Tags

Type your tag names separated by a space and hit enter

Assessment of multifocality and axillary nodal involvement in early-stage breast cancer patients using 18F-FDG PET/CT compared to contrast-enhanced and diffusion-weighted magnetic resonance imaging and sentinel node biopsy.
Acta Radiol. 2015 Aug; 56(8):917-23.AR

Abstract

BACKGROUND

Non-invasive evaluation of the extent of axillary nodal involvement in early-stage breast cancer (ESBC) patients and accurate assessment of multifocality are both challenging. Few reports have explored whether 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) might be more useful than other diagnostic methods in these contexts.

PURPOSE

To prospectively evaluate the diagnostic utility of FDG PET/CT, contrast-enhanced, and diffusion-weighted magnetic resonance imaging (DCE-MRI and DWI), and sentinel lymph node biopsy (SNB), in detection of axillary metastatic lymph nodes in ESBC patients; and to explore the utilities of FDG PET/CT and DCE-MRI for identification of multifocality.

MATERIAL AND METHODS

Twenty-four female patients (mean age, 47 ± 9.9 years; range, 24-68 years) with ESBC underwent whole-body FDG PET/CT and breast MRI prior to operation. SNB and axillary lymph node dissection (ALND) were performed on all patients, as was mastectomy or wide local tumor excision. Histopathological findings served as the gold standard when evaluating either multifocality or axillary nodal involvement.

RESULTS

The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, of PET/CT and DCE-MRI, used to detect multifocality, were as follows: 67% versus 78%, 100% versus 53%, 100% versus 50%, 83% versus 80%, and 88% versus 63%. SNB afforded the highest sensitivity (93%) in terms of detection of axillary metastasis. The sensitivity, NPV, and accuracy of PET/CT were 67%, 62%, and 75% respectively, thus higher than the equivalent values of either DCE-MRI or DWI.

CONCLUSION

For assessment of multifocality in ESBC patients, highly specific results of PET/CT should be taken into account along with DCE-MRI findings. For evaluation of axillary nodal involvement, PET/CT has higher sensitivity, NPV, and accuracy values than DCE-MRI and DWI and may guide a surgical decision to proceed or not to SNB or ALND.

Authors+Show Affiliations

Department of Nuclear Medicine, Bezmialem Vakif University School of Medicine, Istanbul, Turkey nurhanergul@yahoo.com.Department of Surgery, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.Department of Radiology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.Department of Radiation Oncology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.Department of Pathology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.Department of Nuclear Medicine, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.Department of Nuclear Medicine, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.Department of Surgery, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25013091

Citation

Ergul, Nurhan, et al. "Assessment of Multifocality and Axillary Nodal Involvement in Early-stage Breast Cancer Patients Using 18F-FDG PET/CT Compared to Contrast-enhanced and Diffusion-weighted Magnetic Resonance Imaging and Sentinel Node Biopsy." Acta Radiologica (Stockholm, Sweden : 1987), vol. 56, no. 8, 2015, pp. 917-23.
Ergul N, Kadioglu H, Yildiz S, et al. Assessment of multifocality and axillary nodal involvement in early-stage breast cancer patients using 18F-FDG PET/CT compared to contrast-enhanced and diffusion-weighted magnetic resonance imaging and sentinel node biopsy. Acta Radiol. 2015;56(8):917-23.
Ergul, N., Kadioglu, H., Yildiz, S., Yucel, S. B., Gucin, Z., Erdogan, E. B., Aydin, M., & Muslumanoglu, M. (2015). Assessment of multifocality and axillary nodal involvement in early-stage breast cancer patients using 18F-FDG PET/CT compared to contrast-enhanced and diffusion-weighted magnetic resonance imaging and sentinel node biopsy. Acta Radiologica (Stockholm, Sweden : 1987), 56(8), 917-23. https://doi.org/10.1177/0284185114539786
Ergul N, et al. Assessment of Multifocality and Axillary Nodal Involvement in Early-stage Breast Cancer Patients Using 18F-FDG PET/CT Compared to Contrast-enhanced and Diffusion-weighted Magnetic Resonance Imaging and Sentinel Node Biopsy. Acta Radiol. 2015;56(8):917-23. PubMed PMID: 25013091.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of multifocality and axillary nodal involvement in early-stage breast cancer patients using 18F-FDG PET/CT compared to contrast-enhanced and diffusion-weighted magnetic resonance imaging and sentinel node biopsy. AU - Ergul,Nurhan, AU - Kadioglu,Huseyin, AU - Yildiz,Seyma, AU - Yucel,Serap Baskaya, AU - Gucin,Zuhal, AU - Erdogan,Ezgi Basak, AU - Aydin,Mehmet, AU - Muslumanoglu,Mahmut, Y1 - 2014/07/10/ PY - 2014/01/11/received PY - 2014/05/23/accepted PY - 2014/7/12/entrez PY - 2014/7/12/pubmed PY - 2015/9/24/medline KW - Breast KW - PET KW - magnetic resonance diffusion/perfusion KW - magnetic resonance imaging (MRI) SP - 917 EP - 23 JF - Acta radiologica (Stockholm, Sweden : 1987) JO - Acta Radiol VL - 56 IS - 8 N2 - BACKGROUND: Non-invasive evaluation of the extent of axillary nodal involvement in early-stage breast cancer (ESBC) patients and accurate assessment of multifocality are both challenging. Few reports have explored whether 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) might be more useful than other diagnostic methods in these contexts. PURPOSE: To prospectively evaluate the diagnostic utility of FDG PET/CT, contrast-enhanced, and diffusion-weighted magnetic resonance imaging (DCE-MRI and DWI), and sentinel lymph node biopsy (SNB), in detection of axillary metastatic lymph nodes in ESBC patients; and to explore the utilities of FDG PET/CT and DCE-MRI for identification of multifocality. MATERIAL AND METHODS: Twenty-four female patients (mean age, 47 ± 9.9 years; range, 24-68 years) with ESBC underwent whole-body FDG PET/CT and breast MRI prior to operation. SNB and axillary lymph node dissection (ALND) were performed on all patients, as was mastectomy or wide local tumor excision. Histopathological findings served as the gold standard when evaluating either multifocality or axillary nodal involvement. RESULTS: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, of PET/CT and DCE-MRI, used to detect multifocality, were as follows: 67% versus 78%, 100% versus 53%, 100% versus 50%, 83% versus 80%, and 88% versus 63%. SNB afforded the highest sensitivity (93%) in terms of detection of axillary metastasis. The sensitivity, NPV, and accuracy of PET/CT were 67%, 62%, and 75% respectively, thus higher than the equivalent values of either DCE-MRI or DWI. CONCLUSION: For assessment of multifocality in ESBC patients, highly specific results of PET/CT should be taken into account along with DCE-MRI findings. For evaluation of axillary nodal involvement, PET/CT has higher sensitivity, NPV, and accuracy values than DCE-MRI and DWI and may guide a surgical decision to proceed or not to SNB or ALND. SN - 1600-0455 UR - https://www.unboundmedicine.com/medline/citation/25013091/Assessment_of_multifocality_and_axillary_nodal_involvement_in_early_stage_breast_cancer_patients_using_18F_FDG_PET/CT_compared_to_contrast_enhanced_and_diffusion_weighted_magnetic_resonance_imaging_and_sentinel_node_biopsy_ L2 - https://journals.sagepub.com/doi/10.1177/0284185114539786?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -