Impact of<sup>18</sup>F-FDG PET/MRI on Therapeutic Management of Women with Newly Diagnosed Breast Cancer: Results from a Prospective Double-Center Trial
Our rationale was to investigate whether <sup>18</sup>F-FDG PET/MRI in addition to (guideline-recommended) conventional staging leads to changes in therapeutic management in patients with newly diagnosed breast cancer and compare the diagnostic accuracy of <sup>18</sup>F-FDG PET/MRI with that of conventional staging for determining the Union for International Cancer Control (UICC) stage. <b>Methods:</b> In this prospective, double-center study, 208 women with newly diagnosed, therapy-naïve invasive breast cancer were enrolled in accordance with the inclusion criteria. All patients underwent guideline-recommended conventional staging and whole-body <sup>18</sup>F-FDG PET/MRI with a dedicated breast examination. A multidisciplinary tumor board served to determine 2 different therapy recommendations for each patient, one based on conventional staging alone and another based on combined assessment of conventional staging and <sup>18</sup>F-FDG PET/MRI examinations. Major changes in therapy recommendations and differences between the conventional staging algorithm and <sup>18</sup>F-FDG PET/MRI for determining the correct UICC stage were reported and evaluated. <b>Results:</b> Major changes in therapeutic management based on combined assessment of conventional staging and <sup>18</sup>F-FDG PET/MRI were detected in 5 of 208 patients, amounting to changes in therapeutic management in 2.4% (95% CI, 0.78%-5.2%) of the study population. In determining the UICC stage, the guideline-based staging algorithm and <sup>18</sup>F-FDG PET/MRI were concordant in 135 of 208 (64.9%; 95% CI, 58%-71.4%) patients. The conventional guideline algorithm correctly determined the UICC stage in 130 of 208 (62.5%; 95% CI, 55.5%-69.1%) patients, and <sup>18</sup>F-FDG PET/MRI correctly determined the UICC stage in 170 of 208 (81.9%; 95% CI, 75.8%-86.7%) patients. <b>Conclusion:</b> Despite the diagnostic superiority of <sup>18</sup>F-FDG PET/MRI over conventional staging in determining the correct UICC stage, the current (guideline-recommended) conventional staging algorithm is sufficient for adequate therapeutic management of patients with newly diagnosed breast cancer, and <sup>18</sup>F-FDG PET/MRI does not have an impact on patient management.
Authors
- Julian Kirchner (ORCID: https://orcid.org/0000-0001-8224-3433)
- Nils Martin Bruckmann (ORCID: https://orcid.org/0000-0002-8982-5601)
- Janna Morawitz (ORCID: https://orcid.org/0000-0001-6694-247X)
- Christiane Matuschek (ORCID: https://orcid.org/0000-0002-6578-1704)
- Svjetlana Mohrmann
- Eugen Ruckhäberle
- Werner Schmid (ORCID: https://orcid.org/0000-0002-8868-5942)
- Lena Häberle (ORCID: https://orcid.org/0000-0002-8793-568X)
- Lale Umutlu (ORCID: https://orcid.org/0000-0001-5215-7171)
- Gerald Antoch (ORCID: https://orcid.org/0000-0001-7834-3714)
- Wolfgang P. Fendler (ORCID: https://orcid.org/0000-0002-5106-3584)
- Iréne Esposito (ORCID: https://orcid.org/0000-0002-0554-2402)
- Kai Jannusch (ORCID: https://orcid.org/0000-0001-7285-3430)
- Johannes Grueneisen (ORCID: https://orcid.org/0000-0002-7560-8657)
- Martin Stuschke (ORCID: https://orcid.org/0000-0001-6836-0940)
- Wilfried Budach
- Andreas Stang (ORCID: https://orcid.org/0000-0001-6363-9061)
- Ann‐Kathrin Bittner (ORCID: https://orcid.org/0000-0002-8909-5514)
- Bernd Kowall (ORCID: https://orcid.org/0000-0003-4163-1696)
- Oliver Hoffmann (ORCID: https://orcid.org/0000-0003-3093-9054)
- Ken Herrmann
- Christian Buchbender
- Frederik Lars Giesel (ORCID: https://orcid.org/0000-0002-9669-5593)
Institutions
- Zimmer Biomet (Netherlands) (NL)
- Düsseldorf University Hospital (DE)
- Essen University Hospital (DE)
- West German Heart and Vascular Center Essen (DE)
- Deutsches Konsortium für Translationale Krebsforschung (DE)
- Heinrich Heine University Düsseldorf (DE)
- University of Duisburg-Essen (DE)
Publication Details
- Journal
- Journal of Nuclear Medicine
- Published
- 2024-10-10
- DOI
- https://doi.org/10.2967/jnumed.124.268065
- Primary Topic
- Medical Imaging Techniques and Applications
- Type
- article
- Field-Weighted Citation Impact
- 0.00