title: Clinical utility of 18F-FDG-PET/MR for preoperative breast cancer staging.
abstract: OBJECTIVE
  To evaluate the performance of 18F-fluorodeoxyglucose (FDG) positron emission tomography magnetic resonance imaging (PET/MR) for preoperative breast cancer staging.
  
  
  METHODS
  Preoperative PET/MR exams of 58 consecutive women with breast cancer were retrospectively reviewed. Histology and mean follow-up of 26 months served as gold standard. Four experienced readers evaluated primary lesions, lymph nodes and distant metastases with contrast-enhanced MRI, qualitative/quantitative PET, and combined PET/MR. ROC curves were calculated for all modalities and their combinations.
  
  
  RESULTS
  The study included 101 breast lesions (83 malignant, 18 benign) and 198 lymph node groups, (34 malignant, 164 benign). Two patients had distant metastases. Areas under the curve (AUC) for breast cancer were 0.9558, 0.8347 and 0.8855 with MRI, and with qualitative and quantitative PET/MR, respectively (p = 0.066). Sensitivity for primary cancers with MRI and quantitative PET/MR was 100 % and 77 % (p = 0.004), and for lymph nodes 88 % and 79 % (p = 0.25), respectively. Specificity for MRI and PET/MR for primary cancers was 67 % and 100 % (p = 0.03) and for lymph nodes 98 % and 100 % (p = 0.25).
  
  
  CONCLUSIONS
  In breast cancer patients, MRI alone has the highest sensitivity for primary tumours. For nodal metastases, both MRI and PET/MR are highly specific.
  
  
  CONCLUSIONS
  • MRI alone and PET/MR have a similar overall diagnostic performance. • MRI alone has a higher sensitivity than PET/MR for local tumour assessment. • Both MRI and PET/MR have a limited sensitivity for nodal metastases. • Positive lymph nodes on MRI or PET/MR do not require presurgical biopsy.
authors.affiliation: Department of Imaging, Division of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland. diomidis.botsikas@hcuge.ch.
authors.forename: Diomidis
authors.identifier: http://orcid.org/0000-0002-0543-0742
authors.initials: D
authors.lastname: Botsikas
authors.affiliation: Department of Imaging, Division of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Kalovidouri
authors.affiliation: Department of Imaging, Division of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Minerva
authors.initials: M
authors.lastname: Becker
authors.affiliation: Department of Imaging, Division of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Michele
authors.initials: M
authors.lastname: Copercini
authors.affiliation: Department of Imaging, Division of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Dahila Amal
authors.initials: DA
authors.lastname: Djema
authors.affiliation: Department of Internal Medicine, Division of Oncology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bodmer
authors.affiliation: Department of Obstetrics and Gynaecology, Division of Gynaecology, Geneva University Hospital, Boulevard de la Cluse 30, 1211, Geneva, Switzerland.
authors.forename: Sindy
authors.initials: S
authors.lastname: Monnier
authors.affiliation: Department of Imaging, Division of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Christoph D
authors.initials: CD
authors.lastname: Becker
authors.affiliation: Department of Imaging, Division of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Xavier
authors.initials: X
authors.lastname: Montet
authors.affiliation: Department of Imaging, Division of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Benedicte M A
authors.initials: BM
authors.lastname: Delattre
authors.affiliation: Department of Imaging, Division of Nuclear Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Osman
authors.initials: O
authors.lastname: Ratib
authors.affiliation: Department of Imaging, Division of Nuclear Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Valentina
authors.initials: V
authors.lastname: Garibotto
authors.affiliation: Department of Imaging, Division of Nuclear Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Claire
authors.initials: C
authors.lastname: Tabouret-Viaud
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG; Breast cancer; Magnetic resonance imaging (MRI); Positron emission tomography (PET); Whole body imaging