[ 18 F]FDG PET/MRI for axillary staging in node positive breast cancer patients receiving primary systemic therapy. A prospective single arm trial.
BreastJul 20, 2026 (epub)
Rosa Di Micco, Edoardo Botteri, Carla Canevari et al.
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In 30 seconds
[18F]FDG PET/MRI was evaluated for axillary staging in node-positive breast cancer patients undergoing primary systemic therapy in a prospective single-arm trial. Among 68 patients analyzed, residual axillary disease was confirmed in 30 (44.2%). The sensitivity of [18F]FDG PET/MRI was 53.3%, with specificity at 68.4%, indicating limited diagnostic accuracy.
Key findings
- [18F]FDG PET/MRI had a sensitivity of 53.3% and specificity of 68.4% for detecting residual axillary disease.
- Residual axillary disease was confirmed in 30 out of 68 patients (44.2%).
- Positive predictive value (PPV) was 57.1% and negative predictive value (NPV) was 65.0%.
- PPV was higher in luminal subtypes at 85.7%, while NPV was greater in HER2+ and triple-negative tumors at 83.3%.
Why it matters
The study highlights the challenges in accurately assessing axillary nodal status in breast cancer patients post-primary systemic therapy. Understanding the limitations of imaging techniques like [18F]FDG PET/MRI is crucial for optimizing treatment strategies and surgical planning.