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@ARTICLE{Morawitz:277878,
      author       = {J. Morawitz and N.-M. Bruckmann and K. Jannusch and F.
                      Dietzel and A. Milosevic and A.-K. Bittner and O. Hoffmann
                      and S. Mohrmann and E. Ruckhäberle and L. Häberle and W.
                      P. Fendler$^*$ and K. Herrmann$^*$ and F. L. Giesel and G.
                      Antoch and L. Umutlu and B. Kowall and A. Stang and J.
                      Kirchner},
      title        = {{C}onventional {I}maging, {MRI} and 18{F}-{FDG} {PET}/{MRI}
                      for {N} and {M} {S}taging in {P}atients with {N}ewly
                      {D}iagnosed {B}reast {C}ancer.},
      journal      = {Cancers},
      volume       = {15},
      number       = {14},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2023-01546},
      pages        = {3646},
      year         = {2023},
      abstract     = {Background: This study compares the diagnostic potential of
                      conventional staging (computed tomography (CT), axillary
                      sonography and bone scintigraphy), whole-body magnetic
                      resonance imaging (MRI) and whole-body
                      18F-fluorodeoxyglucose positron emission tomography (18F-FDG
                      PET/)MRI for N and M staging in newly diagnosed breast
                      cancer. Methods: A total of 208 patients with newly
                      diagnosed breast cancer were prospectively included in this
                      study and underwent contrast-enhanced thoracoabdominal CT,
                      bone scintigraphy and axillary sonography as well as
                      contrast-enhanced whole-body 18F-FDG PET/MRI. The datasets
                      were analyzed with respect to lesion localization and
                      characterization. Histopathology and follow-up imaging
                      served as the reference standard. A McNemar test was used to
                      compare the diagnostic performance of conventional staging,
                      MRI and 18F-FDG PET/MRI and a Wilcoxon test was used to
                      compare differences in true positive findings for nodal
                      staging. Results: Conventional staging determined the N
                      stage with a sensitivity of $80.9\%,$ a specificity of
                      $99.2\%,$ a PPV (positive predictive value) of $98.6\%$ and
                      a NPV (negative predictive value) of $87.4\%.$ The
                      corresponding results for MRI were $79.6\%,$ $100\%,$
                      $100\%$ and $87.0\%,$ and were $86.5\%,$ $94.1\%,$ $91.7\%$
                      and $90.3\%$ for 18F-FDG PET/MRI. 18F-FDG PET/MRI was
                      significantly more sensitive in determining malignant lymph
                      nodes than conventional imaging and MRI (p < 0.0001 and p =
                      0.0005). Furthermore, 18F-FDG PET/MRI accurately estimated
                      the clinical lymph node stage in significantly more cases
                      than conventional imaging and MRI (each p < 0.05).
                      Sensitivity, specificity, PPV and NPV for the M stage in
                      conventional staging were $83.3\%,$ $98.5\%,$ $76.9\%$ and
                      $98.9\%,$ respectively. The corresponding results for both
                      MRI and 18F-FDG PET/MRI were $100.0\%,$ $98.5\%,$ $80.0\%$
                      and $100.0\%.$ No significant differences between the
                      imaging modalities were seen for the staging of distant
                      metastases. Conclusions:18F-FDG PET/MRI detects lymph node
                      metastases in significantly more patients and estimates
                      clinical lymph node stage more accurately than conventional
                      imaging and MRI. No significant differences were found
                      between imaging modalities with respect to the detection of
                      distant metastases.},
      keywords     = {18F-FDG PET/MRI (Other) / breast cancer (Other) /
                      metastases (Other) / staging (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37509307},
      pmc          = {pmc:PMC10377867},
      doi          = {10.3390/cancers15143646},
      url          = {https://inrepo02.dkfz.de/record/277878},
}