Determining the axillary nodal status with four current imaging modalities including 18 F-FDG PET/MRI in newly diagnosed breast cancer: A comparative study using histopathology as reference standard
To compare breast magnetic resonance imaging (MRI), thoracal MRI, thoracal F-fluorodeoxyglucose positron emission tomography ( F-FDG PET)/MRI and axillary sonography for the detection of axillary lymph node metastases in women with newly diagnosed breast cancer. This prospective double-center study...
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| creator | Morawitz, Janna Bruckmann, Nils-Martin Dietzel, Frederic Ullrich, Tim Bittner, Ann-Kathrin Hoffmann, Oliver Mohrmann, Svjetlana Haeberle, Lena Ingenwerth, Marc Umutlu, Lale Fendler, Wolfgang Peter Fehm, Tanja Herrmann, Ken Antoch, Gerald Sawicki, Lino Morris Kirchner, Julian |
| description | To compare breast magnetic resonance imaging (MRI), thoracal MRI, thoracal
F-fluorodeoxyglucose positron emission tomography (
F-FDG PET)/MRI and axillary sonography for the detection of axillary lymph node metastases in women with newly diagnosed breast cancer.
This prospective double-center study included patients with newly diagnosed breast cancer between March 2018 and December 2019. Patients underwent thoracal (
F-FDG PET/)MRI, axillary sonography, and dedicated prone breast MRI. Datasets were evaluated separately regarding nodal status (nodal+ vs. nodal-). Histopathology served as reference standard in all patients. The diagnostic performance of breast MRI, thoracal MRI, thoracal PET/MRI and axillary sonography in detecting nodal positive patients was tested by creating receiver-operating-characteristic curves (ROC) with a calculated area under the curve (AUC). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for all four modalities. A McNemar test was used to assess differences.
112 female patients (mean age 53.04 ± 12.6 years) were evaluated. Thoracal PET/MRI showed the highest ROC-AUC with a value of 0.892. The AUC for breast MRI, thoracal MRI and sonography were 0.782, 0.814 and 0.834, respectively. Differences between thoracal PET/MRI and axillary sonography, thoracal MRI and breast MRI were statistically significant (PET/MRI vs. axillary sonography,
= 0.01; PET/MRI vs. thoracal MRI,
= 0.02; PET/MRI vs. breast MRI,
= 0.03). PET/MRI showed the highest sensitivity (81.8%, 36/44) (95%-CI: 67.29-91.81%) while axillary sonography had the highest specificity (98.5%, 65/66), 95%-CI: 91.84-99.96%).
F-FDG PET/MRI outperforms axillary sonography, breast MRI and thoracal MRI in determining the axillary lymph node status. In a clinical setting, the combination of
F-FDG PET/MRI and axillary sonography might be considered to provide even more accuracy in diagnosis. |
| doi_str_mv | 10.2967/jnumed.121.262009 |
| format | Article |
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F-fluorodeoxyglucose positron emission tomography (
F-FDG PET)/MRI and axillary sonography for the detection of axillary lymph node metastases in women with newly diagnosed breast cancer.
This prospective double-center study included patients with newly diagnosed breast cancer between March 2018 and December 2019. Patients underwent thoracal (
F-FDG PET/)MRI, axillary sonography, and dedicated prone breast MRI. Datasets were evaluated separately regarding nodal status (nodal+ vs. nodal-). Histopathology served as reference standard in all patients. The diagnostic performance of breast MRI, thoracal MRI, thoracal PET/MRI and axillary sonography in detecting nodal positive patients was tested by creating receiver-operating-characteristic curves (ROC) with a calculated area under the curve (AUC). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for all four modalities. A McNemar test was used to assess differences.
