Pathology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium., Khaled C; Department of Pathology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium., De Grove V; Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020, Brussels, Belgium., Salem Wehbe G; Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium., Cannie MM; 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., Jani JC; Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2024 Jan; Vol. 34 (1), pp. 165-178. Date of Electronic Publication: 2023 Aug 09.
DOI: 10.1007/s00330-023-10060-0
Abstrakt: Objective: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
Clinical Relevance Statement: Whole-body-MRI including DWI is a promising technique for detecting metastases in the initial staging of breast cancer at high risk of metastases.
Key Points: 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%.
(© 2023. The Author(s), under exclusive licence to European Society of Radiology.)
Databáze: MEDLINE
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