Detection of internal mammary chain infiltration in breast cancer patients by [18F]FDG PET/MRI. Therapy implications

Revista espanola de medicina nuclear e imagen molecular Pub Date : 2024-03-01 DOI:10.1016/j.remnie.2023.10.004

J.R. Garcia, M. Kauak, A. Compte, P. Bassa, E. Llinares, E. Valls, E. Riera

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Abstract

Objective

To evaluate the detection rate and therapeutic implication of the infiltration of the internal mammary chain (IMCI) by [¹⁸F]FDG PET/MRI for staging of patients with breast cancer.

Methods

Prospective study including 41 women with breast cancer (stage ≥ IIB) staged by [¹⁸F]FDG PET/MR. Two-phase exam: breast imaging (prone), whole-body (supine).

TNM stage assessed by peer consensus with Nuclear Medicine and Radiology specialists. Study of the afferent vessel (AV) to IMC by breast MRI. IMCI was correlated with age, AV-IMC, T stage, breast quadrants, axillary and distant infiltration.

Therapeutic re-evaluation by a multidisciplinary committee.

Results

IMCI detection rate of 34% (14/41), with 8/14 patients under 55 years of age. All 14 patients with IMCI showed AV-IMC, 6 of them (43.9%) without VA-axillary. Of 27/41 patients without IMCI, in 13 (48.1%) only AV-axillary was found, in the remaining 14 (51.9%), AV-axillary and AV-IMC was found.

In 57% (8/14) tumours were multicentric and 42% (6/14) focal, in inner quadrants in 4/6 (66.7%).

In 1/14 patient (7.1%) only IMCI was found, in 9/14 (64.3%) axillary and IMC, in 4/14 patients (28.6%) distant lesions were detected.

Committee re-evaluation: no further treatment in 27/41 patients (65.8%), thoracic radiotherapy in 10/41 patients (24.4%), systemic therapy in 4/41 patients (9.7%).

Conclusion

Our detection rate of IMCI in breast cancer staging by [¹⁸F]FDG PET/MR was 34%.

Related factors were age, multicentric tumours, inner quadrants, detection of AV-IMC, NM staging.

The evidence of IMCI allowed tailored therapy, with thoracic radiotherapy implementation in 24.4% of patients.

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[18F]FDGPET/MRI检测癌症患者内乳链浸润。治疗含义。

目的：评价[18F]FDGPET/MRI乳腺内链（IMCI）浸润在癌症分期中的检出率及治疗意义。方法：前瞻性研究，包括41例癌症（分期 ≥ IIB）由[18F]FDG PET/MR分期。两阶段检查：乳房成像（俯卧）、全身（仰卧）。TNM阶段通过与核医学和放射学专家的同行共识进行评估。乳腺MRI对IMC传入血管的研究。IMCI与年龄、AV-IMC、T分期、乳腺象限、腋窝和远处浸润有关。由多学科委员会进行治疗性重新评估。结果：IMCI检出率为34%（14/41），其中8/14例患者年龄在55岁以下。所有14例IMCI患者均显示AV-IMC，其中6例（43.9%）无VA腋窝。在27/41例无IMCI的患者中，13例（48.1%）仅发现AV腋窝，其余14例（51.9%）发现AV腋窝和AV-IMC。57%（8/14）的肿瘤为多中心肿瘤，42%（6/14）为局灶性肿瘤，4/6（66.7%）为内象限肿瘤。1/14患者（7.1%）仅发现IMCI，9/14患者（64.3%）发现腋窝和IMC，4/14患者（28.6%）发现远处病变。委员会重新评估：27/41例（65.8%）患者未接受进一步治疗，10/41例（24.4%）患者接受胸部放疗，4/41例（9.7%）患者接受全身治疗。相关因素包括年龄、多中心肿瘤、内象限、AV-IMC检测、NM分期。IMCI的证据允许量身定制的治疗，24.4%的患者接受了胸部放射治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Revista espanola de medicina nuclear e imagen molecular

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