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Nuklearmedizin 2014; 53(03): 89-94
DOI: 10.3413/Nukmed-0605-13-06
Original article
Schattauer GmbH

Diagnostic performance of 18F-FDG PET/CT, ultrasonography and MRI

Detection of axillary lymph node metastasis in breast cancer patientsDiagnostische Aussagekraft von 18F-FDG PET/CT, Sonografie und MRTNachweis axillärer Lymphknotenmetastasen bei Brustkrebspatientinnen
Y.-S. An
1   Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
,
D. H. Lee
1   Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
,
J.-K Yoon
1   Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
,
S. J. Lee
1   Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
,
T. H. Kim
2   Department of Radiology, Ajou University School of Medicine, Suwon, Korea
,
D. K. Kang
2   Department of Radiology, Ajou University School of Medicine, Suwon, Korea
,
K. S. Kim
3   Department of Surgery, Ajou University School of Medicine, Suwon, Korea
,
Y. S. Jung
3   Department of Surgery, Ajou University School of Medicine, Suwon, Korea
,
H. Yim
4   Department of Pathology, Ajou University School of Medicine, Suwon, Korea
› Author Affiliations
Further Information

Publication History

received: 25 June 2013

accepted in revised form: 26 August 2013

Publication Date:
02 January 2018 (online)

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Summary

The aim of this study was to evaluate the diagnostic abilities of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) compared with those of ultrasonography and magnetic resonance imaging (MRI) for axillary lymph node staging in breast cancer patients. Patients, methods: Pre- operative 18F-FDG PET/non-contrast CT, ultrasonography and MRI were performed in 215 women with breast cancer. Axillary lymph node dissection was performed in all patients and the diagnostic performance of each modality was evaluated using histopathologic assessments as the reference standard. ROC curves were compared to evaluate the diagnostic ability of several imaging modalities (i. e., ultrasonography, MRI and 18F-FDG PET/CT). Results: In total, 132 patients (61.4%) had axillary lymph node metastasis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the detection of axillary lymph node metastasis were 72.3%, 77.3%, 66.7%, 81.6%, 75.3% for ultrasonography, 67.5%, 78.0%, 65.9%, 79.2%, 74.0% for MRI, and 62.7%, 88.6%, 77.6%, 79.1%, 78.6% for 18F-FDG PET/CT, respectively. There was no significant difference in diagnostic ability among the imaging modalities (i.e., ultrasonography, MRI and 18F-FDG PET/CT). The diagnostic ability of 18F-FDG PET/CT was significantly improved by combination with MRI (p = 0.0002) or ultrasonography (p < 0.0001). The combination of 18F-FDG PET/CT with ultrasonography had a similar diagnostic ability to that of all three modalities combined (18F-FDG PET/CT+ultraso- nography+MRI, p = 0.05). Conclusion: The diagnostic performance of 18F-FDG PET/CT for detection of axillary node metastasis was not significantly different from that of ultrasonography or MRI in breast cancer patients. Combining 18F-FDG PET/CT with ultrasonography or MRI could improve the diagnostic performance compared to 18F-FDG PET/CT alone.

Zusammenfassung

Ziel dieser Studie war die Evaluierung der diagnostischen Bedeutung der 18F-Fluor deoxyglucose(FDG)-Positronenemissionstomo grafie/Computertomografie (PET/CT), verglichen mit Sonografie und Magnetresonanzto- mografie, im Staging axillärer Lymphknoten bei Brustkrebspatientinnen. Patientinnen, Methoden: Präoperativ wurden 215 Frauen mit Brustkrebs mittels 18F-FDG/CT (ohne Kontrastmittel), Sonografie oder MRT untersucht. Allen Patientinnen wurden axilläre Lymphknoten entnommen; die diagnostische jeder Methode wurde mit histopathologischen Ergebnissen als Referenzstandard evaluiert. Zur Beurteilung der diagnostischen Aussage wurden die ROC-Kurven der drei bildgebenden Methoden verglichen. Ergebnisse: Insgesamt wiesen 132 Patientinnen (61,4%) axilläre Lymphknotenmetastasen auf. Sensitivität, Spezifität, positiver bzw. negativer Vorhersagewert und Genauigkeit beim Nachweis axillärer Lymphknotenmetastasen lagen bei 72,3%, 77,3%, 66,7%, 81,6%, 75.3% für Sonografie, 67,5%, 78,0%, 65,9%, 79,2%, 74,0% für MRT sowie 62,7%, 88,6%, 77,6%, 79,1%, 78,6% für 18F-FDG-PET/CT. Hinsichtlich der diagnostischen Aussage bestand kein signifikanter Unterschied zwischen den drei Methoden. Die diagnostische Leistungsfähigkeit der 18F-FDG PET/CT konnte durch Kombination mit MRT (p = 0,0002) oder Sonografie (p < 0,0001) deutlich gesteigert werden. Die Kombination aus 18F-FDG-PET/CT und Sonografie war diagnostisch ähnlich aussagekräftig wie die aus den drei Methoden (18F-FDG-PET/CT + MRT + Sonografie, p = 0,05). Schlussfolgerung: Zum Nachweis axillärer Lymphknotenmetastasen bei Brustkrebspatientinnen unterschied sich die diagnostische Aussagekraft der 18F-FDG- PET/CT nicht signifikant von der der Sonogra- fie oder MRT. Kombinationen aus 18F-FDG- PET/CT und Sonografie oder MRT könnten die diagnostische Leistungsfähigkeit gegenüber der 18F-FDG-PET/CT jedoch verbessern.

Keywords

18F-FDG PET/CT - ultrasonography - MRI - breast cancer - axillary lymph node

Schlüsselwörter

18F-FDG PET/CT - Sonografie - MRT - Brustkrebs - axilläre Lymphknoten
 

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