title: MRI fused with prone FDG PET/CT improves the primary tumour staging of patients with breast cancer.
abstract: OBJECTIVE
  Our aim was to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in primary tumour staging of patients with breast cancer.
  
  
  METHODS
  This retrospective study evaluated 45 women with 49 pathologically proven breast carcinomas. MRI and prone PET-CT scans with time-of-flight and point-spread-function reconstruction were performed with the same dedicated breast coil. The studies were assessed by a radiologist and a nuclear medicine physician, and evaluation of fused images was made by consensus. The final diagnosis was based on pathology (90 lesions) or follow-up ≥ 24 months (17 lesions).
  
  
  RESULTS
  The study assessed 72 malignant and 35 benign lesions with a median size of 1.8 cm (range 0.3-8.4 cm): 31 focal, nine multifocal and nine multicentric cases. In lesion-by-lesion analysis, sensitivity, specificity, positive and negative predictive values were 97%, 80%, 91% and 93% for MRI, 96%, 71%, 87%, and 89% for prone PET, and 97%. 94%, 97% and 94% for MRI fused with PET. Areas under the curve (AUC) were 0.953, 0.850, and 0.983, respectively (p < 0.01).
  
  
  CONCLUSIONS
  MRI fused with FDG-PET is more accurate than FDG-PET in primary tumour staging of breast cancer patients and increases the specificity of MRI.
  
  
  CONCLUSIONS
  • FDG PET-CT may improve the specificity of MRI in breast cancer staging. • MRI fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose PET-CT has better overall diagnostic performance than MRI. • The clinical role of fused PET-MRI has not yet been established.
authors.affiliation: Department of Nuclear Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain. mjgarciave@unav.es.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Garcia-Velloso
authors.affiliation: Department of Nuclear Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Ribelles
authors.affiliation: Department of Nuclear Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Macarena
authors.initials: M
authors.lastname: Rodriguez
authors.affiliation: Department of Occupational Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Fernandez-Montero
authors.affiliation: Department of Nuclear Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Lidia
authors.initials: L
authors.lastname: Sancho
authors.affiliation: Department of Nuclear Medicine, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Prieto
authors.affiliation: Department of Oncology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Santisteban
authors.affiliation: Department of Surgery, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: Rodriguez-Spiteri
authors.affiliation: Department of Pathology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Idoate
authors.affiliation: Department of Surgery, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Martinez-Regueira
authors.affiliation: Department of Radiology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Arlette
authors.initials: A
authors.lastname: Elizalde
authors.affiliation: Department of Radiology, Clinica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Spain.
authors.forename: Luis J
authors.initials: LJ
authors.lastname: Pina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D016684:Prone Position; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Breast cancer; FDG; Magnetic resonance imaging (MRI); Prone positron emission tomography computed tomography (PET-CT); Staging