PR110 18FDG-PET-CT AND STAGE III BREAST CANCER – SINGLE INSTITUTION EXPERIENCE

Abstract

s / The Breast 22 S3 (2013) S19–S63 S57 Aims: To investigate: reason for requesting WB-MRI; preference of WBMRI in subsequent imaging; whether WB-MRI was effective in detecting new previously unidentified BM. Method: All patients who had WB-MRI scan over a 12-month period (04/12-03/13) were identified from the hospital’s imaging-request database. We recorded date of diagnosis, histological and IHC findings, first WB-MRI date, total number of WB-MRIs, previous imaging, reason for requesting WB-MRI and the contribution of the WB-MRI result to the patient’s outcome. Results: The cut-off date for data collection was 31/03/13. During the study period, 115 patients with various malignancies had WB-MRI. Of these, 28 had MBC. The median age at diagnosis was 56.5 yrs (31-81). All patients underwent breast surgery. There were 22 (78.6%) patients with bone only metastases, 2 (7.1%) with visceral only metastases and 3 (10.7%) patients with both bone and visceral metastases. In total, 14 (50%) patients had 1 WB-MRI and 14 (50%) had multiple WB-MRIs (range 2-6). The most common reason (12/28) for requesting a WB-MRI was to clarify the nature of bone lesions after a previous inconclusive CT scan. The WB-MRI provided confirmation in 11 of these 12 patients. Other reasons included: assessing response to hormone treatment (8/28); suspected progression of BM (4/28); persistent pain of unidentified cause despite reassuring CT (3/28); patient request (1/28). New, previously unidentified BM were confirmed in 2/3 patients who had unremarkable CT scans. Conclusions: WB-MRI is increasingly used to answer clinical questions regarding MBC diagnosis and response to treatment. WB-MRI was successful in identifying metastatic bony disease undetected by CT scan and assessing response to treatment. WB-MRI was requested on an ad-hoc basis and the preference of this method was variable within different clinician groups. [i] Pearce T et al, Br J Radiol. 2012 Aug;85(1016):1102-6. doi: 10.1259/ bjr/30649204. Epub 2012 Mar 28. Bone metastases from prostate, breast and multiple myeloma: differences in lesion conspicuity at short-tau inversion recovery and diffusion-weighted MRI. [ii] Nakanishi K et al, Magn Reson Med Sci. 2007;6(3):147-55. Wholebody MRI for detecting metastatic bone tumor: diagnostic value of diffusion-weighted images. [iii] Schmidt GP et al, Eur J Radiol. 2009 Jun;70(3):393-400. doi: 10.1016/j.ejrad.2009.03.045. Epub 2009 May 19. Whole-body MRI for the staging and follow-up of patients with metastasis.