112 female patients (mean age 53.04 ± 12.6 years) were evaluated. Thoracal PET/MRI showed the highest ROC-AUC with a value of 0.892. The AUC for breast MRI, thoracal MRI and sonography were 0.782, 0.814 and 0.834, respectively. Differences between thoracal PET/MRI and axillary sonography, thoracal MRI and breast MRI were statistically significant (PET/MRI vs. axillary sonography,
= 0.01; PET/MRI vs. thoracal MRI,
= 0.02; PET/MRI vs. breast MRI,
= 0.03). PET/MRI showed the highest sensitivity (81.8%, 36/44) (95%-CI: 67.29-91.81%) while axillary sonography had the highest specificity (98.5%, 65/66), 95%-CI: 91.84-99.96%).
F-FDG PET/MRI outperforms axillary sonography, breast MRI and thoracal MRI in determining the axillary lymph node status. In a clinical setting, the combination of
F-FDG PET/MRI and axillary sonography might be considered to provide even more accuracy in diagnosis.</description><identifier>EISSN: 1535-5667</identifier><identifier>DOI: 10.2967/jnumed.121.262009</identifier><identifier>PMID: 34016726</identifier><language>eng</language><publisher>United States</publisher><ispartof>The Journal of nuclear medicine (1978), 2021-05</ispartof><rights>Copyright © 2021 by the Society of Nuclear Medicine and Molecular Imaging, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0001-6694-247X ; 0000-0002-5106-3584 ; 0000-0002-8982-5601</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34016726$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morawitz, Janna</creatorcontrib><creatorcontrib>Bruckmann, Nils-Martin</creatorcontrib><creatorcontrib>Dietzel, Frederic</creatorcontrib><creatorcontrib>Ullrich, Tim</creatorcontrib><creatorcontrib>Bittner, Ann-Kathrin</creatorcontrib><creatorcontrib>Hoffmann, Oliver</creatorcontrib><creatorcontrib>Mohrmann, Svjetlana</creatorcontrib><creatorcontrib>Haeberle, Lena</creatorcontrib><creatorcontrib>Ingenwerth, Marc</creatorcontrib><creatorcontrib>Umutlu, Lale</creatorcontrib><creatorcontrib>Fendler, Wolfgang Peter</creatorcontrib><creatorcontrib>Fehm, Tanja</creatorcontrib><creatorcontrib>Herrmann, Ken</creatorcontrib><creatorcontrib>Antoch, Gerald</creatorcontrib><creatorcontrib>Sawicki, Lino Morris</creatorcontrib><creatorcontrib>Kirchner, Julian</creatorcontrib><title>Determining the axillary nodal status with four current imaging modalities including 18 F-FDG PET/MRI in newly diagnosed breast cancer: A comparative study using histopathology as reference standard</title><title>The Journal of nuclear medicine (1978)</title><addtitle>J Nucl Med</addtitle><description>To compare breast magnetic resonance imaging (MRI), thoracal MRI, thoracal
F-fluorodeoxyglucose positron emission tomography (
F-FDG PET)/MRI and axillary sonography for the detection of axillary lymph node metastases in women with newly diagnosed breast cancer.
This prospective double-center study included patients with newly diagnosed breast cancer between March 2018 and December 2019. Patients underwent thoracal (
F-FDG PET/)MRI, axillary sonography, and dedicated prone breast MRI. Datasets were evaluated separately regarding nodal status (nodal+ vs. nodal-). Histopathology served as reference standard in all patients. The diagnostic performance of breast MRI, thoracal MRI, thoracal PET/MRI and axillary sonography in detecting nodal positive patients was tested by creating receiver-operating-characteristic curves (ROC) with a calculated area under the curve (AUC). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for all four modalities. A McNemar test was used to assess differences.
112 female patients (mean age 53.04 ± 12.6 years) were evaluated. Thoracal PET/MRI showed the highest ROC-AUC with a value of 0.892. The AUC for breast MRI, thoracal MRI and sonography were 0.782, 0.814 and 0.834, respectively. Differences between thoracal PET/MRI and axillary sonography, thoracal MRI and breast MRI were statistically significant (PET/MRI vs. axillary sonography,
= 0.01; PET/MRI vs. thoracal MRI,
= 0.02; PET/MRI vs. breast MRI,
= 0.03). PET/MRI showed the highest sensitivity (81.8%, 36/44) (95%-CI: 67.29-91.81%) while axillary sonography had the highest specificity (98.5%, 65/66), 95%-CI: 91.84-99.96%).
