Onofrio Antonio Catalano MD, Presenter: Nothing to Disclose

Carlo Iannace MD, Abstract Co-Author: Nothing to Disclose

Maria Lepore MD, Abstract Co-Author: Nothing to Disclose

Alexander Ramos Guimaraes MD, PhD, Abstract Co-Author: Speakers Bureau, Siemens AG Expert Witness, Siemens AG

Bruce R. Rosen MD, PhD, Abstract Co-Author: Research Consultant, Siemens AG

Dushyant V. Sahani MD, Abstract Co-Author: Nothing to Disclose

Peter F. Hahn MD, PhD, Abstract Co-Author: Stockholder, Abbott Laboratories Stockholder, Covidien AG Stockholder, CVS Caremark Corporation Stockholder, Kimberly-Clark Corporation Stockholder, Landauer, Inc

Mark Vangel PhD, Abstract Co-Author: Nothing to Disclose

Angelo Luongo, Abstract Co-Author: Nothing to Disclose

Emanuele Nicolai, Abstract Co-Author: Nothing to Disclose

Andrea Soricelli MD, Abstract Co-Author: Nothing to Disclose

Marco Salvatore MD, Abstract Co-Author: Nothing to Disclose

To compare the diagnostic staging performance and SUV measurement accuracy of whole-body hybrid MR/ PET with PET/CT in patients with breast cancer.

In this prospective IRB approved study, 23 consecutive patients with breast cancer underwent whole-body hybrid FDG PET/CT (Gemini TF, Philips) and same day MR/PET (Biograph mMR, Siemens). PET/CT and MR/PET studies were independently evaluated by two readers. Attenuation correction of MR/PET images was performed with Dixon sequences. The tumor with the highest FDG uptake (primary cancer or metastases) -to-liver SUV ratios were calculated and compared between PET/CT and MR/PET.

MRPET imaging quality was deemed adequate for diagnostic purposes in all patients. 22 out of 23 primary breast cancers showed intense FDG uptake. One breast cancer and the associated metastatic lymph nodes were morphologically consistent with malignancy at MR imaging but showed no FDG uptake. MR/PET imaging had higher mean tumor-to-liver ratios than did PET/CT (2.87± 1.46 for MR/PET vs 2.59 ± 1.1 for PET/CT). The staging for MR/PET and PET/CT agree for 18 of 23 cases (estimated probability of agreement 0.78 +/- 0.09; 95% confidence interval (0.61, 0.95)). In all 5 of the cases of disagreement, the MRPET stage was more advanced than the PETCT stage (PET/CT stage 0, 2a, 2a, 3c, 3c; MR/PET stage 3c, 3c, 4, 4, 4, respectively). In these 5 cases MR/PET findings were confirmed by pathology and/or follow up. Differences were due to absent FDG uptake in one breast cancer and the associated lymphadenopathy that were visible on MR/PET only; detection by MR/PET using DWI and morphologic criteria of non regional lymphadenopathy in two cases and of regional lymphadenopathy in one case, detection of a liver metastases in one case due to a small focus of liver FDG uptake associated with an area of restricted diffusion and altered enhancement in one case that was missed on PET/CT due to its small size.

MR/PET imaging of breast cancer is feasible and provides diagnostic image quality in the assessment of the primary cancer and of possible metastases. MR/PET did not understage any patient when compared to PET/CT. Similar lesion characterization and tumor stage were found in comparing PET/CT and MR/PET images in 18/23 patients.

MR/PET might represent an innovative and valid tool for accurate staging of breast cancer patients.

Catalano, O, Iannace, C, Lepore, M, Guimaraes, A, Rosen, B, Sahani, D, Hahn, P, Vangel, M, Luongo, A, Nicolai, E, Soricelli, A, Salvatore, M, Breast Cancer Staging: Comparison of Whole-body Hybrid MR/PET and PET/CT Imaging: Initial Experience.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044382.html