PT  - JOURNAL ARTICLE
AU  - Jannusch, Kai
AU  - Umutlu, Lale
AU  - Kirchner, Julian
AU  - Bruckmann, Nils-Martin
AU  - Morawitz, Janna
AU  - Herrmann, Ken
AU  - Fendler, Wolfgang Peter
AU  - Bittner, Ann-Kathrin
AU  - Hoffmann, Oliver
AU  - Mohrmann, Svjetlana
AU  - Ruckhäberle, Eugen
AU  - Stuschke, Martin
AU  - Schmid, Werner
AU  - Giesel, Frederik
AU  - Häberle, Lena
AU  - Esposito, Irene
AU  - Budach, Wilfried
AU  - Grueneisen, Johannes
AU  - Matuschek, Christiane
AU  - Kowall, Bernd
AU  - Stang, Andreas
AU  - Antoch, Gerald
AU  - Buchbender, Christian
TI  - 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
AID  - 10.2967/jnumed.124.268065
DP  - 2024 Dec 01
TA  - Journal of Nuclear Medicine
PG  - 1855--1861
VI  - 65
IP  - 12
4099  - http://jnm.snmjournals.org/content/65/12/1855.short
4100  - http://jnm.snmjournals.org/content/65/12/1855.full
SO  - J Nucl Med2024 Dec 01; 65
AB  - Our rationale was to investigate whether 18F-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 18F-FDG PET/MRI with that of conventional staging for determining the Union for International Cancer Control (UICC) stage. Methods: 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 18F-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 18F-FDG PET/MRI examinations. Major changes in therapy recommendations and differences between the conventional staging algorithm and 18F-FDG PET/MRI for determining the correct UICC stage were reported and evaluated. Results: Major changes in therapeutic management based on combined assessment of conventional staging and 18F-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 18F-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 18F-FDG PET/MRI correctly determined the UICC stage in 170 of 208 (81.9%; 95% CI, 75.8%–86.7%) patients. Conclusion: Despite the diagnostic superiority of 18F-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 18F-FDG PET/MRI does not have an impact on patient management.