title: Comparison of CE-FDG-PET/CT with CE-FDG-PET/MR in the evaluation of osseous metastases in breast cancer patients.
abstract: BACKGROUND
  Despite improvements in treatments, metastatic breast cancer remains difficult to cure. Bones constitute the most common site of first-time recurrence, occurring in 40-75% of cases. Therefore, evaluation for possible osseous metastases is crucial. Technetium 99 ((99)Tc) bone scintigraphy and fluorodexossyglucose (FDG) positron emission tomography (PET)-computed tomography (PET-CT) are the most commonly used techniques to assess osseous metastasis. PET magnetic resonance (PET-MR) imaging is an innovative technique still under investigation. We compared the capability of PET-MR to that of same-day PET-CT to assess osseous metastases in patients with breast cancer.
  
  
  METHODS
  One hundred and nine patients with breast cancer, who underwent same-day contrast enhanced (CE)-PET-CT and CE-PET-MR, were evaluated. CE-PET-CT and CE-PET-MR studies were interpreted by consensus by a radiologist and a nuclear medicine physician. Correlations with prior imaging and follow-up studies were used as the reference standard. Binomial confidence intervals and a χ(2) test were used for categorical data, and paired t-test was used for the SUVmax data; a non-informative prior Bayesian approach was used to estimate and compare the specificities.
  
  
  RESULTS
  Osseous metastases affected 25 out 109 patients. Metastases were demonstrated by CE-PET-CT in 22 out of 25 patients (88%±7%), and by CE-PET-MR in 25 out of 25 patients (100%). CE-PET-CT revealed 90 osseous metastases and CE-PET-MR revealed 141 osseous metastases (P<0.001). The estimated sensitivity of CE-PET-CT and CE-PET-MR were 0.8519 and 0.9630, respectively. The estimated specificity for CE-FDG-PET-MR was 0.9884. The specificity of CE-PET-CT cannot be determined from patient-level data, because CE-PET-CT yielded a false-positive lesion in a patient who also had other, true metastases.
  
  
  CONCLUSIONS
  CE-PET-MR detected a higher number of osseous metastases than did same-day CE-PET-CT, and was positive for 12% of the patients deemed osseous metastasis-negative on the basis of CE-PET-CT.
authors: Department of Radiology, University of Naples Parthenope -SDN IRCCS, Via F. Acton 38, Napoli, Na 80143, Italy.
authors: O A
authors: OA
authors: Catalano
authors: Department of Nuclear Medicine, SDN IRCCS, Via Gianturco 113, Napoli, Na 80143, Italy.
authors: E
authors: E
authors: Nicolai
authors: Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard University Medical School, 149 Thirteenth Street, Charlestown, MA 02129, USA.
authors: B R
authors: BR
authors: Rosen
authors: Department of Radiology, University of Naples 'Federico II', Naples, NA 80131, Italy.
authors: A
authors: A
authors: Luongo
authors: Department of Radiology, University of Naples 'Federico II', Naples, NA 80131, Italy.
authors: M
authors: M
authors: Catalano
authors: Department of Surgery, Breast Unit, G. Moscati Hospital, Avellino, AV 83100, Italy.
authors: C
authors: C
authors: Iannace
authors: Department of Radiology, Oregon Health and Sciences University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA.
authors: A
authors: A
authors: Guimaraes
authors: Department of Radiology, MGH Biostatistics Center and MGH Martinos Center, Harvard University Medical School, 149 Thirteenth Street, Charlestown, MA 02129, USA.
authors: M G
authors: MG
authors: Vangel
authors: Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard University Medical School, 149 Thirteenth Street, Charlestown, MA 02129, USA.
authors: U
authors: U
authors: Mahmood
authors: Department of Radiology, University of Naples Parthenope -SDN IRCCS, Via F. Acton 38, Napoli, Na 80143, Italy.
authors: A
authors: A
authors: Soricelli
authors: Department of Radiology and of Nuclear Medicine, SDN IRCCS, Via Gianturco 113, Napoli, Na 80143, Italy.
authors: M
authors: M
authors: Salvatore
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18