Diagnostic accuracy of fused positron emission tomography/magnetic resonance mammography: initial results.
OBJECTIVE
The aim of this study was to evaluate the diagnostic accuracy of fused fluoro-deoxy-D-glucose positron emission tomography/magnetic resonance mammography (FDG-PET/MRM) in breast cancer patients and to compare FDG-PET/MRM with MRM.


METHODS
27 breast cancer patients (mean age 58.9±9.9 years) underwent MRM and prone FDG-PET. Images were fused software-based to FDG-PET/MRM images. Histopathology served as the reference standard to define the following parameters for both MRM and FDG-PET/MRM: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for the detection of breast cancer lesions. Furthermore, the number of patients with correctly determined lesion focality was assessed. Differences between both modalities were assessed by McNemaŕs test (p<0.05). The number of patients in whom FDG-PET/MRM would have changed the surgical approach was determined.


RESULTS
58 breast lesions were evaluated. The sensitivity, specificity, PPV, NPV and accuracy were 93%, 60%, 87%, 75% and 85% for MRM, respectively. For FDG-PET/MRM they were 88%, 73%, 90%, 69% and 92%, respectively. FDG-PET/MRM was as accurate for lesion detection (p = 1) and determination of the lesions' focality (p = 0.7722) as MRM. In only 1 patient FDG-PET/MRM would have changed the surgical treatment.


CONCLUSIONS
FDG-PET/MRM is as accurate as MRM for the evaluation of local breast cancer. FDG-PET/MRM defines the tumours' focality as accurately as MRM and may have an impact on the surgical treatment in only a small portion of patients. Based on these results, FDG-PET/MRM cannot be recommended as an adjunct or alternative to MRM.
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University at Duisburg-Essen, Germany. till.heusner@uni-duisburg-essen.de
T A
TA
Heusner
S
S
Hahn
C
C
Jonkmanns
S
S
Kuemmel
F
F
Otterbach
M E
ME
Hamami
A R
AR
Stahl
A
A
Bockisch
M
M
Forsting
G
G
Antoch
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D008327:Mammography / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D019275:Radiopharmaceuticals; D012015:Reference Standards; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed / Q000379:methods* / Q000592:standards
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18