Imaging Evaluation Of Breast Cancer Patients With Bone Metastases

Objective: To confirm the value of whole-body diffusion-weighted imaging with background body signal suppression(wb-DWIBS)in the diagnosis and response assessment of skeletal metastases from breast cancer.Materials and Methods:(1)Thirty-seven patients with breast cancer suspected of having bone metastases who completed a wb-DWIBS scan were included in this study.The distribution and extent of bone metastases were compared between wb-DWIBS and bone scan or PET / CT within the same period(interval ≤30 days).(2)Twenty-one patients with bone metastases from breast cancer who underwent baseline and follow-up wb-DWIBS examinations were enrolled in this study.The changes in quantitative parameters between two contiguous wb-DWIBS examinations from lesions of SD patients and PD patients were analyzed and the distribution and extent of bone metastases and response assessment result were compared between wb-DWIBS and CT within the same period(interval time ≤ 30 days).Results:(1)The sensitivity and specificity of wb-DWIBS in detection of bone metastases were higher than those of bone scan(93.7% and 87.3%,98.9% and 94.4%,respectively),the difference was statistically significant.The sensitivity and specificity of wb-DWIBS and PET / CT in the detection of bone metastases were not statistically different(88.6% and 91.4%,100.0% and 100.0%,P=1.000).(2)The SI500 and SI1000 of bone metastases in SD patients were significantly reduced,while the SI500 and SI1000 of bone metastases in PD patients were significantly increased.Differences in response assessment were found in 17.9% of episodes,all due to progressive disease(PD)on wb-DWIBS being reported as stable disease(SD)on CT.According to statistical results,wb-DWIBS has a tendency to diagnose more PD patients compared with CT.Conclusions:(1)wb-DWIBS can detect bone metastases from breast cancer with high accuracy.Its detection performance is superior to bone scan,and similar to PET / CT.It can be considered as an alternative method for the screening of bone metastases from breast cancer.(2)wb-DWIBS plays an important role in the evaluation of the efficacy of bone metastases in breast cancer.It can effectively diagnose PD patients with bone metastases through changes in SI500 and SI1000 of lesions.wb-DWIBS has a tendency to report PD cases earlier then CT,so it may be applied to response assessment for skeletal metastases of breast cancer along with other imaging methods,to early detect progressive disease and contribute to timely adjustment of treatment.