The Role of MR DWIBS in Systemic Assessment of Breast Cancer Patients; Comparative Study with FDG PET CT
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- Category: Vol. 85, June 2017
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The Role of MR DWIBS in Systemic Assessment of Breast Cancer Patients; Comparative Study with FDG PET CT, MAHMOUD M.A. REZK, MOHAMED A. MAHER, MAHA H. HELAL, NAGLAA M. ABDEL RAZEK, NOHA A. EL-DEIB and ESMAT EL-FAYOUMY
Abstract
Background: The detection of neoplastic lesions in cancer patients is recently introduced by MRI whole body with developing safe non contrast diffusion based sequence make it easier in improving the diagnostic accuracy.
Aim: To assess the role of magnetic resonance (MR) diffusion-weighted imaging with background suppression (DWIBS ) in breast cancer patients for metastatic work up.
Material and Methods: This prospective institutional review board–approved study included 50 women with histo-pathologically prove breast cancer (mean age, 57.1 years; range, 50-69 years), who gave informed consent. From July 2014 to January 2016; all of them underwent DWIBS, whole body T1WI and STIR and standardized 18 FDG PET CT. Both F-18-FDG PET-CT and WB-MRI/DWIBS were inde-pendently interpreted using visual qualitative and quantitative analysis in the term of SUV max and ADC mean respectively. Using pathological data and/or combined clinical/radiological follow-up as a reference standard, sensitivity, specificity, PPV, NPV and overall accuracy were estimated for both techniques.
Results: DWIBS showed high sensitivity indices of DWIBS were depicted in assessment of nodal and bone marrow lesions with fair specificity indices. A high degree of agreement also existed between DWIBS and PET CT with little better accuracy of FDG PET CT more appreciated in the pulmonary lesions assessment. It scores over PET CT in assessment soft tissue lesions and hepatic metastatic lesions.
Conclusion: MR DWIBS as diagnostic tool with rather no risk (no radiation, no contrast, no isotope) and with com-parable results to PET CT makes DWIBS as a promising and helpful tool that may become complimentary to initial staging and follow up of patients with proven malignancies.