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[Diagnostic value of whole-body MRI and bone scintigraphy in the detection of osseous metastases in patients with breast cancer--A Prospective Double-Blinded Study at two Hospital Centers].
Rofo. 2009 Mar; 181(3):255-63.ROFO

Abstract

PURPOSE

The purpose of this study was to compare the diagnostic accuracy of whole-body MRI (WB-MRI) and bone scintigraphy (BS) for the screening of bone metastases for the first time in a large and homogeneous patient collective with breast cancer in a systematic and controlled study.

MATERIALS AND METHOD

213 breast cancer patients were evaluated for bone metastases under randomized, double-blinded and prospective conditions at two hospitals. All participants were examined by WB-MRI and BS over an average period of four days. The examinations were performed separately at two different locations. The WB-MRI protocol included T 1-TSE and STIR sequences. WB-MRI and BS were reviewed independently by experienced radiologists and nuclear medicine specialists in a consensus reading.

RESULTS

In 66 % of cases bone metastases were excluded by both procedures, and bone metastases were detected concordantly in 2 % of cases. In 7 % of cases there were discrepant results: in 7 cases BS was false-positive when WB-MRI was negative. In 5 / 7 cases BS was negative when WB-MRI identified bone metastases. In 89 % of cases BS was uncertain when WB-MRI was true-negative. In 17 % of cases WB-MRI showed important (non-) tumor-associated findings. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy for WB-MRI were 90 %, 94 %, 82 %, 98 % and 99 % and for BS those were 40 %, 81 %, 36 %, 91 % and 93 %.

CONCLUSION

It could be demonstrated that WB-MRI is superior to BS for detecting bone metastases in breast cancer patients. These results should be considered for the next version of the S 3 guideline "Diagnosis, Therapy and Follow-Up of Breast Cancer".

Authors+Show Affiliations

Institut für Diagnostische und Interventionelle Radiologie, Caritasklinik St. Theresia, Akademisches Lehrkrankenhaus der Universität des Saarlandes, Saarbrücken. su.oh@web.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

ger

PubMed ID

19229791

Citation

Ohlmann-Knafo, S, et al. "[Diagnostic Value of Whole-body MRI and Bone Scintigraphy in the Detection of Osseous Metastases in Patients With Breast cancer--A Prospective Double-Blinded Study at Two Hospital Centers]." RoFo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin, vol. 181, no. 3, 2009, pp. 255-63.
Ohlmann-Knafo S, Kirschbaum M, Fenzl G, et al. [Diagnostic value of whole-body MRI and bone scintigraphy in the detection of osseous metastases in patients with breast cancer--A Prospective Double-Blinded Study at two Hospital Centers]. Rofo. 2009;181(3):255-63.
Ohlmann-Knafo, S., Kirschbaum, M., Fenzl, G., & Pickuth, D. (2009). [Diagnostic value of whole-body MRI and bone scintigraphy in the detection of osseous metastases in patients with breast cancer--A Prospective Double-Blinded Study at two Hospital Centers]. RoFo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin, 181(3), 255-63. https://doi.org/10.1055/s-0028-1109104
Ohlmann-Knafo S, et al. [Diagnostic Value of Whole-body MRI and Bone Scintigraphy in the Detection of Osseous Metastases in Patients With Breast cancer--A Prospective Double-Blinded Study at Two Hospital Centers]. Rofo. 2009;181(3):255-63. PubMed PMID: 19229791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Diagnostic value of whole-body MRI and bone scintigraphy in the detection of osseous metastases in patients with breast cancer--A Prospective Double-Blinded Study at two Hospital Centers]. AU - Ohlmann-Knafo,S, AU - Kirschbaum,M, AU - Fenzl,G, AU - Pickuth,D, Y1 - 2009/02/19/ PY - 2009/2/21/entrez PY - 2009/2/21/pubmed PY - 2009/3/6/medline SP - 255 EP - 63 JF - RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin JO - Rofo VL - 181 IS - 3 N2 - PURPOSE: The purpose of this study was to compare the diagnostic accuracy of whole-body MRI (WB-MRI) and bone scintigraphy (BS) for the screening of bone metastases for the first time in a large and homogeneous patient collective with breast cancer in a systematic and controlled study. MATERIALS AND METHOD: 213 breast cancer patients were evaluated for bone metastases under randomized, double-blinded and prospective conditions at two hospitals. All participants were examined by WB-MRI and BS over an average period of four days. The examinations were performed separately at two different locations. The WB-MRI protocol included T 1-TSE and STIR sequences. WB-MRI and BS were reviewed independently by experienced radiologists and nuclear medicine specialists in a consensus reading. RESULTS: In 66 % of cases bone metastases were excluded by both procedures, and bone metastases were detected concordantly in 2 % of cases. In 7 % of cases there were discrepant results: in 7 cases BS was false-positive when WB-MRI was negative. In 5 / 7 cases BS was negative when WB-MRI identified bone metastases. In 89 % of cases BS was uncertain when WB-MRI was true-negative. In 17 % of cases WB-MRI showed important (non-) tumor-associated findings. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy for WB-MRI were 90 %, 94 %, 82 %, 98 % and 99 % and for BS those were 40 %, 81 %, 36 %, 91 % and 93 %. CONCLUSION: It could be demonstrated that WB-MRI is superior to BS for detecting bone metastases in breast cancer patients. These results should be considered for the next version of the S 3 guideline "Diagnosis, Therapy and Follow-Up of Breast Cancer". SN - 1438-9010 UR - https://www.unboundmedicine.com/medline/citation/19229791/[Diagnostic_value_of_whole_body_MRI_and_bone_scintigraphy_in_the_detection_of_osseous_metastases_in_patients_with_breast_cancer__A_Prospective_Double_Blinded_Study_at_two_Hospital_Centers]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0028-1109104 DB - PRIME DP - Unbound Medicine ER -