F-FDG PET/MRI outperforms axillary sonography, breast MRI and thoracal MRI in determining the axillary lymph node status. In a clinical setting, the combination of
F-FDG PET/MRI and axillary sonography might be considered to provide even more accuracy in diagnosis.</description><issn>1535-5667</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNqFkE1Ow0AMhUdIiJafA7BBvkDbSUKmKTtEG2CBhFD3lZtxk6kmM9H8UHJBzkUiwZqVpefPz89m7Dbh83QlloujiS3JeZIm81SknK_O2DTJs3yWC7GcsEvvj5xzURTFBZtk9zwRy1RM2feaArlWGWVqCA0Bfimt0fVgrEQNPmCIHk4qNHCw0UEVnSMTQLVYjzPtiKmgyIMylY5yFJMCylm5fob3zXbx9vE6tMDQSfcgFdbGepKwd4Q-QIWmIvcAj1DZtkOHQX3SsDbKHqIfzRrlg-0wNFbbugf04OhAQ4hq5NBIdPKanR9Qe7r5rVfsrtxsn15mXdwPb9l1bsjr-t3f4dm_wA_v0G45</recordid><startdate>20210520</startdate><enddate>20210520</enddate><creator>Morawitz, Janna</creator><creator>Bruckmann, Nils-Martin</creator><creator>Dietzel, Frederic</creator><creator>Ullrich, Tim</creator><creator>Bittner, Ann-Kathrin</creator><creator>Hoffmann, Oliver</creator><creator>Mohrmann, Svjetlana</creator><creator>Haeberle, Lena</creator><creator>Ingenwerth, Marc</creator><creator>Umutlu, Lale</creator><creator>Fendler, Wolfgang Peter</creator><creator>Fehm, Tanja</creator><creator>Herrmann, Ken</creator><creator>Antoch, Gerald</creator><creator>Sawicki, Lino Morris</creator><creator>Kirchner, Julian</creator><scope>NPM</scope><orcidid>https://orcid.org/0000-0001-6694-247X</orcidid><orcidid>https://orcid.org/0000-0002-5106-3584</orcidid><orcidid>https://orcid.org/0000-0002-8982-5601</orcidid></search><sort><creationdate>20210520</creationdate><title>Determining the axillary nodal status with four current imaging modalities including 18 F-FDG PET/MRI in newly diagnosed breast cancer: A comparative study using histopathology as reference standard</title><author>Morawitz, Janna ; Bruckmann, Nils-Martin ; Dietzel, Frederic ; Ullrich, Tim ; Bittner, Ann-Kathrin ; Hoffmann, Oliver ; Mohrmann, Svjetlana ; Haeberle, Lena ; Ingenwerth, Marc ; Umutlu, Lale ; Fendler, Wolfgang Peter ; Fehm, Tanja ; Herrmann, Ken ; Antoch, Gerald ; Sawicki, Lino Morris ; Kirchner, Julian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-pubmed_primary_340167263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morawitz, Janna</creatorcontrib><creatorcontrib>Bruckmann, Nils-Martin</creatorcontrib><creatorcontrib>Dietzel, Frederic</creatorcontrib><creatorcontrib>Ullrich, Tim</creatorcontrib><creatorcontrib>Bittner, Ann-Kathrin</creatorcontrib><creatorcontrib>Hoffmann, Oliver</creatorcontrib><creatorcontrib>Mohrmann, Svjetlana</creatorcontrib><creatorcontrib>Haeberle, Lena</creatorcontrib><creatorcontrib>Ingenwerth, Marc</creatorcontrib><creatorcontrib>Umutlu, Lale</creatorcontrib><creatorcontrib>Fendler, Wolfgang Peter</creatorcontrib><creatorcontrib>Fehm, Tanja</creatorcontrib><creatorcontrib>Herrmann, Ken</creatorcontrib><creatorcontrib>Antoch, Gerald</creatorcontrib><creatorcontrib>Sawicki, Lino Morris</creatorcontrib><creatorcontrib>Kirchner, Julian</creatorcontrib><collection>PubMed</collection><jtitle>The Journal of nuclear medicine (1978)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morawitz, Janna</au><au>Bruckmann, Nils-Martin</au><au>Dietzel, Frederic</au><au>Ullrich, Tim</au><au>Bittner, Ann-Kathrin</au><au>Hoffmann, Oliver</au><au>Mohrmann, Svjetlana</au><au>Haeberle, Lena</au><au>Ingenwerth, Marc</au><au>Umutlu, Lale</au><au>Fendler, Wolfgang Peter</au><au>Fehm, Tanja</au><au>Herrmann, Ken</au><au>Antoch, Gerald</au><au>Sawicki, Lino Morris</au><au>Kirchner, Julian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Determining the axillary nodal status with four current imaging modalities including 18 F-FDG PET/MRI in newly diagnosed breast cancer: A comparative study using histopathology as reference standard</atitle><jtitle>The Journal of nuclear medicine (1978)</jtitle><addtitle>J Nucl Med</addtitle><date>2021-05-20</date><risdate>2021</risdate><eissn>1535-5667</eissn><abstract>To compare breast magnetic resonance imaging (MRI), thoracal MRI, thoracal
F-fluorodeoxyglucose positron emission tomography (
F-FDG PET)/MRI and axillary sonography for the detection of axillary lymph node metastases in women with newly diagnosed breast cancer.
This prospective double-center study included patients with newly diagnosed breast cancer between March 2018 and December 2019. Patients underwent thoracal (
F-FDG PET/)MRI, axillary sonography, and dedicated prone breast MRI. Datasets were evaluated separately regarding nodal status (nodal+ vs. nodal-). Histopathology served as reference standard in all patients. The diagnostic performance of breast MRI, thoracal MRI, thoracal PET/MRI and axillary sonography in detecting nodal positive patients was tested by creating receiver-operating-characteristic curves (ROC) with a calculated area under the curve (AUC). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for all four modalities. A McNemar test was used to assess differences.
112 female patients (mean age 53.04 ± 12.6 years) were evaluated. Thoracal PET/MRI showed the highest ROC-AUC with a value of 0.892. The AUC for breast MRI, thoracal MRI and sonography were 0.782, 0.814 and 0.834, respectively. Differences between thoracal PET/MRI and axillary sonography, thoracal MRI and breast MRI were statistically significant (PET/MRI vs. axillary sonography,
= 0.01; PET/MRI vs. thoracal MRI,
= 0.02; PET/MRI vs. breast MRI,
= 0.03). PET/MRI showed the highest sensitivity (81.8%, 36/44) (95%-CI: 67.29-91.81%) while axillary sonography had the highest specificity (98.5%, 65/66), 95%-CI: 91.84-99.96%).
F-FDG PET/MRI outperforms axillary sonography, breast MRI and thoracal MRI in determining the axillary lymph node status. In a clinical setting, the combination of
F-FDG PET/MRI and axillary sonography might be considered to provide even more accuracy in diagnosis.</abstract><cop>United States</cop><pmid>34016726</pmid><doi>10.2967/jnumed.121.262009</doi><orcidid>https://orcid.org/0000-0001-6694-247X</orcidid><orcidid>https://orcid.org/0000-0002-5106-3584</orcidid><orcidid>https://orcid.org/0000-0002-8982-5601</orcidid></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| title | Determining the axillary nodal status with four current imaging modalities including 18 F-FDG PET/MRI in newly diagnosed breast cancer: A comparative study using histopathology as reference standard |
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