September 1, 2015 - Diagnostic accuracy for suspicious breast lesions >10 mm was equal between ¹⁸F-FDG PET/CT (fludeoxyglucose F 18 positron emission tomography/computed tomography) and CE-MRI (contrast-enhanced magnetic resonance imaging ) at 3 tesla (3T), according to a recent study published in European Journal of Nuclear Medicine and Molecular Imaging.¹ However, for lesions <10 mm, diagnostic accuracy detiorated for both techniques, and CE-MRI at 3 T seemed to be more sensitive but less specific than ¹⁸F-FDG PET/CT.

The researchers evaluated 172 patients with an imaging abnormality to determine he influence of tumour size on diagnostic accuracy and the use of maximum standardized uptake value (SUV_MAX) thresholds to differentiate malignant from benign breast lesions. All patients underwent ¹⁸F-FDG PET/CT and CE-MRI of the breast at 3 T in the prone position. There were 132 malignant and 40 benign lesions; 23 lesions (13.4 %) were <10 mm. They found no significant difference in diagnostic accuracy as both ¹⁸F-FDG PET/CT and CE-MRI achieved an overall diagnostic accuracy of 93%. Diagnostic accuracy dropped to 91% with lesions <10 mm, and CE-MRI at 3T was more sensitive but less specific than ¹⁸F-FDG PET/CT.

Image: 3T MRI is coupled with the latest 3-D color-flow computer-aided diagnosis (CAD) software.²

The authors concluded that ¹⁸F-FDG PET/CT and CE-MRI at 3T showed equal diagnostic accuracies in breast cancer diagnosis, and that quantitative assessment using an SUV_MAX threshold for differentiating benign from malignant lesions was not helpful in breast cancer diagnosis.

References:

1. Magometschnigg HF, Baltzer PA, Fueger B, et al. Diagnostic accuracy of ¹⁸F-FDG PET/CT compared with that of contrast-enhanced MRI of the breast at 3 T. European Journal of Nuclear Medicine and Molecular Imaging. October 2015, Volume 42, Issue 11, pp 1656-1665. (http://link.springer.com/article/10.1007%2Fs00259-015-3099-1)

2. Why should women consider a 3T MRI for breast screening? October 21st, 2013. http://www.imagingsc.com/why-should-women-consider-a-3t-mri-for-breast-screening/