title: Effectiveness of Breast MRI and (18)F-FDG PET/CT for the Preoperative Staging of Invasive Lobular Carcinoma versus Ductal Carcinoma.
abstract: OBJECTIVE
  We evaluated the utility of magnetic resonance imaging (MRI) and (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) for the preoperative staging of invasive lobular carcinoma (ILC) of the breast and compared the results with those of invasive ductal carcinoma (IDC).
  
  
  METHODS
  The study included pathologically proven 32 ILCs and 73 IDCs. We compared clinical and histopathological characteristics and the diagnostic performances of MRI and (18)F-FDG PET/CT for the primary mass, additional ipsilateral and/or contralateral lesion(s), and axillary lymph node metastasis between the ILC and IDC groups.
  
  
  RESULTS
  Primary ILCs were greater in size, but demonstrated lower maximum standardized uptake values than IDCs. All primary masses were detected on MRI. The detection rate for ILCs (75.0%) was lower than that for IDCs (83.6%) on (18)F-FDG PET/CT, but the difference was not significant. For additional ipsilateral lesion(s), the sensitivities and specificities of MRI were 87.5% and 58.3% for ILC and 100.0% and 66.7% for IDC, respectively; whereas the sensitivities and specificities of (18)F-FDG PET/CT were 0% and 91.7% for ILC and 37.5% and 94.7% for IDC, respectively. The sensitivity of (18)F-FDG PET/CT for ipsilateral lesion(s) was significantly lower in the ILC group than the IDC group. The sensitivity for ipsilateral lesion(s) was significantly higher with MRI; however, specificity was higher with (18)F-FDG PET/CT in both tumor groups. There was no significant difference in the diagnostic performance for additional contralateral lesion(s) or axillary lymph node metastasis on MRI or (18)F-FDG PET/CT for ILC versus IDC.
  
  
  CONCLUSIONS
  The MRI and (18)F-FDG PET/CT detection rates for the primary cancer do not differ between the ILC and IDC groups. Although (18)F-FDG PET/CT demonstrates lower sensitivity for primary and additional ipsilateral lesions, it shows higher specificity for additional ipsilateral lesions, and could play a complementary role in the staging of ILC as well as IDC.
authors.affiliation: Department of Radiology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.
authors.forename: Na Young
authors.initials: NY
authors.lastname: Jung
authors.affiliation: Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Sung Hun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Ye Young
authors.initials: YY
authors.lastname: Seo
authors.affiliation: Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
authors.forename: Jin Kyoung
authors.initials: JK
authors.lastname: Oh
authors.affiliation: Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Hyun Su
authors.initials: HS
authors.lastname: Choi
authors.affiliation: Department of Radiology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.
authors.forename: Won Jong
authors.initials: WJ
authors.lastname: You
keywords: 18F-fluorodeoxyglucose positron emission tomography/computed tomography; Breast; Ductal carcinoma; Lobular carcinoma; Magnetic resonance imaging
references.citation: Breast Cancer Res Treat. 2010 Jan;119(2):415-22
references.pmid: 19885731
references.citation: AJR Am J Roentgenol. 2004 Oct;183(4):1149-57
references.pmid: 15385322
references.citation: Am Surg. 2011 Oct;77(10):1368-71
references.pmid: 22127091
references.citation: JAMA. 2003 Mar 19;289(11):1421-4
references.pmid: 12636465
references.citation: Breast Cancer Res Treat. 2004 Jul;86(1):31-7
references.pmid: 15218359
references.citation: AJR Am J Roentgenol. 1996 Dec;167(6):1415-9
references.pmid: 8956569
references.citation: Breast Cancer Res Treat. 2008 Jan;107(1):1-14
references.pmid: 18043894
references.citation: Clin Imaging. 2006 Mar-Apr;30(2):94-8
references.pmid: 16500539
references.citation: AJR Am J Roentgenol. 2002 Jul;179(1):171-8
references.pmid: 12076929
references.citation: J Clin Oncol. 2000 Oct 15;18(20):3495-502
references.pmid: 11032590
references.citation: Breast J. 2004 Mar-Apr;10 (2):89-93
references.pmid: 15009033
references.citation: Eur J Nucl Med Mol Imaging. 2009 Oct;36(10 ):1543-50
references.pmid: 19415270
references.citation: Acta Radiol. 1999 Jul;40(4):369-75
references.pmid: 10394863
references.citation: AJR Am J Roentgenol. 2003 Feb;180(2):333-41
references.pmid: 12540428
references.citation: Ann Surg Oncol. 2010 Oct;17 Suppl 3:255-62
references.pmid: 20853043
references.citation: Eur J Surg Oncol. 2003 Feb;29(1):32-7
references.pmid: 12559074
references.citation: Breast J. 2008 May-Jun;14(3):236-44
references.pmid: 18476882
references.citation: Breast Cancer Res Treat. 2011 Jul;128(2):429-35
references.pmid: 21562708
references.citation: Jpn J Radiol. 2011 Aug;29(7):475-82
references.pmid: 21882089
references.citation: Eur J Nucl Med Mol Imaging. 2004 Jun;31 Suppl 1:S80-7
references.pmid: 15127240
references.citation: Acta Radiol. 2012 May 1;53(4):367-75
references.pmid: 22553225
references.citation: Radiology. 2007 Jun;243(3):670-80
references.pmid: 17446524
references.citation: Ultrasound Med Biol. 2005 Feb;31(2):167-74
references.pmid: 15708454
references.citation: J Clin Oncol. 2002 Jan 15;20(2):379-87
references.pmid: 11786564
references.citation: J Breast Cancer. 2012 Dec;15(4):441-8
references.pmid: 23346174
references.citation: Breast Cancer Res. 2004;6(3):R149-56
references.pmid: 15084238
references.citation: Oncologist. 2012;17 (5):613-9
references.pmid: 22539550
references.citation: AJR Am J Roentgenol. 2003 Apr;180(4):901-10
references.pmid: 12646427
references.citation: Radiology. 1991 Jan;178(1):149-54
references.pmid: 1984294